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Under the Well-being of Future Generations (Wales) Act 2015, certain public bodies, including local authorities and local health boards, have a duty to contribute to the achievement of a number of well-being goals. One of these goals is 'A Healthier Wales - a society in which people's physical and mental well-being is maximised and in which choices and behaviours that benefit future health are understood.’
In 2012, the Welsh Government published a Tobacco Control Action Plan, covering the period up to 2020. This is an all-age action plan, but one of its four strategic areas is ‘reducing the uptake of tobacco use, especially amongst children and young people’.
The Action Plan set a target of reducing smoking levels to 20 per cent by 2016 and to 16 per cent by 2020, with the ultimate aim of a smoke-free Wales where the harm from tobacco has been eradicated.
Action Area Two, reducing the uptake of smoking, has two strands:
- preventing young people from starting to smoke
- reducing access to tobacco products by young people.
A Tobacco Control Delivery Implementation Board was set up to carry the strategy forward.
Measures which have been legislated for include:
- Since 6 April 2015, small shops less than 280 square metres have had to cover their tobacco displays. Large stores removed their tobacco displays in December 2012.
- From 1 October 2015, it became illegal to smoke in private vehicles when someone under the age of 18 is present.
- From 1 October 2015, it became an offence to sell electronic cigarettes to someone under the age of 18. Purchasing these products on behalf of a minor was also made an offence.
The Public Health Wales Act 2017 prohibits the handing over of tobacco and/or nicotine products to a person under the age of 18.
In September 2017, a delivery plan for the tobacco control action plan was published, covering the period 2017-2020. This reviewed progress, including the reduction in tobacco consumption to 19 per cent by 2016/17. It also takes account of new UK-wide legislation, which has required that, since 20 May 2017, tobacco products are sold only in drab-coloured packaging, with large graphic images on the front and back of the packets to highlight the negative health effects of smoking.
New actions concerning young people include:
- securing the ongoing engagement and involvement of children and young people in the development and implementation of smoking prevention plans
- reviewing actions to reduce the availability of tobacco to young people under the age of 18 in light of the best international evidence, and making recommendations for action in Wales (e.g. test purchasing and penalties for suppliers).
Following an open consultation in summer 2019, the Substance Misuse Delivery Plan 2019-2022 was published in October 2019 which outlines priorities for the Welsh Government for 3 years, building on the previous ‘Working Together to Reduce Harm’ 2008-2018 strategy and aligning with ‘A Healthier Wales’ the wider health and social care policy. The 2019-2022 plan maintains the 5 key aims of previous plans which are:
• preventing harm;
• support for individuals – to improve their health and aid and maintain recovery;
• supporting and protecting families; and
• tackling availability and protecting individuals and communities via enforcement activity.
• working with partners to support the development of the substance abuse workforce
Key priority areas for action include:
• Responding to co-occurring mental health problems which are common in substance misuse.
• Ensuring strong partnership working with housing and homelessness services to further develop the multi- disciplinary approach needed to support those who are homeless or at risk of homelessness
• Improving access to services and ensuring people get the support and treatment when they need it.
A Review of Sexual Health in Wales was conducted in 2017/2018. This recognised the pressure on the existing service model and made a number of key recommendations including adding services to increase capacity through the provision of more drop-in clinics and delivery of bespoke services in certain settings, and making oral regular contraception available through an enhanced service within all community pharmacies. The overall aim is to reduce the inequity that exists in the current service provision.
The Sexual Health Service Specification 2018 was developed by Public Health Wales as a result and designed to encompass a model of integrated service delivery based on national policy, best practice, local health needs, and evidence based practice.
The most recent sexual health action plan for Wales went up to 2015. This has not subsequently been refreshed or replaced. Key themes of the all-age plan concerning young people were ensuring a rights-based approach; encouraging the participation by children and young people in the development of sexual health information and services; and the importance of sex and relationships education, both in schools and other settings:
Some of the young people most vulnerable to teenage pregnancy or sexual ill health may not attend school or may respond better to SRE [sex and relationships education] delivered in a community based setting. Training and guidance needs to be developed to support those delivering SRE outside the school setting. For example, Young Offenders Institutions, residential homes, Further and Higher Education settings, and the youth sector (p.10).
Though not specified to young people, the NHS Wales Planning Framework 2020-23 outlines priority areas for sexual health up to 2023. These include increasing accessibility to contraception and treatment for STIs.
Encouraging healthy lifestyles and healthy nutrition for young people
As a response to the 2020 COVID-19 pandemic, the Welsh Government committed to extending free school meals to eligible students throughout the summer holidays.
