Joint memorandum by the Department of Health and the Department for Education and Employment (PH 87)
1. The Government's Healthy Schools Programme was launched in 1998. It is funded and managed jointly by the Department of Health and the Department for Education and Employment, with the support of the Schools and Young People Team at the Health Development Agency (HAD). It is a major investment in the future health of the nation.
2. The aim of the programme is to give every school the chance to become a healthy school. A healthy school is one where:
good health and social behaviour underpin effective learning and academic achievement, which in turn promotes long term health gain (para 4.17, 'Saving Lives: Our Healthier Nation', 1999).
3. The Department of Health evidence to this Inquiry has already referred to the link between education and health as a way of improving the health of school age children, both in the short and long term (para 3.10).
4. The programme comprises four elements:
 the National Healthy School Standard;
 the Young People's Health Network;
 the Wired for Health website; and
 Supporting programmes, such as Cooking for Kids and Safe and Sound.
5. This memorandum deals with all of these elements. The Standard is the main instrument by which schools are engaged in the work of the overall programme and their efforts formally recognised. The memorandum also outlines the context of the establishment of the programme, considers the progress of the programme, and examines its role as a vehicle in promoting a range of public health partnerships.
6. All schools are encouraged to participate in the programme, and Ministers have set targets to reflect this aim. These targets focus on local partnerships which draw together Local Education Authorities (LEAs) and corresponding health authorities, and schools.
 Over half of local partnerships to have achieved accreditation under the National Healthy School Standard by April 2001 (Number of LEAs = 150).
 All partnerships to have achieved accreditation by April 2002.
 A majority of schools will have had the opportunity to participate in the programme by April 2002 (number of schools = 26,000).
7. 14 LEAs covering 4,589 schools have already gained accreditation under the Standard. They are listed in annex 1. The process of accreditation is accelerating. A further 65 LEAs are taking part in the current round of accreditation, due to be completed in April. This is in line with the first target.
The remaining partnerships are on schedule to gain accreditation by April 2002. A note of how the Standard worksand how accreditation is securedis attached as annex 2.
8. This collaboration between the Departments of Health and Education and Employment at national level, and between healthy school co-ordinators and professionals in the field at local level has helped develop a sense of shared ownership of the programme. It also shows how Departmental priorities can be matched and progressed to develop complementary outcomes of improved health and education. These outcomes will be measured in a national evaluation of the Standard next year. The Healthy Schools Programme offers a model for engaging all school age children across a range of public health and educational objectives in a clear and consistent format.
9. The Healthy Schools Programme was established as part of the emerging public health strategy, set out in "Saving Lives: Our Healthier Nation" White Paper (1999), and against the background of the "Excellence for Schools" White Paper (1997). It explicitly linked the benefits for school children of good health and educational achievement. The Acheson report on health inequalities (1998) noted the various ways in which education influences health inequalities, not least its role in influencing future socio-economic positiona key indicator of health status.
10. The potential of schools as a "setting" for targeting health messages and improving health behaviours of children and young people has long been recognised. A lot of work has focused on single topic areas in the past but this has suffered because of its peripheral relevance to schools' concerns. The WHO Health Promoting Schools scheme recognised this weakness and emphasised the need to associate health messages with the delivery of the curriculum. A recent evaluation found that this approach could lead to gains in pupils' knowledge, attitudes, self esteem and health behaviours despite the small number of schools associated with this scheme.
11. The Healthy Schools Programme has taken account of these factors and developed a "whole school" approach, which rests on the involvement of everyonepupils, staff, parents, governors and partner agencies. The National Healthy School Standard was built on this approach and developed through a process of consultation, including an audit of current practice and school case studies. It also reflected the lessons of eight pilot projects undertaken in the first year of the Programme (1998-99).
WHAT IS A HEALTHY SCHOOL ABOUT?
It is about creating a school environment, which promotes the health and well being of individuals. It teaches the life skills they need to assess and resist risks to health, offers the information to make healthy choices and fosters the confidence they need to strive for and achieve the best they can. The examples below offer an insight into their work.
12. The National Healthy School Standard was launched in October 1999. The challenges it faced included: establishing a credible scheme which adds value to the work of schools; developing sustainable local partnerships to support schools and local communities in raising achievement and improving health; and, achieving a high level of school participation across the country. Those working to implement the Standard have been helped by its systematic development through consultation, the identification of good practice and evidence, and the use of the "whole school" approach.
