ADD2502 Delivery support and rapid review for Healthy Schools London

1.1 The Mayor wants to see all London’s children enjoying environments that allow them to develop well and thrive, and to help more children achieve a healthy weight, particularly in deprived communities. To support children to have the best start in life, he wants their mental health and wellbeing to be better supported across a wide range of settings. Furthermore, children in London are more likely to be overweight or obese than their peers in the rest of England.

1.2 The Healthy Early Years London and the Healthy Schools London (previously approved under MD1151) support education and childcare settings to help children develop, play and learn in healthy settings. The programme recognises and supports schools that are making a difference for their pupils. The Healthy Schools London programme supports schools to take a whole school approach to supporting pupil wellbeing across four themes:

• healthy eating;

• physical activity;

• emotional health & wellbeing; and

• Personal, Social, Health Education (PSHE)

1.3 The impact of COVID-19 on schools, children and young people and their families has been immense. All aspects of health and wellbeing for schools have suffered because of COVID-19 including:

• Healthy eating: access to healthy foods, free school meals and the provision of food for vulnerable i.e. breakfast clubs, after school clubs;

• Physical activity: activity levels will be reduced for most – not travelling to school, no break or lunch times, no PE lessons or extra curricula sports, compounded by the stay at home message;

• Personal Social Health Education: online safety, understanding of how to keep healthy and safe (esp. with COVID-19), relationships – children and young people are not socialising;

• Emotional wellbeing and mental health: anxiety, lack of social interaction, bereavement and grief, lack of routine, missed exams and worries about future prospects; and

• Practicalities of return to school; schools need support to implement government guidance in relation to staggered drop off, timetable changes, hygiene, social distancing, testing, what to do if COVID symptoms emerge in school i.e. appropriate PPE.

1.4 Additionally, as they reopen for all London’s children, schools will need to ensure that they can create an environment whereby:

• pupils can access healthy safe food and drinks;

• pupils can exercise and travel to and from school safely;

• pupils’ mental health issues related to COVID-19 are addressed and supported; and

• pupils are supported in how to make safe healthy decisions about online safety, relationships, risky behaviours, violence, domestic abuse resulting from COVID-19 through delivery of tailored PSHE.

1.5 There are more pupils in London schools (1.3 million pupils in 2500 schools) and they are more overcrowded than all other regions in England. There is a bigger challenge for London schools to accommodate all children when schools begin to welcome back all pupils in light of current COVID-safe guidance.

1.6 Healthy Schools London is a mechanism for the Mayor to achieve many of the objectives laid out in his Health Inequalities Strategy (HIS) and Recovery Missions. In support of these strategic frameworks, HSL aims to improve health and wellbeing through:

1.7 Originally launched in April 2013, the programme has since gained the support of 27 London Boroughs which now have a local Healthy Schools Programme or equivalent local support for schools. 2199 (86%) London schools have registered to the HSL programme. Of these, 1276 schools have already achieved a Bronze Award, 756 have achieved a Silver Award and 325 a Gold Award.

1.8 The Mayor’s HSL programme consists of a core, GLA-based team co-ordinating and supporting the work of Borough level leads (1.2 FTE). To augment the core GLA capacity, the GLA HSL Team is seeking to procure additional delivery support in the form of support to borough leads and schools.

1.9 This ADD provides authority to spend up to £45,000 to procure specialist support for the HSL team to inform a planned redesign of the programme based on insights and data gathered through the HSL schemes and to ensure future priorities are designed around the needs of London Boroughs and schools to ensure London's school-aged children are better supported throughout the recovery from the pandemic.

2.1 A comprehensive analysis of data and insights gathered and submitted by participants in the HSL programme. To support the redesign of the programme to ensure HSL participants and activities are addressing identified health and wellbeing issues resulting from Covid. This will be done by providing:

• analysis of data and insights submitted by settings to the HSL programme to identify groups/areas most adversely affected by COVID;

• Recommendations for measurable outcomes so that schools can evidence output and impacts;

• data driven template policies and toolkits to support schools, teachers, parents and children throughout the Recovery Period (e.g., mental health and wellbeing policy, school food); and

• Proposals to support the development of a framework for resetting of the programme.

