Key messages
Partnership working helps to realise health, educational, social and organisational gain, eliminating boundaries and bringing about better outcomes for children and young people.
Efforts should always be focused on the pupil, the resident and the patient. Care or services should be tailor-made for individuals.
Leadership within organisations and communities is an essential ingredient in partnership endeavours.
Why this matters to me
I have always been concerned that organisational change within the NHS has done more to exaggerate the differences between and within organisations than celebrate the connections. I am often struck by the rationale that prevents people working together which is linked to how organisations are structured and how roles are defined (or restricted) by directorates rather than objectives. So the question is this, ‘Is it time to look outside of our organisational constructs to achieve a set of shared objectives using the resources of many?’
The provision of the school nursing service has always been part of our ‘regular’ commissioned schedule. It is a service that supports the personal, social and health element of the educational curriculum. So when the opportunity came to do more to break down the barriers between health and education and join with our partners to create the opportunity to deliver on a set of shared objectives, we grabbed it with both hands. Here was the chance to truly embed health into the curriculum and offer the children in our community the best possible start on their life journey. It was something that the Office of the Schools' Adjudicator obviously recognised too because they awarded the contract to our partnership in the face of stiff competition from an academy. Lime Tree Primary School has the best of all worlds – it is at the heart of its local community, promoting sustainability, wellbeing, lifelong learning and an active lifestyle, supported by 21st century facilities and technology. As the school nears the half-way mark in its first year of operation, we applaud the varied activities they have already experienced, from yoga to gardening on the rooftop allotment and even an Extreme Reading Competition, which saw the joint winners reading a book while doing a snowplough down a mountain and another one perched on an airport carousel. We don't know yet what 2013 will bring in our joint venture, but we are sure of one thing, it will be rewarding and we will be extremely proud of our involvement in this marvellous collaboration which aims to meet our shared objectives.
Keywords: community, education, healthcare, partnership, public health
Abstract
Imagine what fun pupils would have at a school where the head dresses up as Dennis the Menace for World Book Day? And equally beneficial to the school, where parents can achieve a sustainable win–win by donating unwanted clothing, which is then sold to recyclers to boost school funds? These are the values that sustain Lime Tree Primary, Kingston's newest school which opened its doors in September 2012. Central to the school's ethos is the unique partnership between health and education that has transformed this fledgling primary school into a real community asset. The problem was a real one facing many local authorities today: a rising birth rate and too few classroom places; a new build seemed the obvious solution – and a real opportunity. Local children, their families, residents and professionals were interviewed and their ideas translated into proposals for the new school. A magical learning environment for local youngsters was created, embodied by the school motto, which recognises that a healthy body sustains better learning, and better learning leads to enhanced health benefits. The school lives and breathes ‘Healthy Body, Brain and Heart’ and transfers this into all its daily activities. And what of the future? There is no doubt that this type of initiative could be adopted in other parts of the new NHS. Wouldn't it be marvellous if other examples of like collaboration could help us jointly tackle the challenges of modern-day living?
In September 2012, the doors to the newly built school were proudly opened with three reception classes, a morning nursery class and special needs provision. Being a new school, there are first-rate facilities including a purpose-built kitchen for cooking lessons, a learning resource centre, wide corridors for extra learning space, a rooftop garden, an allotment for growing produce and a first-floor external teaching terrace. The unique element in this story is the partnership that had brought this into being. Curiously, one of those partners is the organisation that delivers community services for primary care in Kingston.
It all started with a tender to build a new school on an old hospital site to address an anticipated demand for additional primary school places. Within Kingston, there had been a long history of collaboration between the local NHS and the Local Authority to deliver a range of statutory services. So it was easy to have conversations about how to make the most of this new opportunity. There quickly developed the idea that building the school as a partnership between health and education would have the advantage of developing a curriculum that had health promotion and prevention embedded within the daily activities of the children.
As a newly formed social enterprise providing NHS community health and care services, Your Healthcare was in a position to become a founding partner in the initiative. To be eligible to apply, four health and education partners from the London Borough of Kingston upon Thames formed Surbiton Education Health Trust (‘the Trust’) as a formally constituted company that brings together the partner organisations of NHS Kingston, Your Healthcare CIC, Royal Borough of Kingston Education, and South West London NHS Support Partnership.
Shared vision
The partners all believe that education is the key to a long, happy and healthy life. The more educated you are, the healthier you are, and the healthier you are, the easier it is for you to access education. But we needed to know how to translate this ideal into practice.