13. The link with the National Curriculum is a powerful factor in encouraging school participation. The new statutory status of Citizenship from 2002 and the revised guidance on Personal, Social Health Education (PSHE) read across to the themes of the Standard (such as drug education, healthy eating and physical activity). Importantly, the Standard is cited in QCA guidance as evidence of meeting National Curriculum objectives.
Chapel Break First School in Norfolk developed its PSHE into other curriculum areas. The reception class worked on three health-related modules: "me and my body", "me and my environment and community" and "me and my relationshipsfamily and friends", and it has seen a steady improvement in its SATs results.
14. The Standard comprises:
 Guidance for LEAs and health authorities to support the development of local healthy school programmes.
 Funding through partnerships to help develop local programmes.
 An accreditation process by which the quality of support provided to schools by local programmes is independently assessed.
 Co-ordination, support, training and networking between programmes facilitated by a team of national, regional and local co-ordinators.
15. The Standard operates at two levels: through local education and health partnerships, and through local schools. All LEAs and health authorities have joined together to develop healthy school programmes and work towards meeting the Standard, with other bodies. This will, in turn, allow them to recognise achievements in schools. The Chief Education Officer and Director of Public Health sign joint plans. Funding is provided by both Departments and drawn down through the DfEE Standards Fund. £5.7 million has been made available to support these local partnerships in the current year (2000-01) on a basis which takes account of the different numbers of schools within each LEA.
16. The Standard is also supported through the Standards Fund support for PSHE. £10m will be available next year through this support. This is £3m more than was available last year. This funding is fully devolved to schools and available for use exclusively at the discretion of schools.
At St Peter's CE Junior School in Wigan skills learnt from the textbook in the classroom were supported by the school's healthy eating programme, reinforced by good examples from teachers, a healthy tuck shop and healthy choices available at meal times. Parents became more involved with the school and children visit Leigh Rugby League Club to underline the value of healthy eating and exercise.
17. Linked to the National Grid for Learning, the Wired for Health (WfH) website provides accurate information about health issues appropriate to groups targeted by age, disseminates information about the healthy schools programme and the National Healthy School Standard, and provides support materials for teachers for use in the classroom.
18. WfH has an important role to play in providing examples of good practice at both national and local level. It ensures that young people and their teachers can access relevant and appropriate health information at the touch of the button. There are five WfH websites:
 www.wiredforhealth.gov.ukthe teachers' site
 www.mindbodysoul.gov.ukKey Stage 4 (14-16 years-of-age)
 www.lifebytes.gov.ukKey Stage 3 (11-14 years-of-age)
 www.welltown.gov.ukKey Stage 2 (7-11 years-of-age)
 www.galaxy-h.gov.ukKey Stage 1 (4-7 years-of-age)
17. The sites for Key Stages 1 and 2 are still under development and are planned for launch in January. WfH is linked to over 250 other websites. A website for 16+ students is also under consideration for launch later in 2001.
18. The Acheson report on inequalities highlighted the difficulties in reaching all children within the school setting. The Young People's Health Network reaches a school age audience outside of the school setting. It exchanges information, ideas and examples of good practice among relevant professionals. It also involves young people in health and education programmes, training events, and links with other networks/organisations through a range of databases, networks and directories. The recent work on young men's health has generated considerable interest and activity on the health issues facing young men.
Physical activity was identified as a priority for Lily Lane primary school in Manchester from a health survey carried out by the Healthy Schools Team. To improve the health and fitness of older pupils, it was decided to add two extra physical activity lessons into the timetable and monitor the benefits. The children have enjoyed the opportunity to develop their skills, increase their fitness and have fun with friends.
19. A range of related programmes and projects support the Healthy Schools Programme. These projects support the work of the Programme and encourage the involvement of schools in this work.
 The NHS Plan announced a National School Fruit Scheme where every child in nursery and aged four to six in infants schools will be entitled to a free piece of fruit each school day, as part of a national campaign to improve the diet of children. Pilots to examine the practicalities of the scheme before rolling it out nationally were launched in 32 schools in November.
