ITEM 7
February 2010
Be Healthy Select Committee Report
www.milton-keynes.gov.uk
(77)1 of 22 Introduction
Be Healthy is one of the five Every Child Matters outcomes. Five aims are set out for Be Healthy in the Every Child Matters framework. These are:
. Physically healthy . Mentally and emotionally healthy . Sexually healthy . Healthy lifestyles . Choose not to take illegal drugs
The Annual Performance Assessment (2008) conducted by Ofsted judged performance against the Be Healthy outcome to be adequate (2). Two areas for development were identified, these were:
1. Teenage conceptions are higher than average. A consistent trend has not yet been established.
2. Substance misuse services are underdeveloped and a lower proportion of young people are in treatment than the regional average.
This report seeks to provide:
1. Information on the current programmes being delivered by Milton Keynes Council and its partners to improve children and young people’s health and well being. This information is set out against each of the five aims.
2. An update on the progress made on the areas for development identified in the Annual Performance Assessment.
3. A summary of most recent health related behaviour questionnaire conducted in 2009 with 1043 young people in years 8 and 10 in Milton Keynes.
The committee is asked to comment on the report and make any recommendations as appropriate.
The Children and Young People’s Plan (available at www.mkchildrenstrust.org) and the Children and Young People’s Services Improvement Plan contain details of action plans for all the Every Child Matters outcomes. The Be Healthy priorities are:
All children and young people whatever their backgrounds and needs, however complex, are at their optimal level of fitness and health and knowledgeable about how to keep themselves that way.
All children and young people are able to access a wide range of quality services, opportunities and leisure activities to ensure their emotional and physical well being.
Maternity services have been subject to recent in depth scrutiny through the Milton Keynes Children’s Trust and the Milton Keynes Council Health and Community Well Being Select Committee and therefore are not covered in this report.
(78)2 of 22 Section 1
Current programmes being delivered by Milton Keynes Council and its partners to improve children and young people’s health and well being.
Physically healthy
Addressing childhood obesity
The results of the National Child Measurement Programme (NCMP) shown below for academic year 2008/09 have now been released and show that in Milton Keynes whilst rates of obesity remain high, they have fallen compared to the previous year. Figures for Milton Keynes are also lower than national averages, particularly for Year 6 pupils.
Academic year National MK National MK National MK 2006/07 2006/07 2007/08 2007/08 2008/09 2008/09 Obesity rate in Reception 9.9% 10.1% 9.6 % 13.9% 9.6% 9.4% Year Children (NI 55) Obesity rate in Year 6 17.5% 17.7% 18.3% 16.1% 18.3% 15.9% children (NI 56)
Statistically, it is too early to assess any trends in local obesity prevalence. However, the impression is of around average levels of obesity in Reception year children and below average levels of obesity in Year 6 pupils. However, 1 in 6 Year 6 pupils is clinically obese and likely to progress to become an obese adult. The statistical robustness of NCMP data requires a high percentage of eligible children to be measured each year. In 2008/9, measurements occurred in 82% of eligible children. Whilst this is high enough to ensure data validity, it is below the national target of 85%. During 2009/10, efforts are being made to improve to meet the target.
Since September 2009, the community weight management programme Motiv8 has been delivered for children aged 5 to 16 years. Motiv8 is a joint funded programme between NHS Milton Keynes and the MK Dons Sport and Education Trust working in partnership with the Schools Sports Partnership and Milton Keynes Council. Since September three courses have been completed, with another three starting in January 2010. Plans are underway for another six throughout the year. The programme is aimed at overweight children aged 5 to 16 years is spilt into three age groups; 5-7s, 8-11s and 12-16s. Led by fully trained professionals in physical activity and in Dietetics, families take part in 10 weeks of activities, during the family based intervention scheme. There is an emphasis on fun, practical learning, designed to enable sustainable improvements in families’ diets, fitness levels and overall health. The Motiv8 brand is currently being developed in order to increase awareness and understanding of the programme.
Immunisation
A newly established immunisations review group has been established by NHS MK to continue to increase the take up of immunisations. There will be a particular focus on working
(79)3 of 22 with GPs in areas of inequalities. Most recent data is for Quarter 1 (April to June 2009) and indicate that Milton Keynes continues to be above national average for England:
Primary immunisations course at 12 months Measles, Mumps and Rubella (MMR) MK 2009/10 Quarter 1 93.2% MK 2009/10 Quarter 1 89.6% National 2009/10 Quarter 1 91.9% National 2009/10 Quarter 1 86.3%
Participation in sports
The PE and Sport Strategy for Young People (PESSYP) is a government initiative which aims to get more children and young people taking part in high quality PE and sport. The original Public Service Agreement target was for 85% of all pupils to undertake 2 hours of curriculum PE and Sport per week by 2008. Performance in 2008/09 for Milton Keynes compared to national figures was as below:
Year groups Years 1 – 11 Years 1 – 13 MK MK NA MK MK NA target Actual actual target actual actual 2008/09 2008/09 2008/09 2008/09 2008/09 2008/09 % pupils undertaking 2 hours 93% 92% 91% New 86% 77% curriculum PE % pupils undertaking 2 hours New 46% 51% New 44% 50% PE and 1 hour optional sport
In Milton Keynes, participation in curriculum sport for Years 1-11 (as per the current LAA measure) has risen from 91% in July 2008 to 92% in July 2009 (against a target of 93%) and has continued to exceed the national average, which has increased to 81%. However, for the new survey measure of participation in two hours curriculum plus one hour out of hours school sport, Milton Keynes’ performance is less than national averages.
The PE and Sport Strategy for Young People is now focussed on the 2012 London Olympic Games, and its capacity to motivate increasing numbers of children and young people to take up and maintain their participation in PE and wider sporting opportunities. Building on its vision for school sport, the Government’s aim for 2008-11 is that, in addition to at least 2 hours per week of high quality PE and Sport in school for all 5-16 year olds, all children and young people aged 5-19 will be offered opportunities to participate in a further 3 hours per week of sporting activities provided through schools, Further Education (FE) colleges, clubs and community providers. Challenging targets are being proposed around this 5 hour offer and a strategic group is being established to address the issues which may affect the attainment of the targets. The issues to be considered are:
. Current capacity of the coaching workforce . Current capacity of teachers to support delivery . The availability of affordable facilities . Lack of knowledge about opportunity within the sporting community
Through the Under 16 and Over 60 Free Swimming Programme, children and young people have accessed 89,261 free swimming sessions during 2009/10. Participation in the free swimming scheme for both age groups has also meant that Milton Keynes has been awarded capital funding to enable modernisation and improvement of pool provision (modernisation of
(80)4 of 22 Middleton Pool, the modernisation of Woughton Leisure Centre and the Stantonbury Campus Pool modernisation project).
Extended services
Extended services contribute to Be Healthy outcome by enabling children and young people to access a wide range of high quality out of schools activities. The extended services team works in partnership with clusters of schools to ensure that there is a full ‘core offer’ of extended services for each school.
Activities that support the health and wellbeing of pupils include before school provision, for example breakfast clubs and physical activity sessions including ‘wake up, shake up’, after school clubs providing sport and physical activity, holiday provision including sport and physical activity sessions whether delivered on school sites or signposted to local providers. To facilitate this, extended services work closely in partnership with Sports Development and providers across Milton Keynes including MK Dons Sports and Education Trust, Premier Sports, Sportszone Academy and Elite Sports.
Examples of extended services provision include:
. Woughton Schools Fitness Week: This took place during June/July 2009 with 10 partner agencies involved, providing 20 different physical activities over 281 hours to children from all 10 first schools and primary schools in the Woughton Cluster. In 2010 all 11 schools that make up the Woughton Cluster will participate. Project partners include schools, School Sports Partnership.
