Primary schools on measles alert as vaccination rates plummet
Coverage for the two doses of the MMR vaccine in five-year-olds in England is currently 85.5%, well below the 95% that is recommended by the World Health Organisation (WHO) in order to stop measles from spreading.
Coverage of the first dose for 2-year-olds has also dropped to 88.6%. It means that more than one in 10 children are not fully protected and at risk of catching measles.
Measles is highly contagious and can lead to complications such as ear infections, pneumonia, and inflammation of the brain, which require hospitalisation and on rare occasions can lead to long-term disability or death.
Children are offered two doses of the MMR vaccine by their registered GP surgery, the first when they turn one and the second at around 3 years and 4 months, before they start nursery or school.
It is thought that COVID-19 lockdowns have prevented some parents from attending GP surgeries to take up vaccinations. However, this does not change the fact that MMR vaccination rates have been declining for some time now.
In 2017, the UK was given measles elimination status by the WHO, based on data from 2014 to 2016. However, it promptly lost this status in 2018 when there was a marked increase in the number of cases – with 991 confirmed cases in England and Wales compared with 284 cases in 2017.
Likewise, the Oxford Vaccine Group reports that the numbers of measles cases are currently high in several European countries. In Europe in 2018, there were 82 500 measles cases, more than three times as many as in 2017 and 15 times as many as in 2016.
New research commissioned by the Department of Health and Social Care and the UK Health Security Agency finds that many parents are ignorant of the risks they are taking.
Polling of 2 000 parents of children aged five and under found that half are not aware that measles can lead to serious complications such as pneumonia and brain inflammation and only 38% realise that measles can be fatal.
Two doses of the MMR vaccine give 99% protection against both measles and rubella and offer 88% protection against mumps. Since the introduction of the measles vaccine in 1968, the Oxford Vaccine Group estimates that 20 million measles cases and 4 500 deaths have been prevented in the UK.
However, despite this, a third of parents in the poll who expressed concern about the MMR vaccine said it is because they are worried about MMR side effects.
The NHS and the UK Health Security Agency have now launched a joint appeal to parents to get their young children vaccinated.
Dr Vanessa Saliba, consultant epidemiologist at the UK Health Security Agency, said: ‘The MMR vaccine offers the best protection from measles, mumps and rubella, which is why we're calling on parents and carers to make sure their children are up to date with their two doses.
‘Even a small drop in vaccine coverage can have a big impact on population immunity levels and lead to outbreaks. I would urge parents to check if their children are up to date with their MMR vaccines and if not to get them booked in as soon as they are able. It's never too late to catch up.’
Parents who are unsure if their child is up-to-date with all their routine vaccinations should check their child's Red Book (personal child health record) in the first instance and then contact their GP. The NHS has an information webpage tackling FAQs surrounding the MMR vaccine.
New report into the impact of breakfast clubs on children
Behaviour, eating habits, attainment, parental engagement – the positive impact of school breakfast clubs for children from low-income families has been spelt out in new research.
The evaluation has been published by Family Action and Magic Breakfast, which delivered the government's National School Breakfast Programme between 2018 and 2021.
The evaluation (2021) finds that the schools who hosted breakfast clubs reported that the provision had supported improvement across key areas, including:
- Improved pupil behaviour (94%).
- Healthier eating habits among pupils (95%).
- Readiness to learn (99%).
- Concentration in class (99%).
- Educational attainment (94%).
- Better social skills (93%).
- Better parental engagement (79%).
The schools also reported a 28% reduction in late marks across a term and a 24% reduction in behaviour incidents among pupils attending the clubs.
The programme launched in 2018 and at its peak was supporting 375 000 pupils a day, with as many as 2 400 schools involved. Of the schools in the report, 1 391 were primary and 293 were secondary.
The breakfast offering consisted of a selection of low-sugar cereals and porridge, as well as special recipe low fat bagels. Schools provided their own milk and spreads.
The format differed from school to school, with the most popular format being traditional ‘family-style’ sit-down breakfasts. Other approaches included offering classroom or playground-based breakfasts or offering the food in a ‘grab and go’ style.
A new school breakfast programme – also called the National School Breakfast Programme – has now been launched with £24m in government funding. This is being run by Family Action with a target of reaching 2 500 schools in the poorest areas of the country. Guidance on how to apply has been published (DfE, 2022). The DfE says the scheme is to begin from September 2022 although 1 200 schools have already signed up and are already receiving food.
