YouthWatch. our voice counts. School Nurse Report. Young People s views on a new High School Drop-in Service in Leeds

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1 YouthWatch our voice counts our voice counts School Nurse Report Young People s views on a new High School Drop-in Service in Leeds YouthWatch is the young person s group of

2 Healthwatch Leeds 2014 The text of this document (this excludes, where present, the Royal Arms and all departmental and agency logos) may be reproduced free of charge in any format or medium providing that it is reproduced accurately and not in a misleading context. The material must be acknowledged as Healthwatch Leeds copyright and the document title specified. Where third party material has been identified, permission from the respective copyright holder must be sought. Any enquiries regarding this publication should be sent to us at info@healthwatchleeds.co.uk You can download this publication from

3 School Nurse Report 2014 Contents Contents 2-4 Summary 5 Background 6-7 What we did 7-15 What we found Key Messages 18 Whats happening now? 19 Acknowlegements Appendices 1

4 School Nurse Annual Report Summary Both the school nurses and Healthwatch Leeds want to make sure that this service is designed around what young people want, to ensure that the drop-ins have the best chance of being accessed. About Us Healthwatch Leeds is an independent consumer champion of health and social care services in Leeds and aims to give people a powerful voice about these services. We are committed to ensure service providers and the commissioners (those that plan and buy services) - listen to the issues and concerns of people and use this information to shape and improve their services. We work hard to make sure that we include the people whose voices are not usually heard. YouthWatch is a group of young Healthwatch volunteers aged who are actively involved in helping us with any of our projects that relate to health and social care services accessed by children and young people. Why we did it? Leeds South and East Clinical Commissioning Group who commission (choose and buy) the school nursing service in Leeds are planning to commission Leeds Community Healthcare to roll out a health drop-in service for young people to every high school in Leeds. This does not include the Specialist Inclusive Learning Centres (SILCs) and Pupil Referral Units (PRUs) who have their own specialist services. Both the school nurses and Healthwatch Leeds want to make sure that this service is designed around what young people want, to ensure that the drop-ins have the best chance of being accessed. YouthWatch are working with the school nursing service to coproduce the new drop-in service. This report is part of that process. 2

5 Summary The majority of the young people we spoke to did not have a preference for which day of the week the drop-in was held, but most didn t state a preference for the weekend. Most wanted it to be after school and on the school site. Healthwatch Leeds brings an independent perspective to providing the school nurses with young people s views about what would work for them. What we did? Between July and September 2014, we gathered views from 342 young people aged about what they would like from a health drop-in service in high schools. We captured opinions using a questionnaire which was completed both face to face and online in a variety of settings such as Breeze on tour festivals, local colleges, schools and youth groups. Key findings We found that the majority of the young people we spoke to at schools where there is an existing drop-in Healthy Young People s (HYP) service were not aware of it, suggesting that it was not being promoted well enough. Young people said that they want to be able to see a health worker both in a drop-in setting and by making a one to one appointment. They want to be able to contact the health workers in a range of ways both directly by and text message, but also through teachers and school receptionists. The majority of the young people we spoke to did not have a preference for which day of the week the drop-in was held, but most didn t state a preference for the weekend. Most wanted it to be after school and on the school site. Young people wanted information about a broad range of issues and in a wide variety of formats that they could take away from a drop-in. 3

6 School Nurse Annual Report Summary 69% of young people wanted the dropin to be held on the school site. Young people thought the best ways to advertise the new service were: school website (55%), assemblies (55%), posters around school (49%), newsletters (41%) and the school intranet or moodle (32%). The preferred name for the new drop-in service was Open Door. 77% of young people wanted to take leaflets away with them from a drop-in. 75% of young people at schools where there is currently a HYP were not aware of it. 53% of young people said they would prefer to access a health worker through a drop-in. 45% said they would prefer to make a one to one appointment with a health worker. 7% of young people said they would not go to a drop-in service. 30% of these young people raised concerns about confidentiality as their reason for not wanting to attend. 4

7 Background Background Currently in Leeds, there are several Healthy Young Person s Clinics (HYPs) run in high schools as a partnership between school nurses and youth workers from Leeds City Council Health and Wellbeing Service. These drop ins give advice and information to young people about health issues. Only two of these HYPs remain out of seven, one in South Leeds Academy and one in Leeds West Academy. The remainder have closed and workers have reported that some of these clinics were not well accessed by young people. School nurses are not first aiders in school, they work from a health centre and visit lots of different schools. Their role is to help young people make healthy lifestyle choices and to give them advice and support about how to stay well and happy. Nationally, the Department of Health has the School Nurse Development Programme, which seeks to maximise and promote the school nursing contribution to improving health outcomes for children, young people and their families. As part of this, the British Youth Council produced the report Our School Nurse which captured young people s views on the role of the school nurse. The main findings of this was that school nurses should be visible, accessible and confidential. What we did? We gathered views from young people aged about what they would like from a health drop in service. We captured opinions using a questionnaire that was co-produced by young people from YouthWatch and school nurses. In total we spoke with 342 young people between July and September The survey was completed primarily at the Breeze on tour festivals across Leeds, but also in local colleges, schools 5

