Appendix

Briefing paper for Health of School Age Children

Core team meeting

Monday 6 October 2003

10am-12pm, Estates Practice Room

(this can be found on the first floor next to viewing gallery of the Council Chambers)

This is the second review in the Health Review Committees programme of `health of our children and young people' It will focus on `health of school age children'

1. Mapping

To cover all aspects of health of school age children would be an enormous task and beyond the brief for the review. In order to narrow the scope a map of services that contributed to children's health was produced. This allowed the Review Chair and Team Leader to exclude areas which were felt to be inappropriate for scrutiny at this time.

The rationale for these decisions was as follows:

· Mental health - next topic on HRC programme of reviews, plus Hampshire to be pilot for Children's Trust project.

· Social and emotional health - Children and families services are currently undergoing Best Value review plus huge changes proposed through the Green Paper affecting Health, Social Services and Education.

· Safety, drugs, alcohol and sexual relations - covered by Education, Social Services, Health, Youth service, Connexions Police and voluntary sector.

After excluding the above it became apparent that physical health ie diet and exercise, were areas that could become the focus of scrutiny for this review.

Initial prediction of services that could be included in the review would be:

· Healthy Schools Campaign - Jointly funded Health and Education

· My School Lunch - HC3S (Hampshire Catering )

· Active Schools / Sport - Education and Recreation and Heritage

· School travel plans - Education

· Nutrition - PCT's

· School nurses - PCT's

· Education Other Than at School - Education

· Equalities - Personnel and Training

· Out of School Clubs - Early Education and Childcare Unit

· Personal, Social & Health Education (PSHE) curriculum - Education

· Borough / District Council's Health Promotion departments

2. Legislation

There are several main pieces of legislation directing above activities:

· In 1997 the White paper ` Excellence in Schools' stated that it was the Governments intention for all schools to become `healthy schools'. The Healthy Schools programme was launched in 1998 with the National Healthy Schools Standard emerging in 1999. This sets the criteria and levels of achievement to be reached to achieve Healthy School status. In 2002 the Department of Health (DoH) and Department for Education and Skills (DfES) agreed new national targets for:

o All schools with 20%+ free school meal eligibility (approximately 7000 schools nationally = 87 in Hampshire) to achieve National Healthy School Standard level three status by 2006

o All schools in England to continue to be provided with the opportunity to access the services of a nationally accredited local healthy schools programme 2003 - 2006

· The strategy document ` A Sporting Future for All' sets out the Governments vision for increasing sport in Education. It proposes a five part plan which focuses on school sports facilities, specialist sports colleges, out of school activities, sport's co-ordinators and elite sport. In December 2002 a new report, called Game Plan, set out to combat the `couch potato' culture and increase the levels of mass participation in sport and fitness activities. The summary of this report notes `Participation falls dramatically after leaving school, and continues to drop with age. But the more active in sport and physical activity you are at a young age the more likely you are to continue to participate throughout your life'.

· The Department of Health recently created a Children's Taskforce which has responsibility for ensuring that The NHS Plan is delivered for children and specific responsibility for overseeing the development of the National Service Framework for Children (NSF). The NSF will be published next year and is intended to help local health communities in planning and improving children's services.

· Education Act (2002) National Curriculum inclusion of Personal, Social and Health Education from key stages 1-4

· Childcare Strategy directing growth of Out of School care to support working parents

3. Relevant research

In June 2002 the King's Fund published the results of research into `What young people think makes schools healthy'. A questionnaire, devised by a group of young people aged 12-18, asked students to vote for their top three out of fourteen issues. The questionnaire was sent to all 650 secondary schools in London, 392 were returned from students in 41 secondary schools. The responses ranked by importance showed school food to be the top concern (98%) and PE lessons and fitness to be the third (82%). Additional comments highlighted that:

· 45% of respondents did not have breakfast, some respondents did not eat all day

· concerns over price and monotony of school meals, and the need for more culturally appropriate food

· two thirds of respondents did two hours or less physical education a week (British Heart Foundation recommends an hour a day)

· having a choice of activities made PE more enjoyable

Findings from this research were fed into the `Improving London Young Peoples Programme'.

Bite size chunks

· More than 8.5% of 6 year olds and 15% of 15 year olds in England are classified as obese (DoH)

· Obesity in the UK has doubled over the last decade, with about one in 10 children now affected (All-party parliamentary group on primary care and public health)

· A survey carried out in 1977 for the British Standards Institute suggested that the average waistline of the 16 year old girl in the UK was 66cm, and 72cm for boys. In the National Diet and Nutrition Survey of 1997, the average was 73cm for girls and 80cm for boys

· Research shows that a well fed child is more receptive in school and that where water is freely available and encouraged children's concentration levels improve as they are not dehydrated

4.Project Information

Healthy Schools Campaign.

