Leicestershire County Council, Leicester City Council and Rutland County Council - Leicestershire’s school nursing service has set up a text messaging service for secondary school pupils. It has helped the service engage hard-to-reach groups with pupils reporting it makes them feel more comfortable discussing sensitive issues.
Engaging young people in health services is essential. While rates of smoking, drug taking and sexually transmitted infections are all falling, England still has higher rates than many other European countries.
Meanwhile, obesity rates remain high – one in three start primary school overweight – and mental health problems are rife.
But despite this, services can find it hard to reach out to young people.
The digital age though brings new opportunities to connect with young people.
Research suggests three quarters of children aged nine to 16 have a mobile phone so Leicestershire’s school nursing service has been looking at ways to utilise this technology.
The solution
The service – run by Leicestershire Partnership NHS Trust and commissioned by Leicester City Council, Leicestershire County Council and Rutland County Council – worked with young people to develop a text messaging service for secondary school pupils.
ChatHealth was launched in 2013 and is staffed by school nurses on a duty rota basis from 9am to 5pm during the week in both term time and school holidays.
The message is delivered to a safe and secure web application for the staff to view and pupils using it are guaranteed a response within 24 hours Monday to Friday.
Jimmy Endicott, Leicestershire’s mobile media development manager, is delighted with how it has been received.
“The feedback has been great. ChatHealth is all about bringing healthcare to the smart phone generation who live their lives online – they bank, shop and communicate with family and friends online.
“But the health service doesn’t typically work in that way. ChatHealth is about challenging that tradition to give people more choices about the ways they can get in touch. We really needed an innovation like this to engage with young people.”
The impact
The service has proved to be incredibly popular. It is now available to about 65,000 pupils aged 11 to 19 across Leicester, Leicestershire and Rutland.
Those who use it are full of praise. One user says: “It allows us to express ourselves in a way we would with our friends and to know it is confidential makes us open up to other people other than our friends”.
Another says: “Sometimes you have things that are so embarrassing that you can’t talk about so if you send a message it allows you to get over that and get the help you need”.
Sarah Fenwick, Leicestershire’s lead for school nursing, says it has proved particularly effective with hard-to-reach groups.
“It has helped engage with teenagers who might feel less comfortable speaking face to face with nurses about embarrassing or sensitive issues.
“For example, adolescent males are more likely to ask a question by sending a text message. About one in five ChatHealth services users is male compared to one in 10 attending school nurses clinics.”
In fact, it has worked so well that Leicestershire has started supporting other areas to implement the system. Over 30 different places including Sussex, Shropshire, Greater Manchester and Norfolk are now using ChatHealth, meaning it reaches one million young people across the country.
Lessons learned
In developing the service, Leicestershire recognised it was important to ensure that safeguards were put in place. The service did not want pupils to be contacting the service when they were in the middle of a crisis, but then waiting for a response.
So while a reply is guaranteed in 24 hours, an automated response was built into the service so users are given signposting information of where to go for help if it is needed.
Clear safeguarding procedures have also been developed so that school nurses know when to refer on if a young person disclosures they are at risk of harm.
Although evidence shows that in 97 per cent of cases advice and issues have been able to be resolved by text message.
How is the approach being sustained?
Following on from the success of ChatHealth, Leicestershire has subsequently developed an equivalent service for parents.
It enables them to get help and advice from a public health nurse on everything from diet and nutrition to parenting advice and support.
Meanwhile three websites – Health for Under Fives, Health for Kids and Health for Teens – have been launched. They provide helpful advice, guides and videos on health issues.
For example, Health for Kids, which is targeted at children of primary school age, includes lots of interactive games and quizzes to appeal to this age group. It also has information and advice for parents.
Health for Teens is targeted at secondary school pupils aged 11 to 16 and covers everything from lifestyle tips and healthy eating to coping with anxiety or exam stress.
Weekly webchats are held via the website on a range of topics, including emotional and sexual health and relationships so that young people can talk directly to a school nurse.
Health for Under Fives is the most recent one to be developed and provides information and advice to parents from the antenatal stage until their child reaches school age.
The content is produced by the team’s own experts with input welcomed from pupils about what topics they would like to see covered.