. A summer 2009 programme of sport was delivered to the Oakgrove cluster in partnership with the local Parish Council, School Sports Partnership and Safer MK. 55 students aged 8 to 15 years took part in the summer sports programme with some participating in more than one sport. The partnership will continue to provide sport and physical activity sessions to the Oakgrove cluster every school holiday.
. The Walnuts School after school club: ‘Skill-Zone’ where children and young people aged 6 to 16 improve their Karate, Cooking, Dance and Trampoline skills.
Additionally work in partnership with Bucks Sports to access Sports Unlimited funding has meant that the extended services team was able to support schools to deliver the following projects during 2009:
. Cold Harbour Multi-Sports (Summer Term): 2 x 10 week activity blocks retaining at least 96 children/young people attending at least 60% of a 10 week block.
. Key Stage 5 Sports Afternoons: 2 x 10 week activity blocks retaining at least 40 children/young people attending at least 60% of a 10 week block.
. Shenley Brook End and Tattenhoe Multi Sports: 2 x 10 week activity blocks retaining at least 40 females attending at least 60% of a 10 week block.
. Martial Arts Moves: 2 x 10 week activity blocks retaining at least 32 children/young people attending at least 60% of a 10 week block.
(81)5 of 22 The Sports Unlimited programme will continue into next year with funding agreed subject to approval from Sport England for a number of projects.
Extended services have also worked closely with SaferMK on the ‘More than a School’ pupil consultation, seeking the views of pupils about the activities they would like to access through their schools. In total 2,960 pupils aged 5-16 years old responded. The consultation asked pupils what activities they take part in or want to take part in, where they would like provision to be available, barriers to accessing provision, plus community safety questions including issues that affect the quality of their lives.
The participating schools in the pilot for 2008/09 were West Bletchley Primary Schools, Lord Grey Secondary School, Leon School & Sports College and Oakgrove Secondary School. Each school received a report detailing their results. Actions taken to date in relation to the findings include school holiday sports activity programme to Oakgrove cluster. Extended services co-ordinators are now working with individual schools and relevant partners to take forward the development of provision as identified through the ‘More than a School’ pupil consultation.
Play Rangers
Milton Keynes Play Ranger Team co ordinate and deliver an adventurous, outdoor play programme for 8 -16 year olds in local parks. In January 2010 the service has been extended to three new areas (Coffee Hall, Greenleys and Springfield) in addition to the already established areas of Fullers Slade, Netherfield, two sites on Lakes Estate and New Bradwell.
The Play Rangers work in parks and outdoor public spaces offering open access active play sessions, where children between the ages of 6 and 8 come and play for free. Children help plan the sessions and choose the kind of activities that they would like. The Play Rangers build relationships with the children, giving the children and young people a friend and role model that they can talk to. Play activities include team games and participation. The Play Rangers encourage healthy lifestyles, involvement in local communities and promote positive activities. 703 children and young people are now registered with the scheme – 252 are aged 8 – 10 years, 363 11 – 14 years and 88 are 15-16 years. As well as the positive feedback from the children and young people who have accessed activities, families in the areas have fed back to Play Rangers that they like to bring their younger children to parks when the Rangers are there, as they enjoy the atmosphere and sense of community as well as feeling safe. 97 under eight year olds have also registered to receive details of activities.
Lottery funding for the scheme comes to an end in August 2010. The team are currently looking at ways to measure the impact that the programme has had on participants to evaluate its success and inform future play provision.
Playbuilder programme
Playbuilder is a government scheme, part of the national Play Strategy that aims to change the way play spaces are commissioned, designed and built. Milton Keynes secured £1 million to spend refurbishing a minimum of 22 play spaces which must be open and being used by April 2011. Work on the project started in April 2009, and the revamping work is underway on 13 local parks which will be completed by Easter 2010.
(82)6 of 22 Play provides the opportunity for children to develop social, physical, cognitive, cultural, emotional, imagination and communication skills as well as psychological skills and provides the opportunity for them to be involved with their local environment. In common with the Play Ranger scheme, this project aims to encourage children to get out in the fresh air, enjoying local facilities in a safe but stretching environment.
Decisions on the refurbishment, including the type of play equipment wanted, were reached by gathering the views of local children and young people, parents, residents and those working in partner organisations through a range of activities including:
. School assemblies.
. Working with established groups in play settings and youth clubs.
. Consultation at local community events e.g. carnivals and festivals.
Be mentally and emotionally healthy
Social and Emotional Aspects of Learning (SEAL)
SEAL is a comprehensive, whole-school approach to promoting the social and emotional skills that are thought to underpin effective learning, positive behaviour, regular attendance, and emotional well being. The SEAL programme aims to develop five main areas; self- awareness; empathy; social skills; motivation and managing feelings. National research has shown that programmes such as SEAL have a positive impact on pupil’s attitudes and behaviour. For example:
. Pupils have higher self esteem and confidence.
. Pupils are happier and get on better with each other.
. Pupils are more engaged in learning so fewer disengage with school.
. Quieter pupils become more assertive and confident.
. There is better behaviour in the classroom and improved attendance.
. There is less bullying.
. There are lower rates of truancy, offending and drug misuse.
The SEAL programme is being implemented in 75% of primary schools (based on audit carried out in summer 2009), an increase from 50% in 2008 and above our target of 70%, It is also being used in five secondary schools (42%), one special school and one Personal Education Centre (PEC). Some Primary schools began this journey as early as 2005, but the majority began in 2006-07. Some schools implement SEAL as a whole-school initiative whilst others have introduced it as part of their personal, social and health education programme. It is anticipated that the number of secondary schools using SEAL has increased which will be confirmed through a further audit currently being undertaken across all schools.
(83)7 of 22 A relatively recent addition to the Primary SEAL programme is Family SEAL which seeks to engage parents as partners in developing children’s social and emotional competence through a series of weekly workshops which follow the SEAL themes. With ten of our primary schools now involved with Family SEAL, evidence shows that parental involvement in the programme is more likely to bring about improvements, especially if there were difficult home circumstances inhibiting improvements in the children’s performance.
A formal evaluation of the impact of Family SEAL in Milton Keynes is in its planning stages and is intended to be undertaken during summer 2010 term. This will focus on the programme’s impact upon both the child and family, as well as considering school data, for example attendance and attainment and feedback from teachers.
The strategy adopted has been to develop the use of SEAL in tandem with the achievement of Healthy School Status and through School Improvement Partners as a means for schools to demonstrate, for Ofsted inspections, their actions to improve pupil wellbeing and to secure good behaviour. One barrier to progress in embedding the use of SEAL in schools has been the lack of dedicated staff capacity to promote its use. The appointment of the new post of School Improvement Adviser for Personal Development and Wellbeing from March 2010 will address this and support future adoption of SEAL.
Restorative Project in schools
As reported in the Children and Young People’s Plan, bullying is one of the major issues identified by children and young people as affecting their quality of life and having a negative impact on their emotional well being. Restorative approaches are one of the strategies being used for responding to individual incidents of bullying behaviour. It is also a way of working preventatively to create a culture within the whole school community which recognises and stresses the importance of relationships and explores ways in which ‘harm’ can be addressed with children, young people, parents and staff.
A small scale restorative justice project was piloted with three schools in 2004/05. Over time the project has developed and increased the range of services on offer. Over the past six months, the project has started delivering whole school training. Each of the 13 schools now involved have identified practitioners who can now support staff with the approach.
Initially the aims of the restorative project were to reduce exclusions and to improve social relationships in schools. Over time, these aims have evolved, and the present focus is on developing an explicit framework that will inform the actions of all members of staff in managing social relationships. This framework promotes:
. Respect for all individuals regardless of social or behavioural differences.
. Opportunities for all children and young people to participate in circle activities that enable them to build the communities in which they belong.
. Firm and fair procedures in response to unwanted behaviours.
. An expectation of personal responsibility and accountability.
. Opportunities for personal and social learning when there are incidences of hurt and harm.
