Health education and RSE guidance — the outstanding, the good and the ‘requires improvement’

Firstly, a reminder of some very good news: from 2020 every pupil in England will be guaranteed a PSHE education that covers health education and relationships education (in all primary schools) / relationships and sex education (in all secondary schools). These are major steps from Damian Hinds et al at the DfE towards what parents, pupils and educators are crying out for — an education that fully prepares every child for life’s challenges and opportunities.

Of course it’s hugely disappointing that economic wellbeing and careers education is not yet mandatory for all, but schools should continue to prioritise this vital strand of PSHE until we win that battle too.

Meanwhile, draft statutory guidance on what to cover in the health education and relationships (and sex) education strands of PSHE is out for consultation until 7 November. There’s much to welcome, but also areas of concern.

We’ll be submitting a detailed response of our own but wanted to write broadly here about what we think is outstanding, good or ‘requires improvement’ in this draft guidance. We encourage anyone involved in education to contribute as it’s vital to get this right for children and young people.

 

THIS IS GOOD FOR PSHE (WITH OUTSTANDING FEATURES)

There seems to be a clear and welcome intention to ensure all schools have license to treat PSHE as they would any other curriculum subject. We can’t see a school meeting the new health education and RSE requirements without having a planned PSHE programme in place.

We especially welcome references to “a planned programme of lessons” delivered in a “carefully sequenced way” [p7] and that “a strong curriculum will build on the knowledge pupils have previously acquired” [p33] whilst “schools should have the same high expectations of the quality of pupils’ work” as for other curriculum areas. We welcome the clear message that these areas should be properly “resourced, staffed and timetabled” [p12] with a dedicated “subject lead” [p31], not just replaced by a series of visiting speakers [p14] or isolated interventions. At the same time external providers can play an important role in enhancing planned provision with specialist knowledge and it is good to see this reflected in the guidance [p14], though it is vital that schools choose wisely (see our member guidance on ‘selecting and working with visitors and speakers’).

All of this should encourage the many schools offering regular, high quality PSHE to keep up the good work and help others to follow suit.

 

HEALTH (THEY SAY IT’S GOOD FOR YOU)

Mandatory health education is bad news for anyone who doesn’t like children and young people.

For everyone else it’s great news — there are aspects of the physical and mental health guidance that will improve healthy behaviours and save lives.

This includes physical health topics such as sleep, first aid, cancer education and diet, and aspects of mental health including positive emotional and mental wellbeing, learning when (and how) to get help and tackling stigma. Importantly, it outlines the link between physical and mental health, and how one can impact on the other. The breadth is impressive.

The Chief Medical Officer and various Medical Royal Colleges have long championed PSHE’s preventative power in supporting public health outcomes. Mandatory health education will help to solidify this role and ensure equality of access for all.

There are however issues that we’ll go into in greater detail in our submission. They include a focus on relaying information rather than also fostering the skills, strategies and attributes that make this information useful (we also explore this below).

Another area of concern is the suggestion that issues like eating disorders and extreme weight loss are specialised areas requiring ‘qualified support or advice’ [footnote p29], without providing guidance on how to seek such support or recognising that teachers should be given the skills to teach about these issues themselves.

 

KNOWLEDGE (+ SKILLS + ATTRIBUTES) = POWER!

PSHE education should be rich in knowledge so that pupils have the facts they need to hand. It’s important to know for instance the name of a drug, its likely effects and the legal consequences of possessing it.

Yet knowledge alone won’t help a young person offered a pill at a party when their friends have already popped theirs. The guidance says pupils should be taught “the information” to make good decisions [p24] but is information enough to turn these decisions into action? After all, if knowledge alone was enough to affect behaviour there wouldn’t be a doctor in the country who smoked, drank or ate jam doughnuts.

PSHE is not only about making good decisions, it’s about being able to act on them. To be effective it must be grounded in an understanding of what enables us to act in real life situations, and this includes knowledge, but also skills and personal qualities.

This isn’t a plug for skills over knowledge, nor vice versa (we love them both, why should we have to choose?!). Rather, it’s about recognising that when it comes to acting on critical decisions in our lives there is a natural interplay between knowledge, skills and attributes. PSHE is effective when it develops all three and this should be far better reflected in the guidance.

 

SEPARATION ANXIETY

There is so much crossover between health education, RSE and economic wellbeing that the Department for Education once folded them into a unified subject — PSHE education. Clever move.

