To ensure the voices of Merton people are fed into south west London wide projects allowing them to influence decisions at all levels within the NHS, we work with the South West London Health and Care Partnership team to deliver on projects. Reports are published on the SW London website, to view the reports of our partnership projects, click on the links below.
Trailblazer: Improving emotional support in Schools for Children & Young people
Background and purpose
Across South West London (SWL) we have a high number of children who are self-harming, and we want both to address and prevent this by developing consistent wellbeing support and early intervention.
We aim to reduce the number of children self-harming in South West London through a 'whole system', multi-agency approach, using health, education and local authority resources to provide support in schools to parents and carers and children and young people.
Merton CCG, as part of the South West London Health and Care Partnership, works closely with a cluster of schools in the borough to introduce enhanced support for emotional wellbeing. Having secured funding to establish an innovative 'trailblazer' programme to pilot new approaches to working with children and young people to support them to develop resilience and to get easy and rapid access to specialist help if they need it.
We have worked to ensure the project is informed by the views and experiences of children, young people, parents and carers, and will continue to be built on this foundation as we take forward this important programme.
Our engagement aimed to seek feedback from children and young people around key areas within individual school audits in order to Influence the development of individual school and cluster action plans and interventions. We plan to continually enhance student voice within schools to support future engagement work and as part of best practice
We delivered engagement workshops with each of the schools in the Merton cluster. We worked with individual schools to understand their channels of communication within school, consent processes, existing mechanisms for engagement and previous engagement around emotional wellbeing and resilience.
Working alongside the emotional wellbeing leads within each school, we drafted a session plan, drawing out key areas from the action plan that children and young people were most able to influence. Once the plan was drafted, we worked with each individual school to tailor; content of the session plan; wording and format for different age ranges and agreed how the session would be delivered to foster collaboration and partnership working.
The agreed session plan covered, student voice, school support, school vision and values and peer support and bullying.
Of the 8 engagement sessions delivered, 2 were with secondary schools and 6 were with primary schools. We spoke with 84 children, within the ages of 6-17years old (year 1- year 12), of mixed genders and mixed ethnicities.
Key messages included;
Generally a good understanding and awareness of mental health and wellbeing amongst young people.
School vision and values – some children were clear on what these are were and had ideas on what else could be included. Some children could not recall the schools vision and values but were happy to share what they thought they should be.
Student voice – Good practice in place for children and young people to be involved, but greater promotion needed and methods reviewed. Students value the opportunity to give their voice and would like to encourage more inclusive methods to collate feedback from a more representative sample of the school and involvement in the action plans
School support – children feel able to speak to some school staff for support but better signposting is needed about who to talk to and the choices available. Students understand the value of confidentiality and this needs to be taken into consideration for support mechanisms for example location of worry boxes.
Resilience and emotional wellbeing - Students had a good understanding of resilience and would like more opportunities to build resilience and improve emotional wellbeing.
Outcomes and next steps
Each school has developed a set of actions which will be taken forward based on feedback and consideration will be taken about how the actions will be appropriately monitored throughout the year. One of the 8 schools have asked an engagement session to be delivered after a years' time, to assess impact.
Actions set by the schools included;
- The school will implement an application form for friendship monitors and recruitment to the posts will be based on skill and who will be suitable for the role.
- A specification will be devised for the school prefect's role, to encourage and facilitate them in having more responsibilities within school.
- All ideas raised in the school council, will be fed back to the whole school during an assembly.
- Have a voting system for major changes in school – allow all children to have a view.
- Implement friendship benches in school.
- Give students a better understanding of buddy benches – School Council to deliver an assembly and promote its benefits
- In the new academic year, when the new School Council representatives have been chosen, an assembly to highlight the role to the whole school
- 'Something I would Like My Teacher To Know' box / worry boxes provided in every class
We have evaluated all aspects of the engagement process to improve engagement in future. This evaluation has veen shared with schools so through shared learning, consideration can be taken to improve engagement within school.
Our key learning included;
- Better collaboration – Engagement leads to codesign engagement sessions and materials with teachers and students. More direction given on the questions so the right insight can be collected.
- The purpose and value of the session wasn't always clear at the beginning. Towards the end of the engagement activity teachers reported engagement was valuable and gave them a greater understanding of the children's perspective of emotional wellbeing and support available.
- Presence – ensuring those involved are representative and supported to give their feedback.
- We had a good representative sample, however the selection of students who attended the session could have been improved, as there was an emphasis on students who had a strong voice and were members of the school council. Further work could be done to reach the least heard.
- Some younger students could have been involved but needed extra support to join the discussions.
- It would be helpful for teachers to co-lead the session or be present in the room.
- The timeliness of the sessions could have been earlier in the academic year and been aligned with the school audits and not in the exam period. Less pressure on teachers to fit in the sessions.
- Impact – more understanding needed on how we will be monitoring how the feedback has been actioned and the results.
We have shared an evaluation of the project and our key learnings with South West London colleagues, to enhance the engagement work which will be done with all of the cluster schools across South West London.
Click on the link to read our report.
Children & Young people - from addressing self-harm to developing emotional resilence
We know that across South West London (SWL) we have a high number of children who are self-harming, and we want both to address and prevent this by developing consistent wellbeing support and early intervention.
We aim to reduce the number of children self-harming in South West London through a ‘whole system’, multi-agency approach, using health, education and local authority resources to provide support in schools to parents and carers and children and young people.