 Cooking for Kids promotes healthy eating and basic cooking skills, including food hygiene. A one-day course in school holidays, it provides a child the opportunity to prepare, cook and eat a meal in an informal and relaxed atmosphere. It is often used as a way of introducing children to their new secondary school. Over 15,000 children from over 600 schools have participated in the project.
 Safe and Sound is a challenge scheme, which offers schools the opportunity to develop healthy ways of travelling to school, with cash prizes to the most innovative schemes. It aims to improve physical activity by reducing the number of children travelling to school by car, through the use of establishing safe cycle routes.
 Breakfast Club projects have been established in each health region to test the impact on health and educational improvement of such provision. These projects are currently being evaluated with a final report due in June.
20. The Healthy Schools Programme is an important vehicle for a range of related policy initiatives aimed at school age children. All education and health partnerships have appointed programme co-ordinators, designated people in both health authorities and education departments who co-ordinate this work.
21. The co-ordinators are well placed to act as a conduit between the schools and wider health and educational worlds. They have helped recruit and support schools into the Standard and worked to influence Health Improvement Programmes and Education Development Plans. They work with other health and education agencies, including Health Action Zones and Education Action Zones. They link with other local co-ordinators on Teenage Pregnancy, School Sports and with Local Drug Action Teams. The aim of this work is to mobilise additional support and resources for the Healthy Schools Programmes. In return, it offers access to a vehicle which provides access to young people of school age and a range of tools like the Standard and Wired for Health which can contribute to the common goal of improving young people's health in areas where the most benefit will be felt.
22. The co-ordinators are recognising the role of health authorities and primary care groups and trusts. It is difficult for individual schools without the support of the co-ordinators to understand how health services are provided and how to draw on these skills and services. Equally for health agencies an improved understanding of how schools and the National Curriculum work will help them direct their efforts more effectively for this age group.
In Sefton the healthy schools programme has facilitated joint working between key agencies. It has brought in a school nurse to work with the healthy schools team, and negotiated a five year service agreement with the Health Education Unit to support this work. It has also got its work written into the HIMP by the health authority so that the healthy schools programme now sits within the new primary care strategic planning framework.
23. The Standard also underpins the Government's strategy to improve sport in schools, where £750m will be invested in school sports facilities as part of a £1 billion investment. It sets out an expectation that pupils should have a minimum of two hours physical activity per week. The HDA's Schools and Young People's Team is working closely with Sport England on Active Schools and Sportsmark. There are also links with DCMS on physical activity and school sports where over 600 co-ordinators have been established in areas of greatest need.
24. Public Health and Schools Standards Ministers have been closely involved from the beginning of the Programme. Ad hoc Ministerial Group oversees the programme and the development of the Standard. Ministers also jointly chaired the PSHE Advisory Group, and currently chair an Inter-Ministerial Group on Improving Children's Diet and Physical Activity.
25. As well as DCMS, broader links with other Government Departments include DETR on Safe and Sound and the wider "Safe Travel to Schools" initiatives, and MAFF and the Food Standards Agency on diet and nutrition issues, including the National School Fruit Scheme.
26. These links underline some of the multiple benefits of working together. For example Safe and Sound encourages physical activity and road safety and can reduce pressures on the school run. Breakfast clubs improve diet and nutrition and improve a child's attentiveness in morning classes and can reduce anti-social behaviour in the school neighbourhood.
The future development of healthy schools programme
27. The Healthy Schools Programme has a key part to play in carrying forward a number of health and education priorities. These include teenage pregnancy, drugs, healthy eating and physical activity, and they will continue to be relevant in the future. It has a role to play in the implementation of the NHS Plan (2000) which highlights the need to narrow the health gap in childhood and abolish childhood poverty. It is soundly built for this purpose by:
 its structured framework developed in consultation with, and supported by, education and health professionals;
 its whole school approach and links with the National Curriculum gives it the potential to reach all schools; and
 its role as a vehicle for promoting partnerships and links with other relevant initiatives.
28. It also provides an example of standards based health activity which will serve as a model for others. By evaluating the outcomes and building on its achievements, the Healthy Schools Programme can help carry forward the work of Sure Start and other programmes designed to break the cycle of deprivation and promote health, social and emotional development as well as education attainment.