The Welsh Government’s programme for government for 2016-2021 contains a commitment (p.8) to:
work with schools to promote children and young people’s activity and awareness of the importance of healthy lifestyle choices.
The Welsh Network of Healthy School Schemes launched in 1999. This developed from the European Network of Health Promoting Schools, and is a national network of local healthy school schemes which support schools in their area to promote health.
The ‘Healthy School’ is one which takes responsibility for maintaining and promoting the health of all who ‘learn, work, play and live’ within it, not only by formally teaching pupils about how to lead healthy lives, but by enabling pupils and staff to take control over aspects of the school environment which influence their health. It actively promotes, protects and embeds the physical, mental and social health and well being of its community through positive action.
Within the scheme, there are seven different health topics that schools need to address:
- food and fitness
- mental and emotional health and well-being
- personal development and relationships
- substance use and misuse
An independent assessment for the National Quality Award takes place once a school has reached Phase 6 of the local healthy school scheme, after eight to nine years of active involvement.
In 2015, the Healthy and Sustainable Higher Education / Further Education Framework was developed as an extension of the healthy schools programme. Both programmes are managed by Public Health Wales.
The framework is split into six health topics and four aspects of college and university life. The health topics cover mental and emotional health and wellbeing, physical activity, healthy and sustainable food, substance use and misuse, personal and sexual health and relationships, and a sustainable environment.
The aspects of college and university life cover; governance, leadership and management; facilities, environment and service provision; community and communication; and academic, personal, social and professional development.
The UK-wide UK Healthy Universities Network is part of a global movement which helps its members to develop and implement ‘whole university’ approaches to health, well-being and sustainability. It seeks to build a strong movement of universities committed to creating health-enhancing cultures and environments; enabling people to achieve their full potential; and contributing to the well-being of people, places and the planet.
The Network aims to facilitate peer support, share information and guidance, advocate for Healthy Universities and encourage research and development.
The Healthy Eating in Schools (Nutritional Standards and Requirements) (Wales) Regulations 2013 place a duty on local authorities and the governing bodies of maintained (publicly funded) schools to promote healthy eating in schools.
To ensure they are serving nutritious food to learners schools must:
- not serve confectionery (such as chocolate and sweets) and savoury snacks (such as crisps)
- increase the availability of fruit and vegetables
- limit the number of times that meat products and potatoes cooked in fats and oils are served each week
- serve only healthy drinks, such as water and milk.
The School Holiday Enrichment Programme (SHEP), ‘Food and Fun’, is a school-based programme that provides good quality meals, food and nutrition sessions, physical activity and enrichment sessions to children in deprived areas during the summer holidays.
In 2016, the Welsh Local Government Association (WLGA) piloted the SHEP model nationally in ten schools, working with five local authorities and three local health boards. Cardiff University provided an evaluation report in January 2017.
The Welsh Government part-funded a further roll-out of the programme in 2017 to 39 school settings across 12 local authorities in all seven regional health boards, enabling approximately 1500 children to access at least 12 days of Food and Fun over the six-week summer holiday.
Individual CAP schemes bring together local retailers and licensees, trading standards, police, health services, education providers and other local stakeholders to tackle these problems. While CAP is funded mainly by alcohol retailers and producers, local schemes may receive funding from a range of other sources, e.g. local authorities and Police Forces.
The All Wales School Liaison Core Programme (AWSLCP) is a crime prevention programme funded jointly by the Welsh Government and the four Welsh Police Forces. The programme focuses on:
- drugs and substance misuse
- social behaviour and community
- personal safety.
The programme involves formal lessons delivered by uniformed police in the classroom. Information and resources for teachers, pupils and parents to enable them to follow up on the lessons provided by the School Community Police Officers are available on the schoolbeat website.
The School Health Research Network is a network of secondary schools in Wales who have joined up with researchers, the Welsh Government and other organisations to support young people’s health.
Its aim is to improve health and well-being through helping schools in Wales to work with researchers to generate and use good quality evidence about health improvement.
Health education and healthy lifestyles education in schools
Health education is included within Personal and Social Education (PSE), which is a curriculum requirement at both Key Stage 3 (ages 11-14) and Key Stage 4 (ages 14-16) of secondary education.
