Health and Wellbeing in Schools Project - Final Report

Foreword by the Chief Nursing Officer & Deputy Director of Learning

It is widely recognised that health and well-being is an extremely important issue for Scotland. Children and young people develop, absorb and learn their health and well-being behaviours early in life. Opportunities to positively influence these behaviours will be supported by a range of key policy and legislative initiatives.

Scotland's NHS Action Plan, Better Health, Better Care,^[1] introduced a series of actions to help provide children with the best possible start in life, developing their life skills, resilience and confidence. It recognises that by getting it right in the early years and supporting positive health choices and behaviours among children and young people, will give them the best possible chance of sustaining good health throughout their lives.

The health and well-being of children and young people is being supported through a range of positive national initiatives covering health, social and education issues. These are spearheaded by: Getting It Right For Every Child, ^[2] a programme that promotes a proactive approach to assessing and addressing children's needs and providing early interventions; Equally Well,^[3] the report of the Ministerial Task Force on Health Inequalities; and Curriculum for Excellence, ^[4] which sets out a coherent, flexible and enriched school curriculum for children and young people aged 3 to 18.

The Curriculum for Excellence health and well-being experiences and outcomes enable children and young people to develop the knowledge and understanding, skills, capabilities and attributes they need to promote their mental, social, emotional and physical well-being now and in the future. In addition, all schools are required by the Schools (Health Promotion and Nutrition) (Scotland) Act 2007 to be health-promoting. A health promoting school is one that promotes the mental, emotional, social and physical health and well-being of all children and young people and works with partners to identify and meet the needs of the whole school and wider community.

The Health and Well-being in Schools project, which ran from September 2008 to March 2011 and which is the subject of this report, supported this wide range of policy and legislative initiatives in a meaningful way by promoting early interventions tailored to those who needed them. The project recognised that to really make a difference to children's health and well-being and their future life chances, we need to intervene early, working with children and their families, before potentially harmful health problems and risky health-related behaviours emerge. Within the school context, it demonstrated that by supporting existing initiatives, developing new approaches, increasing the health care capacity of those working with school-age children and young people and strengthening partnerships with key stakeholders, sustainable health and well-being interventions can make positive changes to the lives of children, young people and their families.

In driving innovation and excellence in ongoing initiatives focused on promoting the health and well-being of children, young people and their families, the learning from the project will support the achievement of Scotland's three NHS quality ambitions, as described in The Healthcare Quality Strategy for NHSScotland: ^[5]

• person centredness - mutually beneficial partnerships between service users, their families and those delivering health care services: the project supported a strongly inclusive approach that placed children, young people and their families at the centre and promoted strong multidisciplinary, multi-agency working;
• safety - no avoidable injury or harm to people from the health care they receive: the aim of the early intervention and health promotion programmes developed by the project was to support children and young people to make informed choices that will protect their health and well-being now and for the future; and
• effectiveness - the most appropriate treatments, interventions, support and services being provided at the right time and wasteful or harmful variation being eradicated: the project strongly promoted evidence-based, protocol-driven interventions from appropriately prepared staff in health care teams in schools.

This report provides key messages and learning from the project that can be used by those with responsibility for embedding health and well-being in schools to inform the development of their own tailored approaches. The practical examples in the report illustrate a range of initiatives in which schools may be interested as part of their efforts to support local developments.

The examples highlight the added value achieved for children and young people when health professionals and education staff work together in the pursuit of common goals. The key messages of leadership and partnership working are commonly held and reflect guidance on the health promotion aspect of the Schools (Health Promotion and Nutrition) (Scotland) Act 2007 ^[6]. In addition, practical examples underlining the importance of interventions at key transitions reinforce the Additional Support for Learning Act 2004 (as amended), which places education authorities and partners under a duty to plan and prepare for transitions throughout school education.

Promoting health and well-being is central to the new journey Curriculum for Excellence sets out for children and young people. We have every confidence that the key messages and learning that have emerged from the Health and Well-being in Schools project will not only support health and education staff and others to deliver on Curriculum for Excellence health and well-being objectives, but will also identify initiatives, roles and ways of working that will be transferrable across a range of projects in the future. In particular, it will have important resonance for the work of the Modernising Nursing in the Community Board, ^[7] the implementation of the Pathway of Care for Vulnerable Families (0-3)^[8] and the ongoing work of the Getting it Right for Every Child Programme.