(84)8 of 22 Though restorative approaches children are supported to develop empathy by learning about the effect of their words and actions. The combination of ‘firm and fair’ responses is consistently modelled by adults who recognise that social responsibility and emotional well being are learned rather than taught.
From the beginning of this project, there have been numerous verbal accounts of the way in which the emotional well being of children has been enhanced. Some of these accounts are captured on the DVD ‘Introducing Restorative Justice-A Positive Approach in Schools’.
Work to reduce bullying is also a focus for a number of officers and organisations, including Safer MK and the Safeguarding Children Board. The Council’s Anti Bullying Policy and Development Officer plays a key role in co-ordinating activity.
Oakgrove school have an Anti Bullying Group (ABC) which runs weekly meetings for its members. The ABC has made links with the Oakgrove feeder schools and is looking to develop transition support for pupils. ABC has also met with pupils from Radcliffe school to share ideas and discuss the issue of bullying.
Targeted Mental Health in Schools
The new Targeted Mental Health in Schools is a one year project funded through an external grant of £225,000. The programme will target children young people and their families where turbulence within the family, for whatever reason, is causing anxiety, unhappiness and mental health problems. These factors include problems in family functioning due to SEN issues, family break up, domestic violence and other less serious situations which may still cause anxiety and unhappiness. The programme aims to:
. To build on existing practice using SEAL and Family SEAL.
. To develop systems for the early identification of children and young people at risk through family turbulence.
. To improve existing interventions and develop new evidence based approaches.
. To share and embed good practice based on the project across Milton Keynes.
Schools were required to have achieved National Healthy School Status and be using SEAL to be considered for inclusion in this pilot programme. Oakgrove Secondary School and link primaries (Monkston, Middleton, Broughton Fields and St. Bernadette’s) and Shenley Brook End Secondary School and link primaries (Emerson Valley, Priory Rise, Oxley Park, Long Meadow, Merebrook) have been selected as they have significant pockets of deprivation but have never had enhanced funding because other areas were prioritised.
The Educational Psychology service is taking the lead and they have established a project group to include partners and service providers as above. The evaluation will involve collating baseline data and using a variety of tools to measure changes to children and young people’s social and emotional skills as well as the views of staff, children and parents’ views on the whole school.
(85)9 of 22
Child and Adolescent Mental Health Services (CAMHS)
Child and adolescent mental health services are jointly commissioned by the Council and NHS MK from MK PCT Provider Services. There is an annual NHS contract, which includes the Council CAMHS grant funded tier 2 element of the service.
The service has adopted a new, clearer structure. Dr Hadi is the clinical lead, and Marie Ramsay, a Council employee with an educational psychology background, is the operational manager. Marie is managed formally within the PCT, but meets 6 weekly with Assistant Director (Specialist Services). A small group of CAMHS and Children and Young People’s Services senior staff meet every 6 weeks to discuss ways of improving joint working. A joint working protocol has now been agreed and is currently being consulted on.
Child and adolescent mental health services (CAMHS) are delivered in line with a four tier strategic framework which is now widely accepted as the basis for planning, commissioning and delivering services. The CAMHS service is made up of tiers 2, 3 and 4 (4 being in patient provision). There are around 30 members of staff, including administrators and support workers, of whom 5 are Council employed.
An Open Access Service is available and families, young people, professionals can refer by telephone or letter. Referrals are managed at a weekly allocations meeting. Telephone advice is offered on request whether or not there is an open case.
Tier 2 services are provided in non-clinical community settings (including schools) and includes family support and social work staff, psychology and Primary Mental Healthcare Workers who are either employed by MKC or the PCT Provider. Tier 2 case load is 220 rolling average. This part of service is funded from the Council CAMHS Grant.
Tier 3 service is mostly clinic based, providing psychiatry, psychology and a range of therapeutic services. There is also an intensive eating disorders service, treating young people in the community (and placement in specialist in-patient settings). An additional complex behaviours service to help reduce reliance on in-patient services is to be commissioned from 2010. Tier 3 case load is 650 rolling average. This part of the service is funded by NHS MK.
Unlike many other parts of the country, the Tier 3 service is provided by a community based team and not an acute mental health or hospital. This has been a factor for the service scoring well in previous inspections and ensuring that waiting lists are within limits. CAMHS is provided by MK PCT, whereas almost all CAMHS nationally are provided as part of a large Mental Health Trust.
There has been a higher than average clinician caseload and MK has been an outlier in this respect. The PCT has recognised this with additional funding.
Due to the availability of the Campbell Centre at MK hospital, there is a higher use of young people’s in-patient bed days in adult setting than some others in the Strategic Health Authority area, although overall in-patient bed days are well within the average for population. Tier 4 (in-patient) has been commissioned from Oxfordshire and Buckinghamshire Mental Health Trust (Highfield) with additional use made of spot purchased
10(86) of 22 beds. The intention is from April 2010 to commission in-patient provision from the new purpose built adolescent in-patient unit in Northampton.
Since April 2009 27 children and young people have received in-patient care; this varies from 13 who have had 1-2 nights care to two young people who are in long term hospital placements. The increase of 17 year olds on the caseload has resulted in an overall increase in the number of patients requiring in-patient treatment. They would previously have been adult services patients and may not have met their criteria for services. A multi-disciplinary forum has been established to monitor in-patient placements.
Priorities for CAMHS in Milton Keynes include:
. To meet national requirement for no under 18 in adult mental health beds from April 2010.
. Better management and prevention of admission of severe mental health problems for Children in Care or on the edge of care.
. Commission a more effective Tier 4 service than that currently provided by Oxfordshire and Buckinghamshire Mental Health Trust.
. To develop closer working and information sharing, care planning and service delivery between CAMHS and MKC Children and Young People’s Services Specialist and Targeted services.
Sexually Healthy
Sexual heath services in Milton Keynes have continued to develop. For young people this has included the expansion of free emergency hormonal contraception from pharmacies, the ‘Condom Card’ distribution scheme and the local Chlamydia Screening Programme, as well as the comprehensive services provided by Brook MK.
Work in schools also includes theatre in education. In July 2009 drama company Caught in the Act visited students in 11 secondary schools across the city to perform a show that examines the dilemmas and complications faced by young people as they enter relationships. The aim of the show ‘Just be good to me’ was to actively engage young people in sex and relationship education, raise their awareness of the dangers of unprotected sex and provide information on local support services for young people. In addition, a group of young mums who meet weekly at the Christian Foundation project teamed up with professional theatre company Entertainment MK to produce a show called ‘Mums and Prams’ which was performed to groups of year 10 students in five secondary schools to help raise the awareness about the reality of being a teenage parent.
The Baby Think It Over project was introduced in June 2009 and has been well received by secondary schools such as Shenley Brook End School, using ‘reality babies’. Feedback has been good and subsequently some young people who participated have opted for LARC. Intention is to roll out the project to Lord Grey School and also look at loaning ‘reality babies’ to Oakgrove School, The Radcliffe School, The Hazeley School and Denbigh School. Other new developments include the Can Do Women project was successfully delivered at one secondary school during 2008/09. Funded by the council, the aim of the pilot project was to raise the aspirations and confidence of local girls to promote positive outcomes. As part of
11(87) of 22 the project the 12 girls were paired with a female mentor who lives and works locally. The mentors spent time with their ‘can do woman’, acting as a positive role model.
A new NHS employed part-time sexual health improvement officer has been recruited and took up post in June 2009. Their role includes breaking down barriers to young people accessing sexual health services and works either individually or with small groups of vulnerable young people on a six week programme developing their self esteem, improving their negotiation skills and raising their aspirations. As part of the work to increase local capacity for fitting Long Acting Reversible Contraception (LARC), 45 GPs, family planning nurses and doctors were trained in September 2009. Additionally, well subscribed in depth practitioner training on STIs is being held in February 2010.
Access to diagnostic services have improved with the Sexual Health Clinic (SHC) now offering at least 98% of appointments within 48 hours. The SHC has begun to hold weekly open access evenings, and recently held the first of a programme of evening events for secondary school students.
