A health centre at Penair School

The integration of health and education is a goal that has been a driver in my thinking for many years. Education’s ability to deliver a high quality service to young people is often affected by health issues that are a feature of the lives of young people outside school.

In some ways, Penair School is idyllic.  Surrounded by outstanding natural beauty, the grounds are thick with trees and it would be easy to get the impression that students are growing up in an ideal area.  In fact, experience in Truro is very mixed.

There are pockets of great poverty, where children live their whole lives in just two or three streets.  Some may never have visited the coast, even though it is only 5 miles away.  There are areas where family members have been unemployed for three or four generations – with a huge effect on the eating habits, exercise and on life expectations of children.
Conversely there are children from wealthy families who may be time poor and in need of a chance to pause and reflect on their lives.

This mix of experiences comes together at Penair School.

In 2006, the Duchy Health Charity took the health of young people as the theme for its seminar. The actual title was Health challenges for young people in the 21st century- thinking across the boundaries. One of the statistics at the seminar was about the number of young people (the age of 12 years was mentioned) who are presenting with late onset diabetes as a result of poor diet and a lack of exercise.  These are not the shock-stats of the tabloid press, but something that we have seen amongst young people in Cornish schools.  It was this which prompted me to write a paper An integrated service model focused upon the health of young people in Cornwall: some thoughts and proposals.  It has since become the basis for our plans for a health centre at Penair School.

The Cornwall Community Strategy says that ‘The deprivation found in Cornwall has brought poorer health for the population and contributes to social exclusion’. The three main strands of the strategy are:

•  Individual well-being
•  Strong communities
•  Quality living environment

In addressing these three strands it is clear that the whole community has to work together, in particular across professional boundaries, to achieve a positive outcome; prevention of poor health is fundamental to the economic success of Cornwall.

To give an evidence base for the way Duchy Health structured the seminar, a questionnaire was circulated to local GPs, asking what issues they felt were most often brought to them by young people. The results closely matched the list put forward by the Youth Manifesto:

• Sexual health and relationships
• Drugs and alcohol abuse
• Mental health
• Weight, diet, obesity and exercise
• Aspiration and self-esteem

What do these needs look like on the ground?  In any cohort of pupils, there will be some sports enthusiasts who maintain the level of exercise common a generation ago.  But it’s noticeable that it’s become harder to motivate the more reluctant.  We also refer more children for mental health counselling. 

Although peer pressure has always been around, it’s now reinforced by images in the media and the nature of the peer pressure has changed.  Some children may feel they have failed socially if they have not had sex by the age of 14.   It’s been important for the school to try and instill knowledge and self-esteem much earlier so that teenagers don’t feel obliged to have ‘competitive’ sex.   They also need the knowledge to analyse the media images they see rather than accepting them at face value.

Health then, is strongly linked to knowledge and empowerment.  The Duchy Health Charity also asked young people what improvements they wanted in health services.  The list that they came up with was:

•  Existing health services to be more accessible and young people friendly
•  Drop in health clinics to be on school sites and that details of community provision should be available
•  More and better advice and facilities eg Brook
•  Good quality drugs and sex education in schools, delivered in schools
•  Outside agencies to work in schools covering topics such as drugs and alcohol awareness, sexual health and mental health
•  More support available for young people coping with depression and other mental illnesses
•  Health services to highlight clearly their confidentiality policy

Through our links with partner secondary schools in Rotorua, New Zealand, I knew of the drop-in Health Clinics that exist there; they appeared to be the answer to many of our concerns. But the paper, noted above, also called upon schools to support the proposal for Health Centres through the curriculum and through whole school initiatives such as Healthy Eating and Lifestyle programmes in all subject areas such as PE.

Over the following year a partnership representing the schools, the Local Authority, the Primary Care Trust, Duchy Health and the Prince’s Foundation for Integrated Health have worked together to devise a plan which will deliver three drop-in Health Centres on secondary school sites. This is a pilot project for which capital funding has been secured from the Duchy Health charity. The first centre should be open in the Spring of 2009.

Our students have been involved at every step of the planning and have represented their views directly to all the members of the steering group. Interestingly, students do not want to call our centre a Health Clinic or similar, they prefer words that suggest lifestyle but have yet to finally decide!