1. SASH Introduction to Somerset Public Health?
Alison Bell
Consultant in Public Health - Somerset County Council
Katherine Doran
Deputy Head of Children and young peoples division Somerset Partnership NHS Foundation Trust
I have been appointed to improve the health and well being of children and young people in Somerset. I work in the Public Health team and historically I think education and public health have strong links, building on a strong Healthy Schools programme. As part of my induction I met with exec leads and Rob invited me here today to meet secondary headteachers and explain my role, how we can work together and a few requests.
Aim – to introduce public health services and one of our key providers who deliver PH nursing

2. Public Health
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’
WHO 1946
108,609 children aged 0-17 years in Somerset. 20.3% population (2012)
Majority of children and be should be healthy
NHS focused on those above the after level, PH looks at whole population, our diagnostic tools are not stethscopes, but data and indicators

3. Three Pillars of Public Health. 1. Health Promotion
Public Health Intervention Ladder
Eliminate choice
Restrict choice
Guide choice through disincentives
Guide choice through incentive
Enable choice
Provide information
Do nothing of simply monitor the situation
What PH is known for, but working with CYP more sophisticated, if you tell them not to do something, likely they will want to try out. Understanding more about adolescent brain – testing self, synapses reorganising, risk and experimentation
PH instrumental in getting smoking stopped in public places – took several decades – impact? Nudge theory – promote social norms – disaster of ad campaign targeted at young people warning that a night out could end in A&E if you drink too much, social research found out this became a desirable outcome, not the intention that was required!
Locally the school health and lifestyle survey is being used by schools to work on areas of priority utilising resources from new website – and Fiona Moir and Teresa Day. Specifically healthy lifestyle programme

4. Three pillars of Public Health 2. Health Services
Work with CCG to inform clinical commissioning
Commission Public Health Services
Sexual health services
Somerset Drugs and Alcohol Partnership
Stop Smoking Services
Healthy weight services
School Nursing services
…next year Health Visitors
In a rural county such as Somerset access to health services is a real issue for young people. School nurses provide weekly clinics in all secondary schools, to provide a young people friendly accessible services to promote health (drugs, alcohol, sexual, health, emotional health and well being, bereavement, healthy weight,
From October 2015 we will comisiosn HV – key area is year developmental check, to identify if met milestoines and if not intervene to ensure child is supported to develop appropriately and is school ready by 4 so that they come to school ready to learn
In future childhood flu vaccination will be undertaken for primary school age children – why

5. Three Pillars of Public Health 3. Health Protection
Working in conjunction with Public Health England
Tackle infectious diseases
Spotty Book – delay in being updated
Infection control guidance in schools
Absence and exclusion associated with infectious diseases
Prevention better than cure. Hand Hygiene and exclude symptomatic
Story where a teacher leaving a secondary school, all the parents brought in a plate of food – result 60 children absent from a secondary school and all had to stay off for 48 hrs post cessation of symptoms. All consultants in Somerset are on the out of hours health protection rota.
The pooled
relative risk of diarrhoeal disease associated with not
washing hands from the intervention trials was 1·88 (95%
CI 1·31–2·68), implying that handwashing could reduce
diarrhoea risk by 47%. Curtis and cairncross 2003

6. Working Together: The Links Between Health & Education
Health and education are strongly connected:
Children spend a large proportion of their time at school
Health education, through the formal curriculum is important, recognising that “to lead a healthy life is, to some degree, a matter of making the right choices”
Schools can also promote health and wellbeing through providing a whole school environment that has a positive impact on both physical and mental wellbeing, e.g
Teachers can model positive health behaviours, which will influence how children behave now and in the future.
Health behaviour is a learned behaviour and skill based on making choices  
healthy children achieve better results at school, which in turn are associated with improved health later in life .
and thus schools have the
main common inspection framework there will be a new judgment on personal development, behaviour and welfare for September 2015 with a specific focus on keeping healthy, exercise and healthy eating, particularly with regard to school food
potential to be a powerful domain of influence on children’s health.

7. Public Health Offer to Schools
1. HV to deliver integrated developmental check by Sept 2015
2. Emotional health and well being:
launched mental health toolkit, MindEd and self harm information
Bath Spa University commissioned to deliver emotion coaching to CYP workforce
Rise above it
3. Biannual HWB survey
4. Health Improvement Award and support from PH team to deliver and website of lots of useful info, lessons plans, policies
5. Children’s Food Trust
6. Supporting children in school with a medical condition – directory. PIMS training
7. School nursing
years promoting resiklience
5. which provides resources and support for schools to increase school meal take up and healthy eating
6. With the introduction of the CFA 2014 Governors carrying out their statutory duty to make arrangements to support pupils at school with medical conditions, we have worked with community paed nurses to provide directory of services / help. But we need you to ensure your school has adequate staff who have attended the termly PIMS training which covers anaphylaxis, epilepsy, diabetes, CF and astma. Individual children need a plan and we are working to clarify this process. But the onus is on schools to ensure they have staff trained, as SN can no longer keep providing ad hoc training on particularly epi pens. Next training 19th March in Taunton

8. Working Together: The Health Improvement Award for Education Settings
Foundation Level - Biennial Health Audit
Actions for achieving Foundation Level – Health Audit
Register your school or setting via our website:
Complete the Biennial Health Audit
Record and upload evidence to indicate you are achieving required Foundation Level standard
Advanced Level – Targeted Intervention Programme
Actions for achieving Advanced Level - Targeted Intervention Programme:
Achieve Foundation Level status (by completing a Biennial Health Audit)
Undertake a needs analysis
Identify an Area of Health Improvement
Select an outcome
Establish a baseline
Plan and deliver a programme of universal and /or targeted actions
Review progress against your baseline measure
Record outcomes
Education policy in England increasingly encourages schools to maximise students’ academic attainment and ignore their broader wellbeing, personal development and health (the schools white paper 2010.) The National Healthy Schools programme no longer benefits from government funding and Ofsted reports provide limited focus on how well schools promote students health or personal development.
Health and education are strongly connected: healthy children achieve better results at school, which in turn are associated with improved health later in life .
I can only achieve my objective of improving the health and well being of children in Somerset by working together with schools,

9. School Nursing
This service is visible, accessible and confidential, which deliver universal public health and ensure that there is early help and extra support available to children and young people at the times when they need it.
They should also include services to help children and young people with illness or disability within the school and beyond.
The service model is set within the Healthy Child Programme 5-19 which is based on best evidence to promote and protect the health of children in the developing years. 
The role involves a range of skilled activities and communications at individual, group and community level. It includes health promotion, advice, signposting to other services, active treatment/procedures, education, support, protection, safeguarding and service co-ordination

10. School Nursing service for Somerset
Delivered over four main areas in Somerset Sedgemoor, Taunton, South Somerset and Mendip
The teams comprise of public health qualified nurses as well as registered nurses and support practitioners
Members of the team work term time only as well as all year round
Each school will have a named school nurse
Support and services offered will vary depending on identified need
The key public health priorities are accidents alcohol and drugs smoking cessation mental health obesity nutrition and physical activity sexual health and teenage pregnancy safeguarding and promoting children and young people’s welfare immunisation supporting young carers.
Aim to deliver a clinic in every secondary school in Somerset

11. Contacts:
Kathy Doran
 Deputy Head for Children and Young People’s Division
Divisional Manager for Public Health Nursing ,Integrated Paediatric therapies and Integrated Lifestyles Service
Community Health Services
Somerset Partnership NHS Foundation Trust
hs.uk
Tel:
Alison Bell
Consultant In Public Health
Somerset County Council
Tel:
Mobile:

12. Questions