Brook MK are now providing outreach services to almost all secondary schools in Milton Keynes, as well as through alternative education providers and other key venues such as the Connexions Centre at The Point. This may be on a weekly, monthly or in response to specific requests from schools, and varies from a drop-in, appointment, or targeted one to one, according to the needs and wishes of the school. Brook outreach services also include targeted work with young men.
Weekly sessions are held at Leon School and Sports College, Stantonbury Campus, Lord Grey School (established 18 months ago) and recently expanded to The Radcliffe School. Workers also attend the two of the PECs, Springfield House and Oakgrove School on a monthly basis. Workers attend other schools on an ad hoc basis but this can be as frequent as weekly attendance, for example at Shenley Brook End School. Sessions are also now held at Milton Keynes College.
In addition to outreach services, Brook opened in new city centre premises in January 2010. The new clinic has increased capacity with more consulting rooms and longer opening hours. This will enable more young people to be seen and accommodate the increased demand on services.
British pregnancy Advisory Service (BPAS) have moved into the vacated Brook MK premises which will enable them to extend their opening hours. The intention is for BPAS to establish an early medical abortion service (up to 9th week of pregnancy) not currently available locally. Currently young people have to travel to Luton, London or Leamington Spa for this intervention as well as later stage abortions.
Chlamydia
In 2008/09 17.7% of 15-24 year olds were tested for Chlamydia in Milton Keynes compared to 15.9% nationally. The significantly increased target for 2009/10 is to test 25% of 15-24 year olds. Figures at the end of December 2009, showed that there was only a shortfall of 2% against this target, therefore it is anticipated that the target will be achieved. Current data shows a 6.13% positive rate for the young people tested during 2009. This indicates a continuing downward trend in the prevalence rate for positive testing – from 14% in 2006, 11.6% in 2007, 10% in 2008 and 7% in 2009. The national programme is still based around
12(88) of 22 the assumption of a positive rate of one in 10 young people. According to the latest national figures for Chlamydia screening (September 2009) Milton Keynes is ranked 8th in England.
The Chlamydia Screening Office has been working on new initiatives proposed and developed since last year. These include:
. Screening at the FE College campuses by peer educators.
. Planning for a college based contraception and Chlamydia screening services.
. Setting up of more pharmacies as screening sites.
. Setting up night club screening sites.
Other sexually transmitted infections
Under 19 STI Diagnosis: Milton Keynes Sexual Health (GUM) Clinic
Q1 Q2 Q3 Q4 Total
31 30 28 18 2007 107
40 22 24 24 2008 110
Chlamydia 41 18 17 18 2009 94
2 2 2 2 2007 8
2 4 1 3 2008 10
Gonorrhoea 0 1 2 1 2009 4
0 1 0 0 2007 1
0 0 0 0 2008 0 Syphilis 2 1 0 0 2009 3
22 21 24 18 2007 85
23 18 20 17 2008 78 Warts
22 27 25 13 2009 87
3 1 2 1 2007 9
3 2 5 4 2008 14 Herpes 8 3 9 6 2009 26
13(89) of 22 Healthy lifestyles
Healthy Schools
We have increased the proportion of schools with national Healthy School Status to 81% (from 74% in 2008/09) and expect to achieve our target of 85% by April 2010. This compares favourably to the national figure for July 2009 of 78%.
The Enhanced Healthy Schools programme was introduced this year for schools that have already achieved Healthy schools Status. In Milton Keynes 32% of schools have to date received training in the process. The national target is for 10% of schools to have identified two priorities which have been agreed by the Healthy Schools quality assurance group, by April 2010. 12% of our schools have already indicated they would like to proceed and so we anticipate meeting the 10% target set by April 2010.
The Healthy Schools team are working with schools to ensure that the particular health and well being priorities each school selects are linked to the Children and Young People’s Plan aspirations and targets. This includes developing the use of SEAL and school councils in working toward their meaningful outcomes.
School meals
There are 64 primary schools in the central contract for school meals. Following major problems with the previous contract, since the change of supplier which was fully operative from September 2009, there has been an increase in school meal take up in the period 3 September to 31 January 2010 of 54.4%. The graph shows the rate of increase over the autumn term.
Average Daily Take Up of Cygnet Hot School Meals
4500 4000 3500 3000 2500 2000 1500 1000 500 0 Wk 1 Wk 2 Wk 3 Wk 4 Wk 5 Wk 6 Wk 7 Wk 8 Wk 9 Wk Wk Wk Wk Wk Wk 10 11 12 13 14 15
Autumn Term 09
14(90) of 22 The data for (a) NI52 (i) primary schools that are not participants in Milton Keynes Council’s central contract for school meals; and (b) NI52 (ii) school meal take up in Secondary Schools will be collected early April 2010.
A successful bid for capital funding is enabling the creation of new, ‘mini’ kitchens in 10-15 existing primary schools to increase access to better quality food. One kitchen has already been completed, and two more will be in place by March 2010.
Children and Young People’s Services also provide support and advice to schools in relation to joint procurement of foodstuffs, menu planning aligned to nutritional analysis and marketing campaigns to increase school meal take-up.
Children’s Centres
There are now 19 children’s centres with the final centre due to be designated on the 22 March 2010, meeting the 2009/10 target.
All children's centres provide well attended sessions based around healthy lifestyles, including healthy eating, for example cooking on a budget, family lunches, fitness activities for both toddlers and parents.
As well as the activities organised by children's centre staff, a range of support sessions are delivered by partner organisations within the centres including family counselling sessions, weekly health visitor sessions, community dieticians who deliver healthy eating programmes and oral health clinics.
The Smile Award was launched in May last year; and so far nine training sessions have been delivered to 80 participants. The previous Smile Award Scheme has been developed into Smile Award Plus with the involvement of the Health Promotion Dieticians. This means the award scheme now covers general healthy eating, as well as maintaining the dental emphasis. The age range has also been extended and now covers 0-18 year olds. Training is specifically aimed at all staff working with children and young people in a community, educational, health or social care setting.
Breastfeeding is actively promoted through trained children's centre staff in partnership with health visitors. Three of the six breastfeeding support groups developed across Milton Keynes are provided at children's centres. Centre family support workers carry out outreach work and home visits to encourage new users to make use of facilities and signpost them to appropriate services.
Children's centre staff have recently been trained to use Ferreleavers Scales of Wellbeing, which enables them to recognise emotional and well being factors in the children using centres. Knowledge gained from observing both groups and individual children as well as parents/carers, is used to make adaptations to the environment and service provision, to enable service users to benefit more from the facilities on offer. An early example has been moving the book corner in one centre to a different space which eliminates distractions previously observed.
Feedback from parents using the centres including regular parent forums helps to shape the support and activities provided on site. Monitoring information can identify trends of usage so that services can ensure that what is offered is regularly reviewed according to each community’s needs. However, more needs to be put in place to effectively measure actual
15(91) of 22 outcomes for the children and families using the centres. Work is currently underway to set proxy indicators to capture information and better measure the difference that children's centre support has made.
Healthy Lifestyles Conference
One of the three key campaigns of the Youth Cabinet is a health awareness campaign to improve young people’s health. A one day healthy lifestyles conference has been organised by them in partnership with Milton Keynes Hospital NHS Foundation Trust. All secondary schools were invited to attend the conference held during February 2010. The conference aimed to raise awareness of health issues which affect young people in Milton Keynes and to promote healthy lifestyles. It was attended by 122 young people representing 8 schools including the central PEC. The conference has been designed to feed into the PSHE Curriculum and offer young people the opportunity to develop their knowledge and understanding of a range of health issues, including:
. Diet and healthy eating.
. Understanding diabetes.
. Keeping a healthy heart.
. Understanding lung conditions.
Topics were discussed in small interactive workshops running throughout the conference. In addition, information zones at the conference provided further information and activities about healthy lifestyles.