Schools in disadvantaged areas will be eligible if they have 40% or more pupils in bands A to F of the income deprivation affecting children index (IDACI). The DfE guidance (2022) says it is prioritising schools in the government's 12 Opportunity Areas. All eligible schools should be contacted in January 2022.
Schools on the programme will receive a full subsidy for breakfast club provision until the end of this academic year, with this subsidy to be reduced to 75% from August.
Magic Breakfast is not involved in running the new National School Breakfast Programme, having not applied for the tender. A blog on the charity's website states (2022): ‘Magic Breakfast did not bid for this funding because we do not believe the contract would allow us to meet our charitable mission – to ensure no child is too hungry to learn.’
A poll by the National Association of Head Teachers (NAHT) in 2019 found that 81% of the school leaders responding had seen an increase in the number of children coming to school hungry over the previous five years. The union says this will have only worsened during the pandemic.
Elsewhere, more than 600 000 children attended free, government-funded Holiday Activities and Food (HAF) clubs last summer, including more than 495 000 who were eligible for free school meals.
The clubs offered healthy food and extra-curricular activities such as music, sports, arts, and cooking classes, and for the first time they were also run across the recent Christmas break.
HAF clubs became a national programme in 2021 as part of the government's response to the pandemic and in response to its poor handling of the roll-out of free school meal vouchers. They are targeted at pupils on free school meals, but councils have flexibility over how they can best serve the needs of children and families in their area.
The HAF programme has been allocated more than £200m to continue over the next three years and the 2021 attendance figures come as funding allocations for 2022 have been distributed to local authorities (DfE, 2021).
An independent evaluation exploring how the programme was implemented and its impact is due to be published later this year.
James Bowen, director of policy at the NAHT, said: ‘It's really good to see schools reporting a positive impact from the holiday activities and food programme and breakfast clubs that they have run. Once again, schools have stepped up to go the extra mile for children during the pandemic. It's good news that the government is extending the funding for these programmes.
‘Of course, it is very concerning that child poverty and holiday hunger is something schools are having to try and fix. We'd like to see more done to tackle the root causes of poverty to eliminate the problem entirely.’
Relationships and sex education: too many still not being taught the basics
New research finds lessons are inconsistently delivered, with few opportunities to ask questions, and with students having little influence over how to improve things.
And at a time when peer-on-peer sexual abuse and harassment is a significant problem, young people are not being taught about healthy relationships or to recognise grooming behaviour.
Research involving 1 002 young people aged 16 to 17 has sought to shine a light on their experience of RSE. Published by the Sex Education Forum (SEF, 2022), the report says that better training and long-term funding are urgently needed to support teachers to deliver comprehensive and quality RSE.
Statutory RSE in secondary schools and relationships education in primary schools should have been delivered from September 2021. Schools are expected to follow statutory RSE guidance (DfE, 2019) which sets out a range of topics.
However, many young people report still not receiving the basic information they need about mandatory topics, such as how to recognise healthy relationships (28%), attitudes of men and boys towards women and girls (26%), or indeed topics such as FGM (40%), and feelings and emotions to do with relationships (25%).
Young people under-25 account for nearly half of all new cases of sexually transmitted infections in England, but 33% said they didn't learn how to access local sexual health services. And the topic least likely to be discussed was sexual pleasure, with 46% reporting they learned nothing about this.
Missing education: The SEF polling asked young people which topics they were taught about and which they had learnt nothing about (source: SEF, 2022)
More ‘traditional’ sex education subjects continue to be tackled, including puberty, pregnancy, and condoms, showing that schools are getting the scientific element of RSE right.
The survey also finds that there have been ‘some improvements’ in issues of consent being taught when compared to the SEF's 2019 report, with only nine% now saying they were not taught about this.
However, despite this, the SEF survey found that 37% of the young people have learnt nothing about ‘power imbalances in relationships’, 29% have not been taught how to recognise grooming for sexual exploitation, and 36% have learnt nothing about pornography.
This is crucial given that Ofsted's review last year (Ofsted, 2021) uncovered an epidemic of sexual harassment and abuse targeting girls in schools and colleges. Inspectors found that nearly 90% of girls (and nearly 50% of boys) said being sent explicit pictures or videos of things they did not want to see happens a lot or sometimes to them or their peers.
The review reported: ‘Children and young people told us that sexual harassment occurs so frequently that it has become ‘commonplace’. The frequency of these harmful sexual behaviours means that some children and young people consider them normal.’
Ofsted recommended that the RSE curriculum should be carefully sequenced with time allocated for topics that children and young people find difficult, such as consent and sharing explicit images. It also called for high-quality training for teachers delivering RSE.