3.1 A Health Inequalities Impact Assessment (HIIA) was conducted in March of 2013, prior to HSL’s launch, to consider the impact of the programme on disadvantaged groups, who already suffer poorer health. The HIIA informed delivery of the HSL programme in order to minimise the risk of any potential negative impacts on groups with protected characteristics.

3.2 More recently, a health inequality mapping and participation analysis was conducted by the GLA Health Team to determine if the programme was having a positive effect on health inequalities. The analysis determined that London schools which have achieved the HSL Bronze award have a higher proportion of deprived pupils compared to schools which are not involved with the programme.

3.3 On average, schools that have achieved the Healthy Schools London Bronze award have 26% more pupils who are eligible for free school meals, looked after or are children of service personnel.

Key Risks and Issues

Links to Mayoral Strategies and Priorities

4.1 The HSL Programme supports the delivery of the Mayor’s Health Inequalities Strategy as well as the response to the London Health Commission and the work of the London Health Board, which maintains mental health and adolescent resilience as one of its priorities. The HSL programme also supports the delivery of a variety of Mayoral priorities including the Mayor’s Food strategy, Sports Strategy, Education and Youth Team programmes including London Schools for Success programme, TfL STARS programme, GLA Planning Team (Superzones) and Team London.

4.2 HSL supports the London Health and Care Vision priorities:

- reduce childhood obesity;

- improve the emotional wellbeing of children and young Londoners;

- improve mental health and progress towards zero suicides;

- improve air quality;

- improve tobacco control and reduce smoking; and

- reduce the prevalence and impact of violence.

4.3 HSL directly supports many of the Mayor’s Recovery Missions including:

- Healthy Food, Healthy Weight: Work to support mission delivery in relation to malnutrition and obesity in London’s schools i.e., supporting Water Only policies and the child obesity taskforce. Schools engaging in HSL that are meeting many health eating and drinking criteria

- Mental Health and Wellbeing: Building on Mental Health First Aid Training for HSL Borough Leads and schools, they can support this Mission and become wellbeing ambassadors

- High Streets for all: Build on work to establish school streets/active travel and continue support of TfL ad ban work as well as school superzones projects

- Green New Deal: opportunity to support the mission team in relating to encouraging active travel and access to green space to be physically active a

- A New Deal for Young People: Work with mission team to feed in young people’s voices and support roll out of personal mentors

- A robust safety Net: Continue to build on work with welfare team where financial advice/guidance offered in schools. Also support families accessing support in relation to healthy start vouchers and free school meals (including those who are NRPF)

- Building Stronger Communities: work with the mission team in supporting young people within communities most adversely affected by COVID, including BAME and disabled Londoners. Hyperlocal support for seldom heard groups through community hubs which are developed based on local need.

Impact Assessments and Consultations

4.4 As mentioned in section 3 the HSL programme has undergone a Health Inequalities Impact Assessment and a health inequality mapping and participation analysis to ensure the programme does not negatively impact already disadvantaged groups. Additionally, the HSL programme was developed with extensive stakeholder consultation, involving boroughs’ public health and education teams; teachers, headteachers, GLA colleagues and national government. This consultation work shaped the delivery model and helped to establish the necessary delivery networks. Stakeholder consultation continues to be an integral part of the programme’s delivery.

Conflicts of interest

4.5 There are no conflicts of interest to note for any of the officers involved in the drafting of clearance of this decision form.

5.1 Approval is being sought for expenditure of up to £45,000 to procure specialist support for the HSL team to build local capacity in London Boroughs and schools, to tackle the impact of COVID-19 on health and wellbeing.

5.2 The expenditure will be funded from the 2020-21 ‘Healthy Schools London’ programme budget, held within the Health Team.