Aiming High for Children with Disabilities
NHS Milton Keynes and Milton Keynes Council are working together to improve services for children with disabilities and complex needs linked to the Government’s Aiming High for Disabled Children programme. The focus for this programme is to significantly improve the lives of children with disabilities and their families. The whole programme is backed by both capital and revenue funding.
There are funding streams coming through childcare, play, Children's Social Care and health, all of which will provide opportunities to increase access to a wide range of services and activities for children and young people with disabilities and their families.
A key element of Aiming High for Children with Disabilities is the delivery of short breaks. A short break is a period of time from an hour or two to a few days that gives a child or young person with a disability a chance to engage in social and leisure activities. A short break is also a chance for parents to have a break from what is often a very tiring and demanding care routine. It is often an opportunity to spend more time with their other children who are not disabled. The target group for short breaks will be those children who experience multiple and complex disabilities, with moving and handling needs and those with learning disabilities and autism who display challenging behaviours.
We are required to ensure that all relevant children and young people receive some kind of short break known as the local minimum offer. We estimate approximately 600 children
16(92) of 22 potentially eligible for a short break and have been engaged in a comprehensive data gathering exercise to identify eligible children and young people. Through this process will quantify the amount of short breaks they are receiving and will then have a better understanding of the gap and where best to target available resources for 2010/11.
Choosing not to use illegal drugs
One of our highest priorities continues to be to improve young people’s services and access to treatment options. This includes an emphasis on supporting families, ensuring that preventative services and early identification and intervention services are in place so that young people can be diverted away from long term involvement with substance misuse.
The Drug and Alcohol Strategic Group plays a lead role in service development and redesign. A data sub group was set up in 2009 to collate intelligence about young people and substance misuse issues and complete a comprehensive needs assessment to inform treatment planning for Milton Keynes. This work is currently underway for 2010/11. Improvement in data systems has already enabled the group to begin to identify unmet need for key target groups of young people particularly at risk of substance misuse. This includes young people known to children's social care and youth support services. The ongoing monitoring of referrals into the substance misuse treatment service enables us to target work with relevant agencies and a range of community groups to raise awareness and ensure effective support into treatment for young people.
We know that the best outcomes for children and young people are achieved through work with the family unit as a whole and interventions such as the Family Intervention Project work intensively with the whole family to address inter-generational patterns of substance and alcohol use. Our team of family support workers use a ‘Think Family’ approach to working with families to address issues around children and young people’s behaviour or crime. They work closely with partners including the Youth Offending Team, Safer Communities, Housing and Compass to ensure that the whole needs of the family are effectively addressed. Most recently quarterly monitoring of the project shows that cannabis or alcohol use was amongst the issues for 30% of the young people referred.
In Milton Keynes drug treatment services are commissioned from Compass Young People’s Service. Compass provide a confidential, free service available to all young people up to the age of 18. During 2009/10, Compass carried out a service review and is re-focusing its service to deliver Tier 2 and Tier 3 services only. The provider is currently drawing up an action plan to work with Tier 1 providers during the latter part of 2009/10 and the earlier part of 2010/11 to up-skill them to deliver drug awareness training and to identify and refer young people with a treatment need into the service.
The Compass team includes a senior practitioner, and three young people’s drug and alcohol workers, who all carry a tier 3 one to one caseload as well as delivering tier 2 group work. The team also comprises an administrator and a cluster manager (managing three services).
Compass have refocused their tier 2 service offering group work and drop-ins to vulnerable young people, including young offenders and young parents. Their support programme for parents whose children are substance users, includes effective communication techniques and coping mechanisms as well as information on the effects and risks associated with substance misuse.
17(93) of 22 Compass have established link workers in two secondary schools, and plan to extend the provision to other secondary schools in the area. This includes providing training to staff within the school to enable them to confidently deliver drug and alcohol education and also to enable staff to use the substance misuse screening questions to increase referrals into treatment. This closer work with these schools has increased the number of referrals to Compass and improved the referral pathway. Compass services are also promoted to students at three campuses that comprise Milton Keynes College as part of the ‘Youth Bytes’ project. This ‘ticker tape’ system shows information about key issues and local services for young people each time students use the college computers.
Of those young people being provided with Compass tier 3 service during 2008/09 57% were aged 14 or 15. 53% were male and 47% female, 95% of the young people in treatment with Compass were ‘White British’ (The refocusing of the Compass service to engage with people from BME groups is an identified priority in 2010/11). Over two thirds were in treatment for cannabis use and 23% for alcohol.
Hidden harm
The draft Hidden Harm strategy and action plan is currently being consulted upon. Hidden harm focus is on children with a parent, parents or other guardian whose drug use has serious negative consequences for themselves and those around them. A key activity included in the strategy is the identification of children and young people at risk of short or long term harm due to substance misuse within the family. A number of school briefing sessions around Hidden Harm were held in November 2009 to raise awareness and promote early intervention. Additionally, adult treatment providers have all received training on the use of the Common Assessment Framework (CAF) so that are able to carry out a CAF assessment for any child who is affected by substance misuse in the family. Basic Drug Awareness training is also being offered to school staff during February 2010 and a Drugs Education Workshop is planned for March 2010.
Youth support
The Youth Offending Team (YOT) employs a specialist substance misuse worker to support those young people in the criminal justice system with substance misuse issues. A positive thematic inspection of the YOT in November 2009 focused on alcohol issues. The YOT plans to prioritise identification of alcohol issues in young offenders in 2010/11 and intends to work closely with partners to improve its response to young offenders’ general healthcare.
Following the successful pilot during 2008/09, five youth centres are now delivering regular activities for young people on Friday nights, and two centres on Saturdays. A restructure of the current youth service is planned for 2010/11 which will increase weekend staffing availability within current resources, providing services at the times that take up has shown shows that young people want. The expanded hours provide young people access to positive activities and diversion from drugs and alcohol.
All 15 youth service venues provide a programme of monthly ‘hot topics’ sessions for the young people attending. Sessions include a significant focus health related issues such as substance misuse, relationships and sexual health.
18(94) of 22 Section 2
An update on the progress made on the areas for development identified in the Annual Performance Assessment
Teenage conceptions are higher than average. A consistent trend has not yet been established (Ofsted, 2008)
Progress
The conception rate in Milton Keynes for 2007 (latest full year validated figure) was 39.1 per 1000 girls aged 15-17, which is a 23.6% decrease based on the 1998 baseline. This compares well to an average reduction of 10.7% nationally. Rates in Milton Keynes continued to fall at a time when national rates increased. The chart below highlights this:
60 Milton Keynes UA South East England 50
40
30
20
Under 18 conception rate per 1000 per rate Under conception 18 10
0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Year
Maintaining momentum
Key priorities for 2010/11 include maintaining and extending our successful multi agency approach to tackling teenage pregnancy, ensuring the availability of a well publicised young people centred contraceptive and sexual health advice service and supporting PSHE in schools to develop comprehensive programmes of sex and relationships education. We intend to continue to deliver targeted interventions with young people at greatest risk of teenage pregnancy and further develop youth support services, providing things to do and places to go for young people with a clear focus on addressing key social issues affecting young people, such as sexual health and substance misuse.
19(95) of 22 Substance misuse services are underdeveloped and a lower proportion of young people are in treatment than the regional average (Ofsted, 2008)
Progress
The data set out on page 22 shows a considerable percentage increase in the number of young people in treatment each month in Milton Keynes from April 2008 to December 2009. The percentage increase in Milton Keynes is much greater than in the strategic health authority or at a national level.
Maintaining momentum
Key priorities for developing young people’s specialist substance misuse treatment interventions to meet local needs during 2010/11 are set out in the Young People’s Specialist Substance Misuse Treatment Plan 2010/11. They are:
Hidden Harm
1. Ensuring what is delivered locally to reduce hidden harm to children and families is evidence based. 2. Change the culture in which generic and specific services work to ‘Think Family’ and to reduce staff stigmatising attitudes around parents who misuse substances. 3. Ensure that agencies sign up to the ‘team around the family’ approach.
