Schools (Health Promotion and Nutrition) Scotland Act: Health promotion guidance for local authorities and schools

2. Policy context

2.1 Curriculum for Excellence

Curriculum for Excellence has at its heart the aspiration that all children and young people should be successful learners, confident individuals, responsible citizens and effective contributors. There are strong connections between effective, successful learning and health. Through the health and wellbeing curriculum area, Curriculum for Excellence takes a holistic approach to health and wellbeing.

The main purpose of health and wellbeing within Curriculum for Excellence is to develop the knowledge and understanding, skills, capabilities and attributes necessary for physical, mental, emotional, social and physical wellbeing now and in the future.

A Curriculum for Excellence advocates approaches to learning and teaching that challenge children and young people to develop their knowledge and understanding, skills and attributes. It suggests that schools encourage pupils to develop life skills, such as taking responsibility for their own health and fitness. It also underlines the role of all teachers in supporting the health and wellbeing of all children and young people. A Curriculum for Excellence is not prescriptive about teaching - activities should meet the needs of individual pupils. Approaches to learning and teaching should include participation as well as outcomes. The need for teachers to respond to pupils' views, especially where sensitive issues are involved, is also highlighted.

Personal and social development/personal and social education ( PSD/ PSE) and health education programmes

Focussed programmes covering key elements of personal, social and health education provide a key medium for implementation of the Act and should include whole-school, cross-curricular and special focus components as outlined in Personal Support for Pupils in Scottish Schools ( HMIE 2004) and Health and wellbeing for all. Staff with responsibility for providing guidance and personal support, class teachers and other partners have key roles in delivering these programmes.

Environment, resources and facilities

Health promoting schools provide a safe, supportive, accessible and well-resourced environments and facilities for all pupils, staff and the wider community, including appropriate provision for all who have additional support needs. Being Well - Building Well (Scottish Health-Promoting Schools Unit, 2005) identifies the health-related needs of all school users and informs key stakeholders who are planning the building or refurbishment of school environments.

2.2 Health and wellbeing outcomes

Mental, emotional, social and physical wellbeing

Good mental and emotional health is a fundamental and underpinning component of positive health and wellbeing. A whole-school approach to improving mental and emotional wellbeing will have an impact on all aspects of school life and benefit all who learn and work in schools, as well as providing a supportive environment for those who are experiencing difficulties.

Mental and emotional wellbeing underpins other aspects of health within a school and cannot be considered in isolation. It is crucial to understand how physical activity, healthy eating and emotional wellbeing interact, and how these interactions affect children's behaviour and learning capacity.

Developing positive relationships in school communities is fundamental to fostering a good climate for learning including positive behaviour, and many approaches to promoting positive behaviour aim to improve relationships and develop emotional literacy. These approaches include the use of restorative practices and programmes which develop pupils' inter-personal skills to help them manage their feelings and responses, and to participate fully in school, at home and in the community.

Planning for choices and changes

Children and young people will face a range of challenging stages in the course of their school career, including the transition from primary to secondary school, changes in their personal circumstances, coping with exams and deadlines, and leaving school to start work or embark upon further study. Supporting children and young people to cope with stress and anxiety arising from such changes will be integral to promoting mental and emotional wellbeing. In addition to the specific requirements relating to health promotion, schools need to support children to meet their personal, social and learning needs, and to plan for their future beyond school education.

Physical education, physical activity and sport

The promotion of physical activity in children has been a long term priority for the Scottish Government. 'Let's Make Scotland More Active' set long-term targets for daily moderate physical activity. For children, the aim is to ensure that by 2022, 80% of all those aged 16 and under will meet the minimum level of recommended physical activity. The health and wellbeing experiences and outcomes reaffirm the aspiration of daily physical activity for all.

Schools are a key setting for the promotion of physical activity and a number of major programmes set in the school environment have been introduced These include the Active Schools programme, the School Travel Coordinators network and the Safer Routes to Schools programme.

In 2004, a report on a review of physical education in schools reinforced the important role schools play in providing opportunities for being more active (through play, walking and cycling, etc). However, it also highlighted the fact that these wider opportunities need to be complemented by high quality learning and teaching, and carefully-planned curricular frameworks to ensure all children develop a sufficient range of skills and competencies.

While Curriculum for Excellence gives local freedom and responsibility to those planning the curriculum, the Scottish Government expects schools to continue to work towards the provision of 2 hours of physical education for every child each week. This commitment will be reflected in Building the Curriculum 3: a framework for learning and teaching.

Food and health

A good diet is essential for good health. Health promoting schools can make a valuable contribution to improving the nutritional quality of children's and young people's diets and promoting consistent messages about healthy eating.

School meals in Scotland have undergone a transformation due to the Hungry for Success initiative. The Act builds on Hungry for Success and will require local authorities and managers of grant-aided schools to ensure that food and drink provided in schools comply with the nutritional requirements specified by Scottish Ministers in regulations. These regulations will apply to all food that is sold or served in local authority and grant-aided schools - including at tuckshops and in vending machines, not just school meals - and are supported by guidance. The regulations and guidance are, at the point of writing, still subject to Parliamentary approval after which they will be published on the Scottish Government website. However, a draft version of the regulations is already available on the website.