But the SEF survey finds that there has been no overall improvement in the quality of RSE when compared to its 2019 research. Only 35% of young people rated the quality of their school's RSE as ‘good’ or ‘very good’.
The situation is being compounded by the fact that RSE is not being discussed at home either. The survey finds that only 17% had regular discussions with parents and carers about RSE. Worryingly, one in five respondents said they do not have any trusted adult with whom they feel comfortable discussing matters relating to relationships and sex.
The survey also asked students which topics they would have preferred to have been taught about earlier. It reports: ‘The highest demand for earlier coverage centred on a cluster of relationship topics, with 17% of respondents wanting to have learnt earlier about ‘how to get help if you were sexually abused or assaulted’; ‘how to tell if a relationship is abusive (including online)’; ‘how to tell is a relationship is healthy (including online)’; and ‘sexual harassment’.’
Lucy Emmerson, chief executive of the SEF, said: ‘Relationships and sex education lessons became mandatory in all schools because it was the right thing to do after decades of inconsistent delivery, but this new polling shows the extent to which young people are continuing to be failed.
‘Even the basic building blocks of RSE are still being missed and the knock-on effect is young people lacking the skills and knowledge for healthy and respectful relationships.
‘The poor quality of RSE has long been evidenced and yet ministers have failed to provide schools with adequate funding to develop the skills and confidence of teachers and provide high-quality support for pupils.
‘We know many schools are getting RSE right, but this isn't the picture nationally. The polling must be a wake-up call to the government to change course. Without an immediate intervention, we seriously risk letting down another generation of young people.’
Model policy for allergy management in schools
A fifth of fatal anaphylaxis reactions that take place in schools are in children with no prior history of food allergy.
Allergy organisations have launched new guidelines to help schools safeguard pupils who have severe allergies.
The Anaphylaxis Campaign, Allergy UK and the British Society of Allergy and Clinical Immunology have published a model policy for allergy management at school.
An analysis of national data published last year shows that at least 66 school-aged children are known to have died as a result of food anaphylaxis between 1998 and 2018.
The charities also warn that hospital admissions due to food anaphylaxis in children have increased by 339% between 1998 and 2018.
The guidelines complement the existing government statutory guidance and offer specific detail on supporting children with allergy.
They include measures to minimise risk and advise on training to help school staff recognise the symptoms of anaphylaxis and administer adrenaline early.
Professor Graham Roberts, president of the British Society for Allergy and Clinical Immunology, said: ‘Health care professionals looking after children with allergies often hear about reactions that occur at school and often it is clear that they were avoidable.
‘Schools wanted to help as best they can and work with parents to put the best possible policies in place but there has little guidance available as to what this looked like.
‘With this new model policy, there is a really helpful structure that can be developed locally, in partnership between the school, parents and pupils to create something which works best for them and keeps children safer.’
Excluded and exploited: the forgotten teenagers let down by the care system
With exclusion and absence from school a key driver of risk for the exploitation of young people, we need urgent action to keep vulnerable teenagers at their local school and in communities they know.
The Commission on Young Lives has published a devastating report shining a light on how the care system is failing vulnerable teenagers, especially Black young people and those with SEN, often moving them far away from their communities and into the hands of criminal gangs and county lines exploitation.
The report – Out of harm's way – is brutal in its analysis, accusing the social care system of putting some vulnerable teenagers in greater danger, often placing them out of area in ‘dangerous unregulated accommodation’, sometimes alongside adults and those involved with drugs and crime.
It states: ‘These are the children who too often end up lost to gangs or sexually exploited, caught up in the criminal justice system in their teens, in care for their own protection and leaving school without qualifications or many options.
‘Absence from school is a key driver of risk, acting for many as both a catalyst to further problems and an indicator of things going wrong.’
It adds: ‘There are critical moments in children's lives when a decisive response is necessary to make a difference to their long-term outcomes, including when they are excluded from school, when they are physically injured and when arrested.’
The report includes harrowing case studies of young people who the system has been unable to help effectively, such as Jacob.
A growing problem
The Commission is being led by former children's commissioner Anne Longfield and is to present and seek backing for a ‘new and affordable national system of support, focused on preventing crisis and improving life chances’.
In March 2021, there were 80 850 children in care in England, a one% rise on the year before and the highest on record. Furthermore, 10 to 15-year-olds are now the fastest-growing group of children entering care, while 16- and 17-year-olds with acute needs now make up almost a quarter (23%) of children in care.