Early Intervention in the Criminal Justice System
1. In conjunction with the YOT, identify the target group for early intervention and diversion. 2. Explore how best to work in partnership to provide diversionary interventions for young people using existing services. 3. Ensure that no young people slip through the net and that all young people are offered an intervention if they need one.
Community Engagement
1. Identify unmet needs and identify target groups to engage with. 2. Work with partner agencies to identify and support people currently under-represented in services. 3. Identify people in services to lead on engaging under-represented communities and ensure that staff across agencies have effective training and screening tools to be able to identify and support people with substance misuse needs.
Data
1. Partner agencies to capture data about substance misuse, even if it is not the ‘primary’ presenting need. 2. Partner agencies and the Young People’s Substance Misuse Delivery Group to understand the data collected and make sense together of what the data means for service planning. 3. Ensure that data collection and analysis is properly resourced.
20(96) of 22 Transitions
1. To look at a flexible transitions arrangement up to the age of 25, rather than a strict cut off at 18 in order to prevent a long term career in drug use. 2. To provide choices for young people to remain in younger people’s services or to use adult services, and to provide choices for young people in its broadest sense, i.e. working as partners to provide a choice about a long term career in drug use. 3. To plan for the transition into adulthood in its broadest sense, i.e. supporting young people to plan for a career, college and to ensure that young people are supported into stable accommodation.
21(97) of 22 National Drug Treatment Monitoring System Young people aged under 18 years receiving tier 3 or tier 4 treatment
National South Central Strategic Health Authority Milton Keynes Month No. In % No. of new % No. In % No. of new % No. In % No. of new % Treatment change presentations new Treatment change presentations new Treatment change presentations new Apr 08 8172 1454 17.8 456 71 15.6 15 0 0.0 May 08 8232 0.7 1278 15.5 481 5.5 86 17.9 15 0.0 * Jun 08 8513 4.2 1485 17.4 499 9.4 91 18.2 17 13.3 5 29.4 Jul 08 8711 6.6 1472 16.9 510 11.8 80 15.7 23 53.3 6 26.1 Aug 08 8406 2.9 1150 13.7 485 6.4 69 14.2 20 33.3 * Sep 08 8651 5.9 1367 15.8 496 8.8 82 16.5 23 53.3 5 21.7 Oct 08 9071 11.0 1712 18.9 536 17.5 116 21.6 26 73.3 6 23.1 Nov 08 9356 14.5 1587 17.0 547 20.0 90 16.5 33 120.0 11 33.3 Dec 08 9536 16.7 1403 14.7 564 23.7 105 18.6 32 113.3 5 15.6 Jan 09 10106 23.7 1665 16.5 587 28.7 91 15.5 41 173.3 12 29.3 Feb 09 10303 26.1 1445 14.0 612 34.2 99 16.2 43 186.7 6 14.0 Mar 09 10555 29.2 1386 13.1 621 36.2 77 12.4 42 180.0 6 14.3 Apr 09 7976 -2.4 1312 16.4 401 -12.1 56 14.0 38 153.3 6 15.8 May 09 8213 0.5 1263 15.4 429 -5.9 77 17.9 39 160.0 8 20.5 Jun 09 8482 3.8 1509 17.8 440 -3.5 87 19.8 41 173.3 9 22.0 Jul 09 8649 5.8 1530 17.7 467 2.4 146 31.3 41 173.3 5 12.2 Aug 09 8474 3.7 1118 13.2 473 3.7 69 14.6 34 126.7 * Sep 09 8898 8.9 1358 15.3 505 10.7 78 15.4 43 186.7 9 20.9 Oct 09 9301 13.8 1651 17.8 526 15.4 99 18.8 47 213.3 6 12.8 Nov 09 9540 16.7 1452 15.2 550 20.6 94 17.1 45 200.0 * Dec 09 9565 17.0 1014 10.6 559 22.6 63 11.3 46 206.7 5 10.9 % change = no. in treatment in the specified month as a % of the no. in treatment in April 2008 % new = no. of new presentations in the specified month as a % of the no. in treatment that month * indicates a low number of 1 – 4 data from https://www.ndtms.net/youngpeople.aspx
22(98) of 22 Supporting the health ANNEXof TO ITEM 7 Young People in MILTON KEYNES A summary report of the Health Related Behaviour Survey
These results are the compilation of data collected from a sample of secondary pupils in Milton Keynes during Summer 2009. This work was commissioned by Healthy Schools Milton Keynes to collect reliable information about young people's lifestyles. This survey follows studies completed in 2005 and 2007.
Collecting the figures Comparisons Target-setting Five secondary schools took Comparisons have been Where results can be related part in the study. Teachers made with samples of pupils either to the priorities of the were briefed on how to and students from other Milton Keynes Children and collect the most reliable data areas: a large sample of Young People's Plan and then pupils anonymously pupils from schools across (C&YPP), National Indicators completed the the UK (page 9). (NI) and/or the Local Area questionnaires. The sample Agreement (LAA) then the We have also compared sizes are shown in the table relevant target is given in the results from a select four- below. text. school sample from 2009 Completed questionnaires with the results from the were then returned to SHEU same schools in previous in Exeter for processing. surveys (page 10). Results were available online to schools in Summer 2009 Topics included: and further reports were distributed in Autumn 2009. Being healthy p2 Drugs, alcohol & tobacco p2 Over 1000 young people completed the survey: Healthy eating p3 Year group Year 8 Year 10 Emotional health & Age 12-13 14-15 well-being p3 Boys 267 241 Girls 268 267 Sex and relationships p4 Total 535 508 Physical activity p5 Healthy schools. p5 Staying safe p6
SHEU Schools Health Education Unit Bullying p6 Tel. 01392 66 72 72 Enjoying and achieving p7 www.sheu.org.uk Making a positive contribution p7 The Unit specialises in questionnaire surveys of children and young people for Local Authorities, PCTs, voluntary agencies, charities, schools and Economic well-being p8 colleges and other partnerships. SHEU is also able to undertake consultation, monitoring and evaluation exercises, and bespoke research. Family, income, spending p8
(99) Secondary school pupils in Years 8 and 10 (aged 12-13 and 14-15)
BEING HEALTHY
DRUGS, ALCOHOL & TOBACCO Alcohol C&YPP Identification of young people 30% had at least one misusing drugs or alcohol alcoholic drink in the week before the survey. NI115 (LAA) Young people who say they 4% of drinkers drank have used drugs or drunk alcohol over the advised weekly limit for adult Drugs females of 14 units.
45% reported they were 'fairly sure' or 'certain' that they 4% of pupils bought alcohol from an off-licence that knew someone who used drugs that were not medicines. should only sell to over-eighteens.
23% of pupils have been offered cannabis. Tobacco
21% of pupils have 30% say they have tried smoking in the past or smoke been offered other now. drugs. 8% in the survey smoked at least one cigarette during the last 7 days.
7% say they have 8% say they smoke taken some form of 'regularly' or illegal drug within the 'occasionally'; last month. 63% of all smokers 14% have ever taken would like to give up an illegal drug smoking.
4% of pupils said they have taken more than one type of illegal drug at the same time. 7% reported taking an illegal drug and alcohol on the same occasion.