Joint memorandum by the Department of Health and the Department for Education and Employment (PH 87)
1. The Government's Healthy Schools Programme was launched in 1998. It is funded and managed jointly by the Department of Health and the Department for Education and Employment, with the support of the Schools and Young People Team at the Health Development Agency (HAD). It is a major investment in the future health of the nation.
2. The aim of the programme is to give every school the chance to become a healthy school. A healthy school is one where:
good health and social behaviour underpin effective learning and academic achievement, which in turn promotes long term health gain (para 4.17, 'Saving Lives: Our Healthier Nation', 1999).
3. The Department of Health evidence to this Inquiry has already referred to the link between education and health as a way of improving the health of school age children, both in the short and long term (para 3.10).
4. The programme comprises four elements:
 the National Healthy School Standard;
 the Young People's Health Network;
 the Wired for Health website; and
 Supporting programmes, such as Cooking for Kids and Safe and Sound.
5. This memorandum deals with all of these elements. The Standard is the main instrument by which schools are engaged in the work of the overall programme and their efforts formally recognised. The memorandum also outlines the context of the establishment of the programme, considers the progress of the programme, and examines its role as a vehicle in promoting a range of public health partnerships.
6. All schools are encouraged to participate in the programme, and Ministers have set targets to reflect this aim. These targets focus on local partnerships which draw together Local Education Authorities (LEAs) and corresponding health authorities, and schools.
 Over half of local partnerships to have achieved accreditation under the National Healthy School Standard by April 2001 (Number of LEAs = 150).
 All partnerships to have achieved accreditation by April 2002.
 A majority of schools will have had the opportunity to participate in the programme by April 2002 (number of schools = 26,000).
7. 14 LEAs covering 4,589 schools have already gained accreditation under the Standard. They are listed in annex 1. The process of accreditation is accelerating. A further 65 LEAs are taking part in the current round of accreditation, due to be completed in April. This is in line with the first target.
The remaining partnerships are on schedule to gain accreditation by April 2002. A note of how the Standard worksand how accreditation is securedis attached as annex 2.
8. This collaboration between the Departments of Health and Education and Employment at national level, and between healthy school co-ordinators and professionals in the field at local level has helped develop a sense of shared ownership of the programme. It also shows how Departmental priorities can be matched and progressed to develop complementary outcomes of improved health and education. These outcomes will be measured in a national evaluation of the Standard next year. The Healthy Schools Programme offers a model for engaging all school age children across a range of public health and educational objectives in a clear and consistent format.
9. The Healthy Schools Programme was established as part of the emerging public health strategy, set out in "Saving Lives: Our Healthier Nation" White Paper (1999), and against the background of the "Excellence for Schools" White Paper (1997). It explicitly linked the benefits for school children of good health and educational achievement. The Acheson report on health inequalities (1998) noted the various ways in which education influences health inequalities, not least its role in influencing future socio-economic positiona key indicator of health status.
10. The potential of schools as a "setting" for targeting health messages and improving health behaviours of children and young people has long been recognised. A lot of work has focused on single topic areas in the past but this has suffered because of its peripheral relevance to schools' concerns. The WHO Health Promoting Schools scheme recognised this weakness and emphasised the need to associate health messages with the delivery of the curriculum. A recent evaluation found that this approach could lead to gains in pupils' knowledge, attitudes, self esteem and health behaviours despite the small number of schools associated with this scheme.
11. The Healthy Schools Programme has taken account of these factors and developed a "whole school" approach, which rests on the involvement of everyonepupils, staff, parents, governors and partner agencies. The National Healthy School Standard was built on this approach and developed through a process of consultation, including an audit of current practice and school case studies. It also reflected the lessons of eight pilot projects undertaken in the first year of the Programme (1998-99).
WHAT IS A HEALTHY SCHOOL ABOUT?
It is about creating a school environment, which promotes the health and well being of individuals. It teaches the life skills they need to assess and resist risks to health, offers the information to make healthy choices and fosters the confidence they need to strive for and achieve the best they can. The examples below offer an insight into their work.
12. The National Healthy School Standard was launched in October 1999. The challenges it faced included: establishing a credible scheme which adds value to the work of schools; developing sustainable local partnerships to support schools and local communities in raising achievement and improving health; and, achieving a high level of school participation across the country. Those working to implement the Standard have been helped by its systematic development through consultation, the identification of good practice and evidence, and the use of the "whole school" approach.