Health and emotional well-being is one of the themes of PSE, with the aim of equipping learners ‘to live safe, healthy lives’. Within health and well-being, learners are expected to be given opportunities to ‘accept personal responsibility for keeping the mind and body safe and healthy’, and to have opportunities to understand:
- the short and longer term consequences when making decisions about personal health
- the personal, social and legal consequences of the use of legal and illegal substances
- the factors that affect mental health and the ways in which emotional well-being can be fostered
- the statutory and voluntary organisations which support health and emotional well-being
- how to access professional health advice and personal support with confidence.
The wellbeing of learners is an aspect of the area of inspection wellbeing and attitude to learning under Estyn, the inspectorate’s common inspection framework. According to the guidance handbook for secondary schools, under the wellbeing heading, inspectors should consider how well pupils:
understand how to make healthy choices relating to diet, physical activity and emotional wellbeing, including how to keep themselves safe online. They should consider how well pupils use this understanding in their own lives in school and respond positively to opportunities to undertake physical activity, for example during lessons, at break and lunchtime and through after-school clubs and activities.
Food and Fitness in the Curriculum in Wales (WG, 2009)
In Key Stages 3 and 4, pupils in maintained (publicly funded) schools must also be provided with sex and relationships education (SRE) for which the Welsh Government provides a range of guidance documents.
SRE is included within the framework for Personal and Social Education (PSE). Learners at Key Stage 4 (ages 14-16) are expected to be given opportunities to ‘develop a responsible attitude towards personal relationships’, and to have opportunities to understand:
- the range of sexual attitudes, relationships and behaviours in society
- the importance of sexual health and the risks involved in sexual activity including potential sexual exploitation
- the features of effective parenthood and the effect of loss and change in relationships.
The UK-wide PSHE Association, the subject association for personal, social, health and economic education, makes available a wide range of teaching resources.
However, from September 2020, under new proposals, all pupils will study compulsory health education as well as new reformed relationships education in primary school and relationships and sex education in secondary school. Read more about what is involved in the curriculum here.
Peer-to-peer education approaches
Girlguiding Cymru Peer Educators are Guiding Members aged 14 to 25 (Senior Section) who have attended a basic training weekend and run sessions on a variety of topics, including health-related ones, for their peers. This includes members of the Girlguiding movement and young people outside the movement aged 7+.
The Volunteering Matters 'Sex Matters Too' project uses a peer-led approach to help raise young people’s awareness of issues surrounding healthy relationships, while aiming to increase protective factors against potential exploitation. Young volunteers, aged 16-25, are trained to deliver workshops on sex and healthy relationships to their peers. The project is funded by the Big Lottery.
The Filter Future Leaders project, run by Ash (Action on Smoking and Health) Wales, and supported by the Erasmus+ programme and the Welsh Government, aims to empower young people to educate their peers about important smoking-related issues specific to their communities. The project seeks to develop young people and help them create their own training plan and resources to deliver workshops and sessions to their local youth centres or schools.
Sexpression:UK is a UK-wide, student-led independent charity that empowers young people to make decisions about sex and relationships through the provision, by university students, of sex education workshops in schools and community settings. The scheme delivers informal, near-peer lead sessions on bodily changes and puberty; safe sex, STIs (sexually transmitted infections) and contraception; sex and consent; relationships and abuse; sexual orientation and gender and sex and the media. The core offer focuses on 14- to 18-year-olds.
Collaboration and partnerships
No information available.
Raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people
Public Health Wales, through its Public Health Network Cymru, is the main provider of public health information and services for all ages. Topics covered include alcohol, substance misuse, mental health, sexual health, smoking, obesity, physical activity and nutrition.
The Wales (all-age) Drug and Alcohol Helpline, also known as DAN 24/7 is hosted by the Betsi Cadwaladr University Health Board with funding provided by the Welsh Government. It offers a free bilingual helpline service for individuals, their families, carers and support workers seeking access to information or help relating to drugs and/or alcohol.
The (all-age) Time to Change Wales anti-stigma campaign is delivered by a partnership of three leading Welsh mental health charities and receives lottery, charity and Welsh Government funding. It aims to improve knowledge and understanding about mental illness and so raise awareness and remove stigma and discrimination.
The Welsh Government has also been running the Change4Life campaign since 2010. Its aim is to suggest small achievable changes that families can make to live healthier lives. The campaign began in response to particular concerns regarding rising levels of obesity.
Meic is a helpline service for children and young people up to the age of 25, funded by the Welsh Government. It provides advice, information and advocacy on all areas of concern to children and young people.
The Filter project, funded through the Big Lottery, raises awareness of the effects of smoking and runs cessation projects. Information is provided through a website, workshops in schools, youth centres, Pupil Referral Units, young parent groups, etc. and social media.