8 School Annual Nurse Report What we did and youth groups. There was also the opportunity to complete the survey online. The questionnaire asked young people: Whether they had accessed an existing HYP service and if so what they thought of it. When and where a health drop in should be run What information it should provide How it should be advertised and accessed What it should be called Whether they would access a drop in service if they needed to The survey contained 18 questions and took no more than 5 minutes to complete. All the participants gave verbal consent, could change their mind about taking part at any point, and were reassured about personal details being kept confidential and anonymous. The survey was mainly carried out by YouthWatch volunteers who were briefed about the project and relevant Healthwatch Leeds policies and procedures. Other people that helped with the survey were Healthwatch volunteers, Healthwatch staff, youth workers and school nurses. Who we spoke to A total of 342 young people aged took part in the survey. The majority of the people we spoke to were female (62%). We spoke to young people from all year groups. There was a fairly even spread across the year groups with the highest number from Year 12 (73 young people or 22%) and the lowest number from Year 7 (29 young people or 9%) and Year 13 (22 young people or 7%). We spoke to young people from 34 out of the 43 state funded 6

9 What we did/what we found high schools in Leeds. We also spoke to 33 young people who were in Further Education and 30 young people that didn t state which school or college they attended. 19 of the young people we spoke to went to schools that were outside of the Leeds Metropolitan District, and 5 young people went to private schools in Leeds. We have still used their data to inform this report as we feel it is still relevant to the purpose of this project. As can be seen from the chart in appendix 1, the numbers of young people from each school varied considerably from just 1 young person to 34. The schools/colleges attended by most young people we spoke to were Woodkirk Academy (34), Leeds City College (28), Roundhay High School (22), and Morley Academy (21). What we found We analysed the data by gender and by school/college year group. There were some small differences between what young women and young men wanted from a health drop in, but the most significant differences were between the year groups. Views about existing Healthy Young People services There was only a small number (12 young people) who attended Leeds West and South Leeds Academies where there is currently a HYP service in operation. Out of these 12, 75% of them were not aware of the HYP service in their school. 7

10 School Annual Nurse Report What we found How young people rated existing drop-in services Since this is only 4% of the total number of young people we surveyed, it perhaps limits the extent to which this survey can make judgements about the effectiveness of the HYP service in those schools. However, interestingly the figure of 75% mirrors the findings from the British Youth Council* that 69% of young people advised that they did not have information about how they could access their school nurse for help. Among the respondents in the two schools where the service operates, two people had used it. One rated it as good, the other as average stating that the service was not well known. Interestingly, a total of 86 young people who didn t attend either of the schools where there is currently a HYP service, thought that there was a HYP service at their school, and 62 thought they had accessed it. This implies that there is confusion about what a HYP service is, and stresses the importance of good clear branding and marketing. Despite the fact that young people were commenting on services that were not actually HYPs, there are some interesting insights into what makes a service good or excellent, rather than average or poor. See table above. Contacting the Health Worker The majority of young people (50%) said they would like to contact the health worker through their teacher, although it is important to note that there was a fairly even spread amongst the other options of (22%), text message (18%), school receptionist (15%) and phone (13%). There is a general increase through the year groups from 7 to 13, of wanting to contact a health worker via text or . 8 *Page 6, British Youth Council Report, Our School Nurse

11 What we found There s also a general downward trend of young people wanting to contact a health worker through their teacher, with younger pupils in Years 7-9 significantly preferring this option (69% of Year 7s compared to 36% Year 13s). 9 Young people stressed the importance of being able to contact the health worker directly and that there should be a way of doing it confidentially. One year 10 student said: go to their office to talk to them so no one has to know you have been to see them It is apparent that there is a need to have a range of ways that the health workers can be contacted, both directly by and text message, and through teachers and receptionists. 9

12 School Nurse Annual A&E Report What we found Drop-in or one to one appointment? We asked young people If you wanted to talk about any health issues at school, how would you prefer to do this? For both male and female young people, there was almost equal preference between wanting to access a health worker through a drop-in (53%), and through a one to one appointment based system (45%). The remaining 2% either skipped the question, or left a suggestion about how they would like to talk about health issues in school or college. Some of the YouthWatch volunteers who carried out the survey told us that some young people were unsure what the term drop-in meant. One young person asked whether it meant sitting with a group of other people in a room. Another person said they d go to a drop-in if it was a private drop-in. This suggests that some young people may be deterred from attending a drop-in, if it was not made clear that there would be a space where they could speak confidentially with a health worker. Other suggestions made by young people for making contact with the health worker were: have the health worker go around classes now and again to answer any questions that the pupils have and allow them to set up appointment and inform the pupils on things they may need to know (female, year 12) would like to speak to someone over the phone or web rather than face to face (Male, year 12) 10