13. The link with the National Curriculum is a powerful factor in encouraging school participation. The new statutory status of Citizenship from 2002 and the revised guidance on Personal, Social Health Education (PSHE) read across to the themes of the Standard (such as drug education, healthy eating and physical activity). Importantly, the Standard is cited in QCA guidance as evidence of meeting National Curriculum objectives.
Chapel Break First School in Norfolk developed its PSHE into other curriculum areas. The reception class worked on three health-related modules: "me and my body", "me and my environment and community" and "me and my relationshipsfamily and friends", and it has seen a steady improvement in its SATs results.
14. The Standard comprises:
 Guidance for LEAs and health authorities to support the development of local healthy school programmes.
 Funding through partnerships to help develop local programmes.
 An accreditation process by which the quality of support provided to schools by local programmes is independently assessed.
 Co-ordination, support, training and networking between programmes facilitated by a team of national, regional and local co-ordinators.
15. The Standard operates at two levels: through local education and health partnerships, and through local schools. All LEAs and health authorities have joined together to develop healthy school programmes and work towards meeting the Standard, with other bodies. This will, in turn, allow them to recognise achievements in schools. The Chief Education Officer and Director of Public Health sign joint plans. Funding is provided by both Departments and drawn down through the DfEE Standards Fund. £5.7 million has been made available to support these local partnerships in the current year (2000-01) on a basis which takes account of the different numbers of schools within each LEA.
16. The Standard is also supported through the Standards Fund support for PSHE. £10m will be available next year through this support. This is £3m more than was available last year. This funding is fully devolved to schools and available for use exclusively at the discretion of schools.
At St Peter's CE Junior School in Wigan skills learnt from the textbook in the classroom were supported by the school's healthy eating programme, reinforced by good examples from teachers, a healthy tuck shop and healthy choices available at meal times. Parents became more involved with the school and children visit Leigh Rugby League Club 
to underline the value of healthy eating and exercise.
17. Linked to the National Grid for Learning, the Wired for Health (WfH) website provides accurate information about health issues appropriate to groups targeted by age, disseminates information about the healthy schools programme and the National Healthy School Standard, and provides support materials for teachers for use in the classroom.
18. WfH has an important role to play in providing examples of good practice at both national and local level. It ensures that young people and their teachers can access relevant and appropriate health information at the touch of the button. There are five WfH websites:
 www.wiredforhealth.gov.ukthe teachers' site
 www.mindbodysoul.gov.ukKey Stage 4 (14-16 years-of-age)
 www.lifebytes.gov.ukKey Stage 3 (11-14 years-of-age)
 www.welltown.gov.ukKey Stage 2 (7-11 years-of-age)
 www.galaxy-h.gov.ukKey Stage 1 (4-7 years-of-age)
17. The sites for Key Stages 1 and 2 are still under development and are planned for launch in January. WfH is linked to over 250 other websites. A website for 16+ students is also under consideration for launch later in 2001.
18. The Acheson report on inequalities highlighted the difficulties in reaching all children within the school setting. The Young People's Health Network reaches a school age audience outside of the school setting. It exchanges information, ideas and examples of good practice among relevant professionals. It also involves young people in health and education programmes, training events, and links with other networks/organisations through a range of databases, networks and directories. The recent work on young men's health has generated considerable interest and activity on the health issues facing young men.
Physical activity was identified as a priority for Lily Lane primary school in Manchester from a health survey carried out by the Healthy Schools Team. To improve the health and fitness of older pupils, it was decided to add two extra physical activity lessons into the timetable and monitor the benefits. The children have enjoyed the opportunity to develop their skills, increase their fitness and have fun with friends.
19. A range of related programmes and projects support the Healthy Schools Programme. These projects support the work of the Programme and encourage the involvement of schools in this work.
 The NHS Plan announced a National School Fruit Scheme where every child in nursery and aged four to six in infants schools will be entitled to a free piece of fruit each school day, as part of a national campaign to improve the diet of children. Pilots to examine the practicalities of the scheme before rolling it out nationally were launched in 32 schools in November.