Since our partnership came together in early 2018 we have established a cluster of schools in each borough that is working with each of our CCGs and with other health agencies and higher education partners to introduce enhanced support for emotional wellbeing. We have also secured funding to establish an innovative ‘trailblazer’ programme to pilot new approaches to working with children and young people to support them to develop resilience and to get easy and rapid access to specialist help if they need it.
Our work is informed by the views and experiences of children, young people, parents and carers, and will continue to be built on this foundation as we take forward this important programme.
How have we involved children, young people, parents and carers.
In the summer of 2018 we engaged children and young people and parents and carers, as well as teachers and schools to examine root causes of self-harm and poor emotional wellbeing, as well as to test a number of potential solutions. We accessed children and young people primarily through voluntary sector organisations and schools in each of the south west London boroughs. We ran 8 meetings and we spoke to 42 young people, and had over 1200 responses to our online survey.
Click on the link to read our can read report, which outlines what people have told us. An easy read version is also available.
How have we responded so far?
In response to what we heard we have:
- Narrowed down our long-list of possible interventions to a shorter list that children, young people, parents, carers and teachers told us would work for them.
- Developed a diverse model of support that is based outside of a medical environment – in schools – and that includes one-to-one and group sessions for children and young people, online self-help and counselling, an online directory of services and education/training programmes for parents and teachers
- Secured funding to deliver some innovative ways to deliver emotional wellbeing initiatives through schools, using newly trained mental health support workers who will be based in schools.
What happened next?
We wanted to ensure that children understood what services were available to them. To help achieve this we set out to engage with young people around the language they use to describe mental health and emotional wellbeing, in order to develop effective communications. When communicating with children and young people we have to speak in a language they understand, using words they associate with their own lives and experiences. If we are encouraging them to seek support and change their behaviour, we need to do this in a way which resonates with them.
Insight work with young people in all six boroughs was carried out in May and June 2019 through two rounds of focus groups, ten in total. The objective of the first sessions was to explore how young people understand mental health, how they deal with it and language they associate with it. Focus groups were held with year 5s, year 8s and one session with SEND young people from Carew Academy. We asked year 5s and SEND young people how they would define words like sad and happy, as well as worried or stressed and asked them to describe photos depicting young people in a variety of scenarios. We asked year 8s much broader questions about how they feel about the world around them and what ‘health’ and ‘mental health’ mean to them.
The application of this learning was to develop a campaign to encourage 11-18 year olds to use an online mental health services called Kooth through schools. We used the learning from the sessions with year 8s to develop messaging. We used the second round of focus groups to test these messages and design propositions for the campaign materials in the form of posters.
The sessions were facilitated by CCG comms and engagement leads from the boroughs. The SWL programme comms and engagement leads commissioned a company which specialises in marketing for young people, Giraffe, to design the sessions, analyse the feedback and produce the attached report on our learnings. The report has been shared with our schools and those who shared their views. It was deigned to support children and young people to understand the findings.
Click on the link to read theSWL Children and young peoples mental health insight report.
Feedback captured in a child friendly slide pack and presented back at schools and steering group to explain how their feedback influenced language and look of campaign and online services. Click the link to read the Child friendly slide pack
Winter and Pharmacy campaign
In order to reduce the pressure on A&E during the winter months, we have worked with local people to develop a campaign to encourage patients with minor illnesses to visit their local pharmacist. We wrote a survey which was sent to our 3000 people’s panel members to find out insight about their use of pharmacy services. We specifically wanted to find out
• Level of awareness around what services that pharmacists provide
• Level of awareness around which ailments that pharmacists treat
• What would encourage people to use pharmacists more often
• How people locate their nearest pharmacy
The results were very helpful and helped shape our campaign. We developed an infographic which illustrates what we found out and how this influenced our work. This has been shared with our panel and via social media.
Click the link to view theinfographic
Grassroots Programme 2017/18
NHS England provided a grant to the south west London collaborative commissioning team in March 2016 to run a programme of engagement extending reach into seldom heard communities. With the success of the 2016/17 project, the grassroots funding was extended into 2017/18.
The project worked with Healthwatch organisations across south west London and provided small grants to local grassroots groups to run events/activities enjoyable to their population. We attended these sessions to speak to people about their experiences of local services.
By providing a pot of money to local Healthwatch organisations, we were not only able to capitalise on the extensive community connections that they had developed with local grassroots organisations, but we were also able to strengthen our own relationship with them as key stakeholders in health and care.
In Merton, through the grass roots engagement programme, we spoke to more than 270 people between August 2017 and September 2018. We visited nine different organisations who work with local people who:
- Have mental health issues
- Come from areas of socio-economic deprivation
- Are from different races and religions
- Are the oldest and youngest in the local area
- Have experienced domestic violence
- Have recently given birth
- Have a learning disability
We asked local people about their experiences of health and care in Merton. They spoke to us about issues ranging from how to make the best use of social media, right through to how to improve mental health services.
To support us to reach these diverse communities, we joined
forces to produce a survey with Unique Talent when asking young people
attending Limes College about gangs. We also developed easy read questions to support discussions with learning disabilty groups. Other sessions ranged from formal forum meetings to community fun days.
Feedback from each session was captured and shared with commissioners and providers, the organisers of the events and with Healthwatch Merton – to enable it to inform local developments.Feedback from the sessions was used to help determine our commisioning priorities and inform the commisioning intentions.
Feedback was used to enhance local plans as well as informing and shaping plans on a pan south west London and Surrey Downs basis. A "you said, we did" report is currently being drafted to demonstrate what has been done because of the feedback and we will be sharing this widely with those we spoke to, as well as linking to this on our website. You can read the "you said, we did" report from 2016/17 on the south west London website.