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How I developed an award-winning health website for pupils

A school nurse's health website proved to be such a success it has been rolled out trust-wide – and won the Child Health category of the Nurse Awards 2016. 
Nurse Award winner Ruth Butler

Ruth Butler developed a comprehensive health website for her inner city secondary school which has been such a success it has been rolled out trust-wide and won the Child Health category of the Nurse Awards 2016. Here the Queens Nurse tells us how she created and developed Health Matters.

Since becoming a school nurse in 1987, I have been challenged by how difficult it is to engage young people in health and well-being. Young people want a health service that is visible, accessible and confidential. But how can we achieve that with the resources we have?

There is a national shortage of qualified school nurses and so the nurse's time in school is often limited to a couple of hours a week, which consequently limits the effectiveness of our public health role.

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Ruth Butler developed a comprehensive health website for her inner city secondary school which has been such a success it has been rolled out trust-wide – and won the Child Health category of the Nurse Awards 2016. Here the Queen’s Nurse tells us how she created and developed Health Matters.

Since becoming a school nurse in 1987, I have been challenged by how difficult it is to engage young people in health and well-being. Young people want a health service that is visible, accessible and confidential. But how can we achieve that with the resources we have?


School nurse Ruth Butler with Pimlico Academy pupils. Picture: Nathan Clarke

There is a national shortage of qualified school nurses and so the nurse's time in school is often limited to a couple of hours a week, which consequently limits the effectiveness of our public health role.

I work in Westminster, London, which has extremes of poverty and wealth. Quite rightly, a lot of my work has to be for the most vulnerable and needy children, so many pupils did not have any contact with school health services. That needed to change, so I held focus groups at one of my schools, Pimlico Academy. As you can imagine, the pupils were quick to tell me what they wanted!

Many said they did not access the school nurse because they did not know who it was or when they were in school. I discovered that young people primarily got health information from parents, friends and the internet. I was concerned to learn that young people were more likely to visit websites designed to attract a teenage audience than reliable sites such as NHS Choices, seen as ‘boring’!

Social media connection

When reflecting on how we can best engage young people with their health, I recognised that using websites and social media would be vital. So I decided to create an online school health service for secondary school aged pupils. My aim was that Health Matters would become the hub of our service. 

I wanted the entire secondary school community, but especially the students, to know how and when to access health support through the site. And I wanted to create something to ensure that by the time they left school, they could access health services independently.

Ruth Butler
Getting the message across – Health Matters' Ruth Butler. Picture: Nathan Clarke

I started with a page on the school intranet site – if the geography department could have a page then why couldn’t the school nurse? Over the next two years, I learned how to manage and develop Health Matters by increasing the written content and adding functions, such as enabling pupils to make appointments through the site.

Students no longer have to go through school staff to get an appointment with the school nurse, ensuring confidential access to the service. They can submit an anonymous health question to the problem page or by accessing health questionnaires, consent forms and health care plans.

There are links to other recommended websites, such as Childline, Young Minds and Asthma UK, and advice about other health services. This ensures the less vulnerable students have access to health services at the point of need as well as quickly addressing issues that may be perceived as minor.

Community access

Although primarily designed for students, Health Matters is for the entire school community – teachers, parents, carers and other school nurses. It provides training presentations for teachers (for example on anaphylaxis) and presentations for health education sessions on topics such as menstruation. Parents can – and do – request a telephone call through the site.


The Health Matters' website is used by the whole school community. Picture: Nathan Clarke

Health Matters is regularly used by school nurses as part of their consultations with young people, with most topics having a printable fact sheet, such as on panic attacks, which students can take away – or access later if they do not want to leave with something in their hands. Health promotion resources are readily available and there are six standard health care plans for common medical conditions, such as asthma, anaphylaxis and sickle cell disease.

The website has raised our profile in school and ensures quality care. All the information on Health Matters is evidence-based and ensures consistency in the advice given through the school health service.

Overcoming challenges

Setting up the site was not without its challenges – the first being my limited technological ability. I learned the basics of website design and management from school IT advisers, friends and family and a website design course which I self-funded. During its development, there were constant challenges regarding the look, function and content of the site. Conflict between school nursing and non-school nursing colleagues was the biggest challenge I faced and often the hardest to resolve.

What pupils say they like about Health Matters

  • 'I like Health Matters because you can ask embarrassing questions without anyone knowing it’s you.'
  • 'I can contact my school nurse independently.'

  • 'The information on Health Matters is easy to read and there’s not too much information.'

  • 'It has good links to other sites.'

 

I knew, from my initial focus groups, that it was crucial that Health Matters presented health information in a format that appealed to teenagers. I did this through user focus groups, feedback questionnaires and peer reviews. Young people contributed to the content and design throughout the developmental process.

600

responses were filed after Ruth Butler posted a questionnaire asking for feedback on the site

This co production with the pupils – their role in the way it looks and what it offers – has been key to its success. The logo was chosen by pupils after I took the designs around the playground. They wanted the words Health Matters as a logo and they liked rainbow colours. 

After 4 months I uploaded a questionnaire requesting feedback on the site’s content, look and function. I received nearly 600 responses, which I used to make improvements to the site such as the ‘hide me’ button which improved user privacy and the page titles which were changed to those suggested by the young people. 

Because of the positive feedback I had from users and colleagues, I campaigned tirelessly to raise the profile of Health Matters so that budget holders would recognise its benefits. Central London Community Healthcare NHS Trust heard about it and wanted the resource for all schools within the trust. After much negotiation, it agreed to fund a new Health Matters website that would be publicly available.


Young people's contribution to the content and design of the website was crucial. Picture: Nathan Clarke

Future goals

Over the past year, I have had a lead role in the project as Health Matters’ clinical expert. The site went live and was introduced to the trust's school health teams in September 2015. It is now being introduced to schools as the hub of our school health service.

As school nurses we have to meet young people where they are today. Health Matters does not replace our face-to-face interventions but is an additional resource. Although NHS Choices is a popular and invaluable resource, it does not meet the needs of young people. My dream would be to see an NHS Choices for children and young people which enables them to access appropriate health information and to make informed healthy lifestyle choices.

The project’s aims

1) Raise the profile of the school health service.

2) Provide appropriate evidenced-based health information at the time of need which young people could access independently and confidentially in a format they were accustomed to using.

3) Enable young people to easily and confidentially access the school health service and request intervention. 

4) Safely signpost young people to other services and websites so supporting them to make healthy choices.

 


Further information

Visit the Health Matters website

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