The Healthy Schools initiative continues to be a thriving joint programme, reports Varya Shaw

As health initiatives that straddle health and local government go, the National Healthy Schools Programme is an elder citizen. Eight years after it began, it is an example of what can be achieved when the two sectors work together. Input from schools leads to healthier populations, while input from the NHS - according to some head teachers - leads to rising attainment in education.

When Healthy Schools started in 1999 it was voluntary, so implementation was left to local will and interpretation. However, a national Healthy Schools status accreditation was introduced in September 2005. The status is awarded following a stringent assessment. Schools have to meet standards across four themes - personal, social and health education; physical activity; healthy eating; and emotional well-being.

A national target was set for 50 per cent of schools to achieve the status by December last year. This has been missed - by June only 36 per cent of schools had achieved it. Now, the target is for 55 per cent of schools to have the status by the end of 2007. Sheffield primary care trust is already there: by the end of July, 55 per cent of its schools had made the grade.

Sheffield is not unusual in its programme being led by the local authority. However, genuine joining up has taken place with dedicated teams in both council and PCT working together closely.

A Department of Health spokesperson said: 'Sheffield is a strong Healthy Schools programme that is meeting its targets. The PCT makes a significant contribution to the programme, working to build and maintain effective partnerships with the local authority and other key players.'

Bethan Plant, Sheffield PCT health improvement principal for children and young people and Healthy Schools, says: 'We've been delivering the programme since its start back in the 1990s. We're quite unique here in Sheffield because we have a team which is part of the PCT and the local authority.'

Ms Plant manages five staff, each of whom are responsible for a specialism such as healthy eating, sexual health, substance misuse or social and emotional aspects of learning. Each works as a consultant to a number of schools, and organises additional support on a particular area if requested.

'I have a colleague in the local authority who works very closely with me with a team he manages that delivers the programme in schools, so it's a true partnership,' she says.

That colleague at Sheffield city council is Chris Howard, school improvement adviser for personal, social and health education and Healthy Schools. He says joining up at strategic level has been key: 'At a very high level, the PCT directors are talking to the chief executive of the council. It all comes under our strategic 0-19 partnership board which includes the voluntary sector and youth service, not just health and local government.'

Such collaboration has helped the area bid successfully for funds, and so hire more staff.

Support in kind

But Mr Anderson stresses: 'We are also deploying our manpower in a targeted, sensible way. Because we've got that team we can then support schools, but also monitor them and know where they are in developing the work to achieve national Healthy Schools status.'

He adds: 'We could then traffic-light schools as to their likelihood of reaching the status by this July, so we knew which schools to give extra support to.'

Investment by the health side has also been helpful: 'There's a lot of in-kind support. Bethan is paid for by the PCT, not the grant that comes to the city. The phone and the office are paid for by the PCT.'

Measurements of the impact of the scheme are vague. Mr Anderson says: 'Nationally [the government] is frustrated it hasn't managed to glean harder evidence, which people want.'

But the programme does lead to some tangible improvements for the PCT. 'Tackling childhood obesity, teenage pregnancy, these are targets we are aiming to achieve,' says Ms Plant. She says each PCT has a target to measure the weight of 80 per cent of reception year and year six children. Partly thanks to Healthy Schools, Sheffield has done well on this target, 'which will then have a knock-on effect in delivering the public service agreement target to halt the year-on-year target rise in obesity by 2010', says Ms Plant.

The weight data has been used to work out which schools need most input, to target resources effectively.

The programme also reportedly improves educational outcomes. An evaluation published by the government in December found that just under a quarter of headteachers thought the programme was helping to raise achievement.

Anecdotal evidence suggests the scheme helps boost school climate. 'Headteachers have commented that children feel safer, attendance has increased, there's a more positive ethos in schools,' says Ms Plant.

Mr Anderson adds: 'We've done evaluations of heads and teachers, we've seen a good body of evidence to suggest behaviour is improving and children are more ready to learn. There's anecdotal evidence that youngsters are eating fruit during the day and persuading their parents to buy it.'

The government's evaluation also found that a fifth of headteachers said the programme was helping to tackle health inequalities.

Ms Plant says the programme 'is universal, so it's for all kids to be involved in' but they may offer accelerated support to schools in deprived areas.

'Healthy Schools, up until the new status, had the emphasis on targeting schools with 20 per cent free school meals,' adds Mr Anderson. 'With the new status, that was dropped. Now we've met the present target, we're thinking of putting more effort into schools in deprived areas.'