That’s why references to health, RSE and relationships education as ‘new subjects’ in the guidance creates confusion and false separations that don’t make educational sense and won’t make sense to schools. Real life is messy and doesn’t have such clear boundaries.

The same goes for any idea that economic wellbeing can just be covered in Citizenship or Maths without regard for the personal aspects that impact on relationships and health, only covered in PSHE. Family debt issues could for instance have a big impact on relationships and health (mental and physical). Or what about online gambling? Ostensibly an economic wellbeing issue — so not covered by this mandatory guidance — it involves the same skills and attributes as other areas of PSHE, including understanding and managing risk and peer influence, self-regulation, and critical thinking.

The draft guidance actually helps prove this point, with puberty referenced in health education guidance but not RSE; drugs and alcohol mentioned in health but without their potential influence on relationships; bullying referenced in both the health and relationships guidance; and so on. So it’s all a bit of a muddle and the only glue that hangs it all together coherently remains PSHE education.

And with 85% of schools already teaching PSHE that covers health and relationships, the new requirements should be seen as a ‘levelling up’ of PSHE standards across all schools.

So we’d encourage the majority of schools doing a good job to ignore the false distinctions — if your PSHE ain’t broke, don’t fix it — or if you’re unsure and need help to improve your PSHE, come to us.

 

LET’S TALK ABOUT SEX (OR NOT?)

This separation is most problematic when it comes to attempting to unscramble relationships from sex.

While the guidance for secondary schools suggests no need “to artificially separate sex education and relationships education” [p9], this is precisely what happens with the single focus on making ‘relationships education’ mandatory at primary level.

While we understand the practical realities of getting this final guidance passed through Parliament, there are real concerns about children’s safeguarding that should take precedence over squeamishness about an age-appropriate understanding of sex and our bodies.

Lucy Emmerson, Director of the Sex Education Forum neatly outlines some of the issues in her recent School’s Week article For example, although the guidance suggests primary pupils should have ‘the vocabulary and confidence to report concerns or abuse’, there’s no spelling out of what this vocabulary (e.g. correct terms for genitalia) should be. Without this knowledge it is very difficult to ensure primary pupils know “that each person’s body belongs to them, and the differences between appropriate and inappropriate or unsafe . . . contact” [p17].

It’s also too late to begin covering FGM at secondary, and even then the guidance is non-committal, suggesting schools may “want to address the physical and emotional damage caused” [p21] by FGM at that stage.

And though the guidance rightly says that “the onset of menstruation can be confusing or even alarming for girls if they are not prepared” [p28], it doesn’t include any reference at all to menstruation in primary despite children as young as 8 experiencing it.

The suggestion that LGBT issues should be ‘integral’ is welcome and absolutely vital, but advice and guidance needs strengthening and rewording, particularly at primary level. We would refer you to Stonewall’s response which covers a number of key issues, including that:

  • there should be specific references to families with LGBT parents [p15], and to prejudice-based bullying, including homophobic, biphobic and transphobic (HBT) bullying.
  • schools must ensure teaching is LGBT-inclusive, rather than only 'recommending' that they do [paragraph 33, p12].
  • that respecting the religious ethos of a school [p10] doesn't mean certain topics need to be avoided or watered down.
  • Stonewall also ask that the section on RSE policies [p8,9,10] should require schools to make specific reference to their legal duties under the Equality Act to eliminate discrimination and promote equality of opportunity.

 

VIRTUOUS REALITIES

In a few places the framing and language are particularly problematic. For example, as Lucy from the Sex Education Forum again illustrates in her article, the repeated mention of “virtues” or character attributes such as self-sacrifice, forgiveness and self-control have “never featured in the research evidence on effective RSE” despite this suggestion in the guidance [p20].

Lucy is also rightly concerned “about the message it would give children to teach that relationships are about self-sacrifice, rather than about equality and enjoyment”.

In fact, such terminology sends a worrying message in this context. How can ‘self-sacrifice’ be a recommended response to an abusive relationship? Or could ‘forgiveness’ without question get in the way of disclosing abuse to others?

And though we’re certainly no anarchists at the PSHE Association, the reference to showing ‘due respect’ to “those in positions of authority” [p17, 22] rings alarm bells if that’s suggesting those in authority can never be wrong or have ill intent. We’d encourage a healthy respect for authority where it’s warranted, but the critical thinking skills cited elsewhere in the guidance [p17, 29] are important to establishing where this is the case.