The Healthy Schools Scheme is designed to assist schools in planning and delivering an effective programme of health education which will build partnerships with the whole school community. The scheme covers seven health related focus areas and each school will select two areas:

· Drug education

· Environmental factors of health

· Emotional health and well being

· Healthy eating

· Physical activity

· Safety (including safe transport to school)

· Sexual health and relationships education

Participating schools must identify a health team that represents a cross-section of the school community. They will receive £300 towards supply costs, resources, training and some PSHE advisor time. In Hampshire 262 schools are participating in the scheme with 80 having achieved validation. A further 53 will be starting the scheme in October 2003.

Active Schools / Sport

In Hampshire approximately 300 schools are signed up for the Active Schools programme with 18 schools accredited. It focuses on a review of the PE programme and gaining whole school improvements. As a result of Government vision (see above) Sport England are managing funds to support local authorities set up Schools Sports Partnerships. The partnerships will be established around secondary schools with sports college status and will include all neighbouring schools to form a local cluster. Hampshire currently has one partnership established centred around Staunton Park Community School, others are being developed.

Active Sport is a national project delivered through 45 sports partnerships. Hampshire is partnered with Southampton, Portsmouth and Isle of Wight. Active Sport is focused on fourteen specific sports and helping young people to progress into a club environment through quality coaching sessions held after school. Targets are set 32-35% regular participation and rigorous measurements are kept.

My School Lunch

This is a new initiative by HC3S to engage with more schools and pupils to raise awareness of and change patterns to healthy eating. This is done through:

· a child friendly, interactive web site which provides information and resources for teachers and parents, and educational games for children.

· a school reward scheme which awards points to schools for any extra school meals eaten. The points can be exchanged for outings, equipment resources etc.

HC3S provide healthy and varied menus for pupils to choose from and they focus on balance and education. They would like to engage with a higher number of schools across Hampshire and support schemes to encourage take-up for pupils receiving free school meals.

Education other than at school (EOTAS)

All Teaching Centres have been approached to see what provision made for teaching healthy eating and physical activity to excluded children. All centres reported that health issues were covered in the curriculum and through visiting speakers or groups.

Special Educational Needs

SEN have reported that where children are in special needs schools, nutritional and physical education is well provided for. However children in mainstream schools who have borderline needs may not receive the same levels of support and education. This is highlighted through recent research which shows that children who suffer from ADHD and are prescribed Ritalin often suffer from appetite depression.

Out of School Care

Before and after school clubs can contribute to healthy eating and physical activity. Breakfast clubs especially can help as children study better when having eaten a healthy breakfast.

Safe school travel

Working in partnership with schools, parents and local communities to arrange safe travel which can reduce traffic congestion and encourage children, where possible, to walk/cycle to school.

School Nurses

School nurses are employed by PCT's and are involved in Healthy Schools programmes if the school is participating. Not all schools have a designated school nurse.

More information to follow

PCT Nurses /Nutrition specialists

Information to follow

5.Questions for consideration

· Are there any inclusion issues, for example, provision for travellers, special diets?

· What statistical information already exists to show current levels of health?

· How does Borough/District council health work build on Healthy Schools?

· What local research may have been conducted on children's health?

· What associated health problem arise due to lack of exercise and healthy diet for children now and when they reach adulthood?

· What additional steps could be taken to support existing projects?

· Are there any gaps in provision?

· How successful is Healthy Schools in improving diet and activity levels?

· Who are the stakeholders in this review?

· Could Local Strategic Partnerships (LSP's) become a vehicle for monitoring children's health

6. Useful Links:

· www.healthehants.org.uk/healthy-schools Covers the healthy schools partnership of Hampshire, Southampton, Portsmouth and Isle of Wight.

· www.myschoollunch.co.uk New interactive website from HC3S promoting healthy eating. Aimed at children and young people, teachers and parents.

· www.nheg.org.uk The National Health Education Group aims to improve the quality of health education for children and young people, within an equal opportunities framework

· www.healthedtrust.com The Health Education Trust is a UK-registered charity that promotes the development of health education for young people

· www.wiredforhealth.gov.uk The National Healthy Schools Standard acts as an umbrella for a variety of health initiatives and policies aimed at improving the health of young people

· www.kidshealth.org Health issues on a wide range of issues for parents, kids and teens.

· www.cyh.com Child and Youth Health. An Australian site with different sections for young people and children promoting ` Start Healthy and Stay Healthy.

Penny Velander, Review Team Leader, 2.10.03