 Cooking for Kids promotes healthy eating and basic cooking skills, including food hygiene. A one-day course in school holidays, it provides a child the opportunity to prepare, cook and eat a meal in an informal and relaxed atmosphere. It is often used as a way of introducing children to their new secondary school. Over 15,000 children from over 600 schools have participated in the project.
 Safe and Sound is a challenge scheme, which offers schools the opportunity to develop healthy ways of travelling to school, with cash prizes to the most innovative schemes. It aims to improve physical activity by reducing the number of children travelling to school by car, through the use of establishing safe cycle routes.
 Breakfast Club projects have been established in each health region to test the impact on health and educational improvement of such provision. These projects are currently being evaluated with a final report due in June.
20. The Healthy Schools Programme is an important vehicle for a range of related policy initiatives aimed at school age children. All education and health partnerships have appointed programme co-ordinators, designated people in both health authorities and education departments who co-ordinate this work.
21. The co-ordinators are well placed to act as a conduit between the schools and wider health and educational worlds. They have helped recruit and support schools into the Standard and worked to influence Health Improvement Programmes and Education Development Plans. They work with other health and education agencies, including Health Action Zones and Education Action Zones. They link with other local co-ordinators on Teenage Pregnancy, School Sports and with Local Drug Action Teams. The aim of this work is to mobilise additional support and resources for the Healthy Schools Programmes. In return, it offers access to a vehicle which provides access to young people of school age and a range of tools like the Standard and Wired for Health which can contribute to the common goal of improving young people's health in areas where the most benefit will be felt.
22. The co-ordinators are recognising the role of health authorities and primary care groups and trusts. It is difficult for individual schools without the support of the co-ordinators to understand how health services are provided and how to draw on these skills and services. Equally for health agencies an improved understanding of how schools and the National Curriculum work will help them direct their efforts more effectively for this age group.
In Sefton the healthy schools programme has facilitated joint working between key agencies. It has brought in a school nurse to work with the healthy schools team, and negotiated a five year service agreement with the Health Education Unit to support this work. It has also got its work written into the HIMP by the health authority so that the healthy schools programme now sits within the new primary care strategic planning framework.
23. The Standard also underpins the Government's strategy to improve sport in schools, where £750m will be invested in school sports facilities as part of a £1 billion investment. It sets out an expectation that pupils should have a minimum of two hours physical activity per week. The HDA's Schools and Young People's Team is working closely with Sport England on Active Schools and Sportsmark. There are also links with DCMS on physical activity and school sports where over 600 co-ordinators have been established in areas of greatest need.
24. Public Health and Schools Standards Ministers have been closely involved from the beginning of the Programme. Ad hoc Ministerial Group oversees the programme and the development of the Standard. Ministers also jointly chaired the PSHE Advisory Group, and currently chair an Inter-Ministerial Group on Improving Children's Diet and Physical Activity.
25. As well as DCMS, broader links with other Government Departments include DETR on Safe and Sound and the wider "Safe Travel to Schools" initiatives, and MAFF and the Food Standards Agency on diet and nutrition issues, including the National School Fruit Scheme.
26. These links underline some of the multiple benefits of working together. For example Safe and Sound encourages physical activity and road safety and can reduce pressures on the school run. Breakfast clubs improve diet and nutrition and improve a child's attentiveness in morning classes and can reduce anti-social behaviour in the school neighbourhood.
The future development of healthy schools programme
27. The Healthy Schools Programme has a key part to play in carrying forward a number of health and education priorities. These include teenage pregnancy, drugs, healthy eating and physical activity, and they will continue to be relevant in the future. It has a role to play in the implementation of the NHS Plan (2000) which highlights the need to narrow the health gap in childhood and abolish childhood poverty. It is soundly built for this purpose by:
 its structured framework developed in consultation with, and supported by, education and health professionals;
 its whole school approach and links with the National Curriculum gives it the potential to reach all schools; and
 its role as a vehicle for promoting partnerships and links with other relevant initiatives.
28. It also provides an example of standards based health activity which will serve as a model for others. By evaluating the outcomes and building on its achievements, the Healthy Schools Programme can help carry forward the work of Sure Start and other programmes designed to break the cycle of deprivation and promote health, social and emotional development as well as education attainment.