13 What we found Young people that didn t opt for either drop-in or one to one appointment, said that they would prefer to talk about their health issues to their GP (4 young people), their mum (1 young person), or their teacher (3). Where and when should the service be held? Overall the preferred time for a drop-in was after school (48%), with lunchtime being the second highest (35%). This was consistent across the year groups apart from Year 7 where there was a slight preference for lunchtime (41%) over after school (31%). Before school and Saturday morning were least popular, only chosen by 10 % and 7% of young people respectively. The majority of the young people we spoke to did not have a preference for which day of the week the drop-in was held, with 58% saying any day would be fine. There were several comments which indicated that Saturday was not a popular option, such as definitely not on a weekend, not Saturday, any day except Saturday or Sunday. We asked young people where they thought the drop-in should be held. The majority of young people (69%) said they would prefer it to be in school. The second highest choice was in a local health centre (16%). When asked how far they d be willing to travel to a drop-in, again the majority (63%) said they d prefer it to be in school. One young person in year 12 said they thought it should be in school, because it s more comfortable for students. They don t have to go somewhere unknown 11

14 School Nurse Annual Report What we found Information and advice that young people want We asked young people to tell us what kinds of things they would like information and advice about at a drop-in. Both young men and young women wanted information about all the different options. In addition to this, one young person mentioned depression as one of the issues that wasn t covered. This highlights the importance of ensuring there is help and advice in general about mental health, not just stress and anxiety. For some options the gap between male and female responses was small, for example 30% of young men compared to 32% of young women would like advice on alcohol. Young men chose general health as an option more than young women, and chose the following options less than their female counterparts: friendship/ relationship problems, stress/ anxiety, self-harm, morning after pill and abuse (physical/ emotional). This implies that young women may be clearer about what their health and wellbeing issues are. As young people got older, they expressed more interest in seeking advice on health issues. This was most obvious for sexual health issues such as contraception, STIs, morning after pill and pregnancy testing. General health showed no real difference between year groups and anger, diet, stress/ anxiety showed less of a definite upwards trend, suggesting these are important issues for all age groups. We asked young people what types of information young people would like to take away with them. Leaflets were the most popular option (77%) 12

15 What we found followed by information about apps (39%) and website links (33%). As the chart shows on page 14, there was a fairly broad spread suggesting the importance of having a broad range of types of information at the drop-in. Other suggestions from young people were fact sheets about STIs, and information in large print font size 20 or above. This raises an important issue about having information that is accessible at the drop-in. Except for leaflets which were consistently popular, there was an upward trend for all types of information the higher the year group. Advertising the drop-in Young people thought the best ways to advertise the new service were: school website (55%), assemblies (55%), posters around school (49%), newsletters (41%) and the school intranet or moodle (32%). Other suggestions made by young people were Text messages and s, workshops and Personal Social Health Educational (PSHE) days where visitors can come and talk about health services. These suggestions were also popular with young people in the recent national survey by British Youth Council: Having a lesson about the school nurse, maybe a questionnaire to find out what services the pupils think the nurse can provide and then informing them what the nurse can actually do. An , poster or information board after this would also mean they knew where to go and when (Young woman, 17)*. *Page 14, British Youth Council Report, Our School Nurse 13

16 School Annual Nurse Report What we found What should the new service be called? We asked people to choose between the names Drop-in, Open Door, Talk Health or to suggest any of their own ideas. The first two names were contributed by the school nurses from research they d done into what similar services nationally were called. Talk Health was suggested by a Healthwatch Leeds worker. The favourite name was Open Door (38%), followed by Dropin (31%). There were also two good suggestions made by young people, #allthingshealth and #healthcentral. We wanted to give young people the opportunity to vote on these other names as well so after the original survey closed, we ran a quick poll in our YouthWatch group and online inviting young people aged to vote on their favourite name. The choice was between the top two from the original survey ( Open Door and Drop-in ) in addition to the two suggestions made by young people ( #allthingshealth and #healthcentral ). 27 young people voted in the quick poll, and the winning name was Open Door (37%), mirroring the result of the original survey. 14