The most commonly taken drugs among Year 10 pupils 35% say that they have at least one person who regularly were: smokes at home; we do not know if they do so in the same Males Females room as the pupil. 1 Cannabis resin/oil 19 Cannabis resin/oil 15 44% of all pupils in the survey have a parent or 2 Poppers 8 Poppers 7 sibling who smokes 3 Solvents 6 Ecstasy 3 29% report that a close friend smokes
Percentages of Year 10 Research has shown pupils who have ever that the best single taken cannabis: predictor of young people's smoking is Males 19% whether their best Females 15% friend smokes
Page 2 (100) HEALTHY EATING 20% of pupils in the survey had no lunch yesterday. 20% had a school lunch and 7% bought lunch from a takeaway C&YPP Promotion of healthy eating or shop. The top three foods most commonly reported eaten ON MOST DAYS were: NI52 Take up of school lunches Males Females NI56 Obesity in Year 6 children 1 Any dairy 63% Any dairy 55% 2 Any meat 48% Vegetables 49% 15% of pupils reported 3 Vegetables 46% Fresh fruit 44% having nothing to eat or drink for breakfast on the 8% reported that they day of the survey. had no water to drink
52% reported having a 42% said that they had drink for breakfast and 4% at least a litre, the day had sweets or chocolate. before the survey. 38% reported considering their health when
choosing what to eat at 24% had only one or least 'quite often'. two cups of water yesterday
9% of the pupils in the 18% say that they survey would like to usually eat at least 5 put on weight portions of fruit or vegetables on a school 44% would like to lose day… weight (57% of … while 10% say they females). usually have none at Not all young people all. gave us their height and weight EMOTIONAL HEALTH & WELL-BEING 69% of pupils in the survey worry about C&YPP Raise self-esteem, aspiration, at least one problem emotional resilience 'Quite a lot' or 'A lot'.
66% of pupils reported they are, in general, 'quite a lot' or 'a lot' satisfied The three most common worries were: with their life. Males Females 1 Exams & tests 33% The way you look 50% 2 Family problems 24% Exams & tests 46% 3 Career problems 22% Family problems 40% 44% of pupils had high self-esteem scores. Males: Exams & tests 33% 15% had low self- esteem scores. Females: The way you look 50% 7% in the survey think there are no adults they can trust
29% said they could trust only one or two adults We asked who would they go to for help or support with 47% of pupils reported that they get problems. Mum and Dad scored high for all problems, on best with 'both parents' (this may although some said Keep it to myself. Keep it to myself be compared with the 60% who live may reflect confidence or plain lack of support. at home with both parents).
Page 3 (101) SEX AND RELATIONSHIPS Infections The most common sexually transmitted infection among C&YPP High quality Sex and young people is Chlamydia, an infection which can cause Relationship Education (SRE) damage and infertility but may lie hidden for many months in women (the Greek chlamyda means 'cloak'). Expand access to sexual health services Chlamydia infection can be treated and cured once detected; it is estimated that between 1% and 10% of Support and advice to young people young people are harbouring the germ.
Raise awareness of Chlamydia screening The proportions of young people who correctly identified Can be treated and cured from a list of options (including Integrate Chlamydia screening into Never heard or it, Know nothing about it and Can be services for 15-25 year-olds treated but not cured) were: NI112 (LAA) U18 teenage conceptions NI113 Chlamydia screening NI113ii Chlamydia prevalence
34% of pupils are usually 'at ease' meeting people of their own age.
Yr8 Males Yr8 Females Yr10 Males Yr10 Females
18% of pupils Condoms reported that their 70% of young people in parents were their the survey say they know main source of where they can get information about condoms free of charge. sex.
33% said that school lessons were. The understanding of the uise of condoms as reported by 28% of pupils Year 10 students (males and females combined) was as reported that they follows: thought their parents should be Never Know their main source of heard of it nothing information about sex. 2% about it 2% 47% said that it should be school lessons. Not reliable 34% of Year 10 females said that PSHE lessons about sex to stop were at least quite useful; these were the most highly-rated Reliable to pregnancy lessons in the list for this group stop (Year 8 Males 42%, Year 8 Females 43%, Year 10 Males 29%) 11% pregnancy 51% believe there is a 85% specialist service for young people available locally.
Pupils’ first preferences for the setting of a young people’s contraception and advice 73% of pupils thought service were: condoms were reliable in 27% drop-in centre at school stopping infections like 36% drop-in centre at health HIV/AIDS (80% of Y10 centre females). 17% drop-in centre in city 17% drop-in centre elsewhere
Page 4 (102) PHYSICAL ACTIVITY The three most popular physical activities were: Males Females C&YPP Access to high quality sporting, 1 Football 45% Going for walks 41% leisure and out of school activities 2 Riding a bike 46% Dancing 29% NI110 Participation in positive activities: 3 Jogging 25% Swimming 20% The three physical activities that young people said they NI57(LAA) Participation in high quality would like to start doing (or do more of) were: PE and sport Males Females
72% say they enjoy 1 Football 21% Swimming 26% physical activities 'quite a lot' or 'a lot'. 2 Rugby 18% Dancing 17% 3 Tennis 12% Netball/tennis 13%
School Travel Plan 40% thought they were 'fit' or 'very fit' while 21% thought they were
‘unfit’ or ‘very unfit’. 63% of pupils 38% thought they were walked at least part ‘moderately fit’. of the way to school on the day of the survey 74% of pupils reported
that they had exercised 13% used a bicycle twice or more in the – both physically week before the survey, active modes of which was enough to transport. increase breathing rate. 17% said once and 9% 37% took a car or van at least part of the way and 7% took said none. some form of bus.
HEALTHY SCHOOLS Healthy Schools and the Children and Young People’s Plan Healthy Schools is a delivery vehicle for many of the National Indicators in the Children and Young People’s Plan. In order to achieve National Healthy School Status (NHSS), schools have to fulfil minimum evidence criteria in the four core themes of: • Personal, Social and Health Education – including drugs and SRE policies and programmes; • Healthy Eating – including a whole school food policy, school lunches; • Physical Activity – including a whole school physical activity policy, travel to school; • Emotional Health and Wellbeing – including the understanding and exploration of feelings and a bullying policy. The 79% of schools (as of November 2009) who have achieved NHSS are eligible to move into the Healthy Schools Enhancement Model. Following an annual review of the NHSS minimum criteria, they conduct a needs analysis to inform the selection of two priorities, which will contribute to National Indicators in the Children and Young People’s Plan. Universal and targeted meaningful outcomes are set for both the whole school and targeted groups of pupils, and activities put in place to achieve the outcomes.
Page 5 (103) STAYING SAFE Feeling safe 99% of pupils say they use the Internet CYPP Prevent bullying but only 5% say that they are always NI69 Report having experienced bullying supervised doing so. 76% of pupils say they are never 23% of pupils rate supervised when the safety of their using the Internet area when going out after dark as ‘poor’ or ‘very We asked pupils about a variety of topics in PSHE and if poor’. they remembered any lessons on these issues – and if so, how useful they thought they were. Safety turned out to 4% said this about going out during be one of the topics thought most useful by pupils, with the day. 41% considering their lessons at least quite useful. 13% of all pupils say 9% of pupils reported that they they can't remember were ‘fairly sure’ or ‘certain’ any lessons on they had friends or they keeping safe; 12% of themselves carried weapons for the whole sample say protection when going out. that their lessons on safety were not at all 13% reported that they had useful – a combined been a victim of violence or sum of 25%. aggression in the area where they live, in the last twelve months.
Bullying C&YPP School measures to prevent 4% of pupils reported that bullying/racist incidents they thought others might fear going to school C&YPP Speedy support for tackling because of them. bullying NI69 Report having experienced bullying Percentages of pupils who reported that they thought others might fear going to school because of them:
23% of pupils reported that they felt afraid of going to school because of bullying at least sometimes.
Percentages of pupils who reported that they felt afraid of going to school because of bullying at least sometimes:
Yr8 Males Yr8 Females Yr10 Males Yr10 Females
44% of Year 8 pupils and…
…24% of Year 10 pupils thought that their lessons about bullying were quite useful or very useful Yr8 Males Yr8 Females Yr10 Males Yr10 Females
Page 6 (104) ENJOYING AND ACHIEVING C&YPP Attendance C&YPP (exclusions) C&YPP Speedy support for tackling NI87(LAA) Persistent absences in bullying secondary schools We asked pupils about a variety of topics in PSHE and if they remembered any lessons on these issues – and if so, 34% of pupils report how useful they thought they were. enjoying all or most of their school lessons.