When it comes to parental withdrawal from sex education, the ‘right to be excused’ makes frequent appearances. This concerns the facts of life, not jury service. Yet the terminology suggests something potentially unpleasant that can be avoided with parental intervention.

 

ECONOMIC CONCERNS

The consultation form asks a question on financial education but only at post-16 given that the government haven’t yet committed to making this aspect of PSHE statutory for key stages 1-4.

We do strongly recommend that financial education should be statutory for post 16 students, though such learning cannot begin at the age of 16. The foundations of economic wellbeing must be laid in key stages 1 and 2 and built upon through key stages 3 and 4, in the same way as for any aspect of health education or RSE. A comprehensive and relevant programme of PSHE education should then continue to be provided in key stage 5, that revisits and reinforces earlier learning.

We do not however agree that ‘the maths and citizenship curricula ensure pupils up to 16 can be taught the building blocks of financial education’. These subjects may effectively teach the personal finance content prescribed in the national curriculum, but the personal aspects of financial literacy and careers are only delivered through PSHE. Economic wellbeing is also inextricably linked with mental wellbeing, and relationships, so should always be delivered within a broader PSHE programme that addresses these areas and the relationship between them.

We therefore agree that there is indeed a gap in relation to financial education and economic wellbeing, but that this is not limited to post 16, and it is a gap that only PSHE education can fill. In the absence of statutory commitment to the economic aspect of PSHE, a stronger emphasis from DfE on the value of including aspects of economic education in PSHE is therefore necessary to help improve overall provision.

 

IN CONCLUSION

Though we’ve not been able to cover everything here we hope it provides a useful overview of what we see as some of the main points, both positive and negative. We will go into greater detail in our submission, and raise some additional broad points of concern, including the need for greater emphasis on inclusion for all pupils with SEND (Special Educational Needs and Disability) throughout the guidance.

It’s certainly a big step forward in bringing guidance up to speed to suit the modern age. There are however features and omissions that look back rather than forward and don’t reflect the realities of young people’s lives in modern Britain. These must be addressed to ensure children and young people are equipped for the challenges and opportunities of today, and tomorrow.

The guidance is only one part of the picture of course, and the success of these measures will depend on all of the dedicated professionals and schools charged with putting it in place. Schools and teachers need support and training to deliver this material safely and effectively. We will continue to make the case to government that resources allocated to getting schools ready not only support initial implementation but ongoing development — this is key in such a fast-moving area of the curriculum.

We will also continue to develop our support for members to meet these new requirements. This includes our range of resources (such as our planning toolkits and guidance on writing RSE and PSHE policies) and our suite of training days, including training on preparing for statutory relationships education and the statutory relationships and sex education aspects of PSHE.

In the meantime, we would strongly encourage any of you working in this area to respond to the consultation in your own words. The form is long, and you may not have something to say for each question, but your experience will give you invaluable insight into what young people need from PSHE education and how it can work best for schools.

Once responses have been reviewed, the guidance will be updated and debated in Parliament, with a view to it being available for schools from next year and mandatory from September 2020.


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Comments (2)

  • anon

    Really helpful and reassuring to read this article. Will pass it onto our Head. Thank you for keeping your members up to date in a factual and sympathetic way.

    Sep 25, 2018
  • anon

    This is an excellent start - thank-you!

    My concern is that the DfE have asked for responses to one set of questions, but that professionals and experts in the field should not be restricted to those questions, and that we should also comment on:

    1) Given that many girls start their periods in KS2, why include menstruation in the section on physical health and mental well-being for secondary school pupils? This needs to be taught in the primary curriculum, for both boys and girls, as part of the changing adolescent body.

    2) Would it help primary schools to have clearer guidance about the naming of body parts that children should learn from Year 2 or 3, certainly at the start of KS2, partly to link with NC Science but principally to support safeguarding.

    3) What additional recommendations would you like to see about the contribution from local Public Health / School Nursing would you like to see to help inform the curriculum and possibly to provide CPD?

    4) Finally and perhaps most importantly Does your school currently have adequate resources, support and training to be able to implement the Guidance? Should DfE make additional funding available to support CPD?

    Sep 26, 2018

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