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The school that heals

At Gloucester House in north London, nurses and other mental healthcare professionals work alongside teachers to give children with complex problems a chance to thrive.
Kirsty_Brant_tile_BN_0017.jpg

At Gloucester House in north London, nurses and other mental healthcare professionals work alongside teachers to give children with complex problems a chance to thrive

The children who attend Gloucester House in Hampstead, receive lessons in standard subjects based on the national curriculum. But alongside their education, these students also receive intensive support from mental health professionals, embedded in the daily life of the school, to help them express their emotions and manage their behaviour.

Gloucester House is unique, an NHS-run primary and early secondary school, designed to meet the needs of children with complex emotional, social and behavioural problems.

Based in a Victorian house, the school, which has been helping children for 40 years, is part of the Child and Adolescent

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At Gloucester House in north London, nurses and other mental healthcare professionals work alongside teachers to give children with complex problems a chance to thrive


Lead nurse and clinical lead Kirsty Brant helps children
develop the building blocks for a more successful future. Picture: Barney Newman

The children who attend Gloucester House in Hampstead, receive lessons in standard subjects based on the national curriculum. But alongside their education, these students also receive intensive support from mental health professionals, embedded in the daily life of the school, to help them express their emotions and manage their behaviour.

Gloucester House is unique, an NHS-run primary and early secondary school, designed to meet the needs of children with complex emotional, social and behavioural problems.

Based in a Victorian house, the school, which has been helping children for 40 years, is part of the Child and Adolescent Mental Health Service (CAMHS) at the Tavistock and Portman NHS Foundation Trust. Its teachers and mental health staff work closely together to support the children, many of whom have had an extremely difficult start to life. 

Lead nurse and clinical lead at the school Kirsty Brant says the children, who are aged four to 14, receive therapy and other forms of intervention alongside and during their lessons. The staff includes teachers, Ms Brant and two mental health clinical nurse specialists, as well as other clinical staff including psychotherapists, a consultant psychiatrist, arts therapists and an occupational therapist.

The team members work closely together to equip the children for a better future, preferably one that involves returning to a mainstream school. The groundbreaking approach was the subject of a Channel 4 documentary, Kids on the Edge: Last Chance School, which aired last year.

Clear systems 

'The vast majority of children have been excluded from one or more schools and have quite often had a period out of education,' Ms Brant says. 'They tend to be children who have had significant difficulties in their lives. Often they have been looked after, or are adopted. Multiple agencies have been involved and they tend to be children and families who are quite difficult to engage.'

Ms Brant says the children are inclined to 'test the barriers'. 'There is a lot of shouting and swearing, violence and aggression,' she says. 'The children often have real difficulty turning feelings into words.

'We have a model of very clear systems for how we work. We think in a lot of detail about the children, about what they need and the different things we can offer. We get a lot of information from previous schools and any other agencies involved to try and be as prepared as we can.'

The children are divided into three small classes, with a maximum of seven pupils per class, and follow a normal school day of around 9am to 3pm. At the time of writing, there were 18 pupils at the school, with another two due to join and a further five supported on an outreach basis. Each day starts with breakfast for the staff and pupils, before they move into lessons.

'The teaching staff are therapeutically-minded,' Ms Brant says. 'People are thinking all the time about therapeutic support. The clinical staff see what is going on and how the children are interacting with each other. We all do a lot of helping the children to put feelings or experiences into words.'

Family contact

Each child has a care plan, which can include targeted interventions, psychotherapy, group therapy, family therapy and art therapy. The clinical and educational staff work with the children to develop their capacity to be part of a group, build their self-esteem and improve their emotional literacy.

Ms Brant says: 'We support their social skills, resilience and capacity to think about themselves and their relationships with each others. This helps them have the building blocks for a more functional, successful future.'

The school staff work closely with parents, if possible, and have much higher levels of contact with families than a mainstream school would.

Referrals are made from education, health and social care, and often come from a combination of agencies. The cost is generally covered by local education authorities, and as it is a day unit, children must live close enough to be able to travel to the site daily.

The aim is generally to support the child to move back into mainstream education, and about 50% of the children will return to mainstream or specialist schools. Supporting long-term stability for the pupils is also a key aim: 82% of children are stable and doing well a year after leaving. The school was rated outstanding by Ofsted in its last assessment.

Academic improvement

Results from 2015-16 suggest that the Gloucester House approach boosts academic performance. From low starting points, with 100% of children significantly underachieving in at least two areas, and the vast majority significantly underachieving across the curriculum, all achieved nationally expected rates of progress in reading. A total of 91% achieved the same in writing, and 83% in maths.  

The level of support provided at Gloucester House does not come cheap: a placement for a year costs £58,567, compared to £4,000-6,000 for a place in a mainstream school. This price needs to be seen in the context of what a child who does not receive support could cost society in the future, Ms Brant says.

When she joined five years ago, Ms Brant was the first nurse at the school. She has since recruited two clinical nurse specialists, one of whom leads an outreach service working with schools.

Ms Brant says that adding nurses to the school's team has helped bring together the different aspects of education and care. 'There is a big overlap between teachers and nurses in being able to think, reflect and be proactive.'

The challenging nature of the work means that staff all need to support each other. Clinical supervision and continuing professional development are among the ways that staff can gain support and develop resilience. Talking and reflecting with other staff members is important to ensure that the team stay robust, Ms Brant says, and there is a planning meeting every morning and a debrief every day.

Immersive experience

'Reflective practice is so important here because of the intensity of the way we work,' she says. 'Staff need to be resilient. The most important thing is for staff to have a belief that things can be different and to know that there are going to be parts where it is going to be very difficult. There will be a sense of helplessness and inadequacy and, as staff, we have to understand that it is being projected by the children.'

Ms Brant says working at Gloucester House is tough but rewarding. She adds that being able to work closely with pupils over an extended period of time – children generally spend one and a half to three years at the school – is part of what makes the role so satisfying.

She has worked in CAMHS for 17 years, including stints in schools and outreach services. A formative experience was working in therapeutic communities, including the well known Cassell Hospital in Richmond, which provides treatment and assessment for people with severe and complex personality disorders. But the experience at Gloucester House is different, she says.

'From a nursing point of view there is something clinically rich about being able to be in the moment with a child,' she explains. 'You can have a different sort of experience about what is going on or why. I enjoy the challenge, I think it has to do with the level of immersion we have here.'


Erin Dean is a freelance health writer

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