Physical activity was the topic thought most useful by males
54% of pupils did 48% thinking their homework on the lessons quite useful or previous evening. very useful in Year 8…
27% reported they did …32% in Year 10. more than an hour. The most useful topic for 46% of pupils did no females was different in homework last night Year 8 and Year 10 We see that 24% have 53% of females in year a regular paid job 8 found lessons to be about safety to be useful
34% of Year 10 females found their lessons on sex education useful
MAKING a POSITIVE CONTRIBUTION C&YPP Access to high quality sporting, 24% of pupils reported leisure and out of school reading a book for pleasure for at least activities part of the evening 25% of males and before the survey 32% of females say 85% watched some TV they cared for the previous night family members at some point on the 14% watched for over night before the 3 hours. survey
84% of pupils had used the Internet at home in the last month and 80% at school. 50% of males and 34% of females took part 69% of pupils use the in some sort of sport or Internet for chatting. other physical activity 94% of pupils use the after school last night Internet without adult 46% of pupils met with supervision at least friends sometimes.
Page 7 (105) ECONOMIC WELL-BEING Family Income
78% of pupils described themselves as white 55% reported getting pocket money 88% of the pupils in the survey have at least one brother or regularly. sister, and for 35% of these they are the oldest child. 24% said they got 20% of pupils have money when they broadsheet needed it, while 15% newspapers in their said they don’t usually homes. get any. 28% have popular Total income exceeded £10 last week for 60% in the tabloids only. survey (33% said they got more than £40 last week). 34% reported 38% of pupils said they having no national had put some of their newspaper at home. own money into a savings scheme in the last 7 days.
60% of all pupils in the survey live with both parents. 65% of households Spending have 2 or more cars. 55% of pupils spent over £10 in the week before the survey.
46% of pupils live in The 10 main items pupils spent money on were: home with three Males % Females % bedrooms; 9% live in 1 Sweets 37 Clothes & footwear 37 homes with fewer bedrooms and 41% have 2 Soft drinks 30 Sweets 32 more. 3 Clothes & footwear 29 Soft drinks 24 37% live in a home where 4 Computer games 24 Cosmetics/Toiletries 23 at least 2 more people live 5 Fast food (hot) 22 Mobile phone 18 than there are actual 6 Mobile phone 20 Fast food (hot) 18 numbers of bedrooms 7 Sports equipment 17 Comics, Magazines 16 Work 8 CDs, tapes, other music 17 Fares 14 24% of the pupils in the 9 Leisure/sports centre 14 CDs, tapes, other music 12 survey have a regular 10 Crisps 13 Crisps 11 paid job (35% of Year 10 males) Among the list of items on which pupils spent money there were some others that didn't make it into the top 10 but are nonetheless important. Our view of the most important results was:
The most common forms of work were: Sweets 34%
Males Females Fresh fruit 6%
1 Paper/milk round 49% Babysitting 37% Cigarettes 5% 2 Paid housework 15% Paid housework 21% Lottery scratchcards 2% 3 Other work 11% Paper/milk round 16% Alcohol 8% 3% of pupils say they worked for more than 8 hours last week (4% of Year 10 pupils). Arcade gambling 3%
The range of hours reported being worked was 2-21 hours. Hot fast food 20% Soft drinks 27%
Page 8 (106) Differences between Milton Keynes pupils and a reference sample of schools across England and Wales Results from each sample were compared, and results which were statistically significant (unlikely to be due to chance alone) have been selected and shown below. We have also included figures for experience of illegal drugs (mostly cannabis) where there is no significant difference despite offers of cannabis being higher locally. We have indicated good news with a green title and unwelcome news with a red one.
Percentage Percentage who who live with know a user of both parents* illegal drugs*
M Keynes Reference M Keynes Reference
Percentage Percentage who who score have ever been high for self- offered cannabis esteem
M Keynes Reference M Keynes Reference
Percentage Percentage who who enjoy have ever taken ‘most' or ‘all' illegal drugs of their (this difference is lessons not significant) M Keynes Reference M Keynes Reference
Percentage Percentage who who often know where to consider their get free health when condoms* choosing food M Keynes Reference M Keynes Reference
Percentage Percentage who who had no know about a lunch sexual health yesterday* service for young people* M Keynes Reference M Keynes Reference
Percentage Percentage who who smoked can trust three or a cigarette more adults last week
M Keynes Reference M Keynes Reference * Also found in 2007
Page 9 (107) Comparisons with previous surveys
Different schools took part in the survey in 2009 and 2007/2005. Four schools took part in the survey in all three waves [Stantonbury Campus, Walton High School, Ousedale School and Shenley Brook End School], and just the results from these four schools have been used for this analysis. Therefore, the 2007 and 2005 percentages cited on this page are different from those previously circulated.
2005 2007 2009 Broadsheet newspapers 16% 14% 21% First of all, we checked to make sure that Popular tabloid newspapers 24% 25% 23% background factors looked more or less the same in Pupils living with both parents 59% 58% 62% both samples: 3+ cars 18% 19% 19%
Reassured that these schools hadn't changed very much in the last two years, we then we picked out the most significant differences, rises or falls, in levels seen in the samples. Again, we have indicated good news with a green title and unwelcome news with a red one.
% of all % of all students who students who enjoy all or think cannabis most lessons at is always school unsafe This rose between 2005 and 2007 and 2005 2007 2009 has not declined. 2005 2007 2009 % of all % of all students who students who smoked last think solvents week are always unsafe
2005 2007 2009 2005 2007 2009 % of all % of all students who students for never smoked whom school is main source of information about drugs
2005 2007 2009 2005 2007 2009 % of all % of all students who students who never drink know a drug user
2005 2007 2009 2005 2007 2009
Page 10 (108) % of y10 % of all students who students who taken cannabis spent nothing last week An interesting change! This cannot be explained by increased saving. 2005 2007 2009 2005 2007 2009 % of all % of all students who students who say safety eat sweets on going out after most days dark is good
2005 2007 2009 2005 2007 2009 % of all % having no students for portions of whom school fruit and is their main vegetables source of yesterday information about sex
2005 2007 2009 2005 2007 2009 would prefer drop-in sexual Note for statisticians: even modest differences can still health service be significant, because we have large samples. The 95% to be at school confidence limits for these observations are around (top was health ±3%, and significance testing with ANOVA confirms centre ~40%) that they are unlikely to arise through chance alone.
60 2005 2007 2009 55 % of all 50 students who 45 think condoms are reliable to 40 stop infections 35 30 25 20 2005 2007 2009 2005 2007 2009
% of all students who know a drug user F=3.3, p = 0.001
Page 11 (109) Credits We are grateful to the teachers, schools, and young people for their time and contributions to this survey: Stantonbury Campus, Walton High School, Ousedale School, Shenley Brook End School and The Lord Grey School.
The Way Forward – and over to you As a result of their work we have excellent data to be used by schools, Milton Keynes Council, the PCT as well as other statutory and voluntary agencies that support the health of young people in Milton Keynes. This work will inform action plans for joint working between and within organisations involved in improving the health and well-being of pupils in schools, including the Children and Young People's Plan. We invite everyone reading this report who has contact with young people – whether as a parent, teacher, community leader, volunteer or in some other role – to think about what the findings mean for young people in the area, and think about what you might be able to do to make healthier choices easier for them.
Contact For further information about the survey contact: Terry Brown, Healthy Schools Co-ordinator [email protected] Tel no: 01908 233 001 The full findings are accessible at www.mkiobservatory.org.uk
Milton Keynes Healthy Schools Programme The aims of the National Healthy Schools Programme (NHSP) are:
* to support children and young people in developing healthy behaviours; * to help to raise pupil achievement; * to help to reduce health inequalities; and * to help promote social inclusion.
To find out more about the National Healthy Schools Programme, visit www.healthyschools.gov.uk.
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