Health promoting schools should help children and young people to develop an understanding of the relationship between food, health and wellbeing. They should also develop an awareness of various issues regarding food, including sourcing and production and cultural differences.

The Food Standards Agency's food competences framework is intended to help schools and community-based organisations provide children and young people with the foundation to make healthy food choices now and into adulthood. As a framework of core skills and knowledge for children and young people, it sets out the essential building blocks for healthy eating, cooking and food safety.

In terms of dental health, the Scottish Dental Action Plan has targets for supervised tooth brushing schemes in primary schools. The target is to have 20% of schools with the highest need offering tooth brushing schemes by March 2008. Many schools have extended this to other age groups.

Guidelines on Commercial Activities in Schools were published by the Scottish Consumer Council in March 2006 and the Public Health and Wellbeing Directorate have commissioned the Scottish Consumer Council to prepare similar guidelines that extend to the wider public sector environment. This will provide additional information to ensure that sponsorship decisions reinforce positive messages around health promotion.

Substance misuse

Substance misuse education in schools is often the first line of prevention against smoking and alcohol and drug misuse, providing opportunities to pass on accurate, up-to-date facts, explore attitudes and, crucially, foster the skills needed to make positive decisions. The key focus of policy on substance misuse (including alcohol, tobacco and illegal drugs as well as prescription medicines and other substances) is to help young people resist substance misuse in order to achieve their full potential in society. Through Curriculum for Excellence, schools have an important role to play in developing in young people qualities of resilience and adaptability so that they are able to make informed choices to enhance their own and their families' health and wellbeing.

Substance misuse education is not just about classroom teaching, but encompasses all policies, practices, programmes, initiatives and events in the school connected with the prevention and reduction of tobacco, alcohol and drug-related harm. The evidence is clear that no single approach to prevention and education is effective, and that one-off interventions will have limited value. Furthermore, we know that the culture, relationships and opportunities in schools contribute to young people's social and academic outcomes, and that these are relevant to a whole range of behaviours including drug use ( Evaluation of the Effectiveness of Drug Education in Scottish Schools 2007)

The Scottish Government is seeking long term, sustainable improvements in teaching practice, including the partnership delivery that should come from the Curriculum for Excellence approach. An expert steering group on substance misuse education in schools has been established, to produce advice, guidance and proposals aimed at helping schools and authorities to achieve improvements, in the context of Curriculum for Excellence and the Concordat with local government. In particular, it will look at how to boost knowledge, skills and confidence about substance misuse, for teachers and other professionals involved in delivering health education in schools, through improving access to suitable resources appropriate for each age group and more effective partnership planning and delivery with Health, the Police and the community. More emphasis is also being placed on the role of parents or carers in educating their own family about substance misuse.

If young people are misusing drugs within the school premises or grounds, staff should refer to the Guidelines for the Management of Incidents of Drug Misuse (June 2000). All schools are expected to have a policy on the handling of drug-related incidents, developed in consultation with the police and Children's Reporter.

This Government is committed to the continuation of public information campaigns, such as Know the Score, which has been effective in increasing knowledge and promoting avoidance of substance misuse and positive lifestyles. Specific campaigns for young people, currently from around age sixteen, though the merits of providing information for younger age groups are currently being investigated. The Choices for Life initiative for all Primary 7 children has also provided a mechanism for information and messages around substances and healthy living more generally. In addition, the informative and popular " Parents' Guide" is to be distributed to every household/family in the country, as well as to key public institutions such as Further Education colleges, Universities and prisons.

The Government plans to work with all concerned to implement a programme to tackle the drug misuse problem in Scotland and will be publishing a new drugs strategy later in May 2008. The Government will work with all interests to ensure successful implementation.

In addition, the Scottish Government has a new 5-year smoking Prevention Action plan. The plan is based on the recommendations made in Towards a future without tobacco (2006) which highlights the need for education on drugs, alcohol and tobacco to embrace the concept of health promoting schools and to inform parents about tobacco and other substances, and their related responsibilities.

The Scottish Government is developing a longer term, cross-Government approach to tackling alcohol misuse, appropriate to the scale of the problem in Scotland and focussing on the long term objectives of reducing harm and achieving sustainable change. We intend to publish our proposals for action for consultation before the summer.

Relationships, sexual health and parenthood

Respect and Responsibility, Strategy and Action Plan for Improving Sexual Health , (2005) makes recommendations for the provision of sex and relationships education ( SRE) for children and young people. In particular, it recommends that schools, in consultation with parents, should provide SRE linked to other aspects of the curriculum and delivered by trained and supported staff. This includes contributions from partners such as sexual health promotion specialists, public health nurses and the voluntary sector. As a priority, SRE should be supported by local services for young people such as 'drop-in' centres which are in or near to schools.

It is important to take account of the beliefs and philosophies of denominational and faith schools in structuring provision for education in relationships, sexual health and parenthood. For example, the Catholic Education Commission provides the ' Called to Love' programme of teaching resources. The programme promotes a Catholic Christian vision of loving relationships.

Children and young people attending primary and secondary schools should receive consistent and accurate messages regarding sex and relationships education through materials which are stage and age-appropriate.