17 What we found We wanted to give young people the opportunity to vote on these other names as well so after the original survey closed, we ran a quick poll in our YouthWatch group and online inviting young people aged to vote on their favourite name. Would young people access the service? When asked whether they would use such a health drop-in if they had a problem, 62% of young people said yes they would, 31% said maybe, and 7% said no, they wouldn t. This was spread fairly evenly across the year groups. Of the relatively small number (23) of young people that wouldn t access a drop-in, 7 people raised issues of confidentiality. no I wouldn t because it probably wouldn t stay confidential as school always end up telling and finding out things that has nothing to do with them where as if you go elsewhere to like a sexual health clinic it is kept confidential as people don t know who you are there like they do at school (Year 10, female) I don t like doctors or anything like, if I did go I would like things to be confidential (Year 10, female) I wouldn t feel comfortable (Year 12, female) would not trust school to keep it confidential. Even for health and safety some people would not want anyone else to know unless they told them they could say something (Year 10 female) These findings echo the British Youth Council s report Our School Nurse which found that, 39% of young people said it wasn t clear to them that they could receive a confidential service when visiting their school nurse. * Other young people said they d prefer to go elsewhere to get their health needs met: I prefer to deal with my health issues out of school-with my GP or a sexual health clinic. I d rather talk to my family about my problems or talk to my GP and my friends *Page 7, British Youth Council Report, Our School Nurse 15

18 School Annual Nurse Report Key Messages Young people want a service which is both flexible and accessible, providing a broad range of information of different types and formats. They want a service that is confidential. Our Key Messages Young people want a service which is both flexible and accessible, providing a broad range of information of different types and formats. They want a service that is confidential. Key to the success of the new service is good advertising and promotion. It needs to be advertised in a way that clearly explains what the service provides and there needs to be an emphasis on confidentiality. A flexible and accessible service Young people want to be able to see the health worker both through a drop-in and by making a one to one appointment. We think that both these options should be available to young people. They want to be able to contact the health worker either directly or through their teacher or the school receptionist. This means that it is vital that schools buy in to the service and all staff are made aware of it so that they can refer to it effectively. Young people want to be able to contact the health worker directly by or text message. We think that both of these modes of communication should be available in all high schools. The drop-in service should provide a variety of different information on different issues as well as general health and wellbeing. Young people were interested in a variety of formats, and the service needs to consider access needs when putting together this information, so that young people with different access needs are not excluded from the service. 16

19 Key Messages Advertising and Promotion of the drop-in It is clear from lack of awareness amongst young people of the existing HYP services, that any new service needs to be better advertised and promoted if it is to be well used. There needs to be clear branding so that people are aware of what the service offers to young people. Promotion of the drop-in should as a minimum include the following channels: school website, assemblies, posters around school, newsletters and the school intranet or moodle. Promotion needs to happen in different ways at different times through the young person s time at the school. This could be, for example, as recommended by the British Youth Council in their report: When entering secondary school, all young people should receive an induction about the role of the school nurse, the service on offer and how to access the service. * We think that there needs to be a planned approach to communications. It needs to be made clear in the advertising what drop-in means and that within the drop-in it is possible to speak to a worker confidentially. The term confidentiality should also be explained. Any publicity should also make young people aware of their options eg. different ways of contacting the health worker, the possibility of making a one to one appointment with a health worker if this is preferred, and how they can do this. Promotion of the drop-in needs to happen with both young people directly and to staff within the schools, including the receptionists, so that they know how to refer or signpost effectively. *Page 7, British Youth Council Report, Our School Nurse 17

20 School Annual Nurse Report Report What s happening now? What s happening now The school nursing service has welcomed this report, and we are meeting regularly with them to ensure that our messages are listened to. They are planning to pilot the new drop in services in three Leeds high schools with a view to rolling it out to all Leeds high schools in the future. some posters and credit card sized leaflets to promote the drop in. YouthWatch has been working with the Communications team from Leeds Community Healthcare to design a logo for the new drop in service. Young people helped develop four logos which were then put online for young people to vote on. The winning logo is pictured above. you can see the other designs in Appendix 2). Next steps will be for YouthWatch to help design 18

21 Acknowledgements Acknowledgments Thank you to all the young people who helped us by completing our survey. We would also like to say a big thank you to all of our YouthWatch volunteers who helped to create the questionnaire, carry out the survey and analyse all the data which has enabled us to put together this report: Also thanks to Laura Hobman (Breeze Team), Fran Kinchin (Woodkirk Academy) Julie Kurij and Helle Crisp, (School Nurses) for doing the questionnaire with young people they came into contact with. Sharmimah Matti Gurdesh Birdi Shanjida Ahmed Liv Powell Ernest Kusi Asante Mohammed Abdul Azim Sharon Asare Agyemang Rosie Brookes Claire Vaval Jevante Stewart Trizah Okingo Alice Wayman Daisy Cox Hannah McGibbon Aliane Uwase Rajjak Ahmed 19

22 Annual School Report Nurse Report Appendix 1 Schools attended by young people who took part in the survey 20

23 Appendix 2 Logo designs for the drop-ins 21

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