At an initial partners meeting in April 2011, feedback from local people led the partners to believe that there was support to build a school that went beyond teaching health and wellbeing, to play a central role in building a healthy community. Our plans were informed by the ideas of local children who had been interviewed as part of a wider listening exercise. The aspirations of the children, their families and local professionals were translated into a key assertion, a motto for the school:
Healthy Body, Brain and Heart translates into the idea that a healthy body sustains better learning, and better learning leads to enhanced health benefits. The school lives and breathes this ethos, which is transferred into all its daily activities – whether it be learning, playing or eating.
Our partnership vision was to put health and educational excellence at the heart of Surbiton's new primary school, and the school at the centre of community life. We aimed for the school to act as a focus for the ideals of sustainability, wellbeing, lifelong learning and an active lifestyle, supported by 21st century facilities and technology.
Our bid to build the school described our aims that every child who attends the school will:
develop flexibility, curiosity, creativity and problem-solving skills
develop the confidence to take risks and to ‘have a go’
develop reflection and evaluation skills and the ability to learn from their successes and mistakes
show initiative, generate ideas and think for themselves
develop independence as well as collaboration and responsibility
develop self-awareness, integrity, tolerance and a respect for others, as well as their views
develop clear verbal, written and electronic communication and the ability to influence others positively
develop a respect for the environment
develop the knowledge and skills to ensure they have a healthy body, brain and heart
develop to become independent thinkers who make connections across areas of learning.
We called the school Lime Tree Primary School because while there is a lime tree on the school premises, there was also a desire to let the name reflect the school's ethos and its regard for sustainability and the living environment.
Progress at six months
The head teacher writes in his welcome letter:
The curriculum has a strong focus on the basic skills of reading, writing and mathematics, to ensure children have those vital skills for everyday use. Health is also a focal point which feeds into the curriculum through physical education, the development of social skills and emotional literacy, healthy eating, and raising awareness of wider health issues such as illnesses, diseases and immunisations. This is where our health partnership is invaluable. Underlying all of this is the development of independent thinkers who can explain how they have solved different problems. Children do not only develop knowledge, but they are then able to apply this knowledge across a range of situations. At the heart of the school is the partnership between the family, school and community.
The principles that started us on the journey are now driving the curriculum. The links to health and community engagement are strong. Each form is named after an innovator in healthy eating (Karmel, Orrey, Apple and Oliver) and in 2013 these forms will also adopt exercise-related names, building on the legacy of the London Olympics. Parents and guardians are strongly supportive of the school and the establishment of an active Parent and Teacher's Association in record time is an example of local eagerness. Father's Day in 2013 will be extended to involve uncles and grandfathers. Last year saw the men weeding at the school allotment and providing positive male role models for the children and it was the success of the initiative that met with a demand for more of the same in 2013. Mothers, grandmothers and aunties are not being left out either. There will shortly be a special day for them too. There is little room for gender stereotypes at Lime Tree. Examples so far of linking healthy body, brain and heart include international dressing up day, supermarket trips to buy fruit and vegetables (for ‘five-a-day’) and a Santa fun run in Richmond Park.
Broader reflections
This type of initiative could be adopted in other parts of the new NHS. NHS initiatives often focus on different disciplines delivering different tasks – health visiting and school nursing, for example. Although each focus is important, without a mechanism to integrate their efforts they will struggle to achieve anything more than the sum of their part contributions. In this instance, the school could become such a mechanism – providing regular reasons for children, families and communities of professionals to collide and work positively together.
Health and Wellbeing Boards can help to make this type of development more common, furnishing local communities with a vehicle for permanent and enduring health gain. Health and Wellbeing Boards are strategically positioned to see where gaps, joins and overlaps exist, and to facilitate integration of effort with mutual advantages. For example, when an overlap or duplication of service is noticed, the traditional approach would be to recommend that commissioners reduce the value of the contracts to secure a saving. Health and Wellbeing Boards might adopt a different approach and recommend that commissioners help partners to explore ways in which they could synchronise their activities to achieve things that are more than the sum of the parts.
There is an inherent excitement about this adventure that keeps all involved motivated and watchful for opportunities to enhance the existing plans. Health and Wellbeing Boards could stimulate such motivation by adopting a brokerage role that could contribute to the development of integrated care.
We know we have much more to learn in this adventure – and that is part of the excitement. It was Lewis Caroll in Alice's Adventures in Wonderland and Through the Looking-Glass (1865) who wrote:
No, no! The adventures first, explanations take such a dreadful time.