The report argues that a care system that was largely designed for small children is struggling to adapt to the needs of older children. For these teenagers, there is an over-reliance on a limited number of residential places where demand significantly outstrips supply, leading to many being moved out of area.
An ongoing problem is inadequate early identification of those at risk of exploitation and the frequent criminalisation of children in care. Social services' caseloads are increasing, the report warns, as are the costs of care (an estimated £200 000 per year for many of these children). It means funds available for early intervention and prevention are reducing year-on-year.
Exclusion and absence
For schools, the message is clear. Absence and exclusion are too often a key waypoint on the ‘conveyor belt’ of vulnerability that so often precedes sexual or criminal exploitation.
The report says there has been a 55% rise in the number of permanent exclusions between 2010 and 2018, reaching almost 8 000.
Other factors include poverty or the late diagnosis of SEN such as dyslexia or ADHD.
The report states: ‘Before they entered care, around two thirds (of young people) were eligible for free school meals and just over two thirds had SEN. They were more likely to face instability in school: in the year before entering care, one in 10 was out of school for a term, one in six moved school in the middle of the year, one in three was persistently absent, and more than one in three had a fixed-term exclusion.’
The report calls on the government for ‘coordinated action with regard to school inclusion’, but it says that where exclusion is unavoidable, we need to see better information-sharing between agencies.
It quotes the 2021 annual review of the Child Safeguarding National Review Panel, which warned that ‘weak information-sharing, and communication and risk assessment … has for decades impeded our ability to project children and help families’.
The panel concluded: ‘If it is unavoidable then there needs to be immediate wraparound support to compensate for the lack of structure, sense of belonging and rejection that exclusion from mainstream school can cause.’
Systemic bias
The report finds ‘systemic racial bias’. Black children are already more likely to be in care compared to their peers and Black boys in care are more likely to enter the youth justice system and are already disproportionately affected by gang criminal exploitation. The report says they often receive different services, including different police responses – bluntly, Black teenage boys are less likely to be seen as victims and more likely to be viewed as offenders.
And young people with SEN are also more likely to be excluded from school and to find themselves in care. In the 12 months to March 2020, 56% of children who were in care had an SEN, compared to 15% of all children (and 48% of children in need).
Recommendations
Among reforms that the Commission intends to consult on in due course, the report sets out a ‘new offer’ to protect and support vulnerable teens. It wants to see new duties and protections for support for teenagers at risk and their families with better information-sharing and co-ordination between local authorities, schools, GPs and the police.
The report calls for: ‘A system of early identification of teenagers on the edge of care or in care who are at risk, supported by professionals, including teachers, parents, police and teenagers themselves, which knows how to identify risk and how to trigger help.’
It wants Family Hubs and Supporting Families funding to be targeted at vulnerable teenagers and for the Department for Education to lead a new ‘Teenager in Care’ package of ‘appropriate and high-quality modes of care for teenagers’, increasing the capacity of residential care for teenagers and financing new local community children's homes.
It recommends that teenagers and their parents be given a Teenager at Risk helpline service: ‘The helpline should have a direct line to local agencies for longer-term help with a guarantee of a named person assigned to help and respond.’
Other recommendations include a new Vulnerable Teenagers at Risk ministerial taskforce which among other areas would look at improving inclusion in schools.
The Commission says that national programmes to deliver mental health support and reduce exclusion from school should prioritise teenagers at risk and intends to focus on this area in its forthcoming reports this year.
It wants to see a ban on the use of unregulated accommodation and long-term funding for things like Violence Reduction Units.
Ms Longfield said that the social care system was ‘unfit for purpose’ and ‘stretched to its absolute limit’. She added: ‘We know the number of vulnerable teenagers at risk of exploitation entering the care system is growing, and they are becoming older and with more complex and expensive needs. We also know this is putting an enormous strain on the whole children's social care system.
‘Resetting children's social care in this new offer for teenagers will require determined action and some funding, but it is clear there are huge benefits not only to those vulnerable young people who need protection, but also to the public purse. We need a new offer for vulnerable teenagers in care and on the edge of care, and this report provides one.’
‘Jacob experienced more horrors in his life than most of us could comprehend. He was reported missing more than 20 times. Jacob owned three mobile phones, was selling drugs and was a suspect or offender in 26 police reports. Found intoxicated and distressed, Jacob died in 2019 after being sucked into a dangerous criminal world. He fell through gaps in the school, care and youth justice systems. His death could have been prevented.
He was 16-years-old.