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FINAL VERSION




Turning the Tables:
Transforming School Food

Main Report


A report on the development and implementation of nutritional standards for school lunches

Prepared by the School Meals Review Panel

29 September 2005



CONTENTS


Members of the School Meals Review Panel

4

Acknowledgements

5

EXECUTIVE SUMMARY

6

Panel Recommendations

11

SECTION 1: BACKGROUND

16

The School Meals Review Panel

16

The History of School Meals Standards

17

Recent Developments

19

The Nutrition of School Aged Children

21

The Role of School Meals in the Nutrition of Children

23

School Meals as a ‘Safety Net’

24

Educating for Health: Whole School Polices

24

SECTION 2: THE WAY FORWARD FOR FOOD IN SCHOOLS

26

The Development of Mandatory Nutritional Standards for School Lunches

26

Summary of Recommended SMRP Nutrition Standards for School Lunches

27

How the Standards are Intended to be used in Schools

31

Social, Cultural and Environmental Aspects of the Standards

35

Other School Food

36

SECTION 3: DELIVERING CHANGE

38

School Catering: The Starting Point

38

School Catering: Training for Change

39

Schools

40

A Phased Programme for Change

42

Guidance on an Integrated Approach to Delivering Change

43

SECTION 4: FINANCIAL INVESTMENT

45

Funding Arrangements for School meals in England

45

Expenditure on School Meals

46

International Comparisons

47

Investing in School Meals – Revenue Costs

47

Investing in School Meals – Capital Costs

49

Investing in our Children’s Future

51

Free School meals

51

Conclusion

52

SECTION 5: MONITORING AND EVALUATING CHANGE

53

Assessing Change

53

Self Monitoring

53

External Monitoring

55

National Evaluation of Standards

57

SECTION 6: CONCLUSION

59



Members of the School Meals Review Panel



CHAIR

Suzi Leather



MEMBERS

Beverley Baker Local Authority Caterers’ Association

Gina Birley School Governor, St Martin in the Fields School

Gaynor Bussell Food and Drink Federation

David Butler National Confederation of Parent Teacher Associations

Judy Buttriss British Nutrition Foundation

John Caperon Former Headteacher, Bennett Memorial Diocesan School, Tunbridge Wells; Secondary Heads Association

Helen Crawley Caroline Walker Trust

Sue Davies Chief Policy Adviser, Which?

Paul Dornan Child Poverty Action Group

Alasdair Friend Headteacher, Thomas Fairchild Community School

Joe Harvey Health Education Trust

Paul Kelly Compass Group Plc

Christine Lewis National Officer, UNISON

David Lucas School Catering Manager

Joan McVittie Head teacher, Leytonstone School

Peter Melchett Soil Association

Sylvia Morris Headteacher, Cathedral School of St Saviour and

St Mary Overie

Mike Nelson Kings College, London

Jenny Poulter Independent Public Health Nutritionist

Mike Rayner University of Oxford, Department of Public Health

Keith Sorrell Headteacher, Windsor High School

Eileen Steinbock Brakes

Lynn Stockley Independent Public Health Nutritionist

Sheila Walker Birmingham City Council

Carol Weir British Dietetic Association
OBSERVERS

Hannah Booth Department of Health

Jamie Blackshaw Food Standards Agency

Louis Levy Food Standards Agency

Stuart Miller Department for Education and Skills

Penny Jones Department for Education and Skills


GROUP SECRETARIAT

Catherine Evans Department for Education and Skills

Carol MacMillan Department for Education and Skills

Debra Toomey Department for Education and Skills



Acknowledgements

  • Presentation by Michael Nelson - ‘Nutrition in School Children’.

  • Presentation by Rayma Crawford at Hull Local Education Authority - ‘The Challenge of Improving School Meals in Primary Schools’.

  • Demonstration by Helen Crawley of Hungry for Success (H4S) menu planning software

  • Presentations by Heather Jones, Gillian Kynoch and Majorie Robertson of the Scottish Executive - ‘Hungry for Success’ scheme.

  • Presentation by Ashley Riley – The Impact of Child Poverty on Child Nutrition.

  • Presentation by Lynn Stockley – Options for new school meals standards.

  • Presentation by Kay Knight – Implementing the Caroline Walker Trust guidelines.

  • Presentation by Paul Kelly and Sheila Walker – Delivering the School Meals Service in UK.

  • Presentation by Michael Nelson – The Contribution of School Meals to a Child’s Daily Nutritional Intake.

  • School Meals Funding Delegation report commissioned by DfES from Pamela Storey and Mano Candappa of the Thomas Coram Research Unit, Institute of Education, University of London.

  • Unison report ‘Understanding the Private Finance Initiative – the school governor’s essential guide to PFI – January 2002’ by David Rowland and Professor Allyson Pollock, School of Public Policy, University College London.

  • Paper by Birmingham City Council – School Meals in Birmingham: The DSO Perspective.

  • The Sodexho School Meals and Lifestyle Survey 2005.

  • Paper by Bath and North East Somerset Local Education Authority dated 6 June 2005 – Overview and Scrutiny In-Depth Review Report: A Review by the Education, Youth, Culture and Leisure Overview and Scrutiny Panel.

  • Summary reports provided by Food Standards Agency for pilot schemes that took place in Cambridge, Southwark and Knowsley –Piloting school meal menu changes to determine impact on pupil nutrient intake to support DfES’ work to revise standards for secondary school meals.

  • DEFRA paper – Sustainable Procurement.

  • Update on training and qualifications by Liz Randall.

  • Presentation by Janet Dallas on Curriculum Policy.

  • Presentation by Sam Mellor on Healthy Schools Policy.

  • Presentation by Julia Richardson at Greenwich Council.

  • Presentation by South Gloucestershire Council – The South Gloucestershire Experience.

  • Paper by Price Waterhouse Cooper commissioned by the Panel – Economic Cost of Implementing the Caroline Walker Trust Recommendations.

Finally with special thanks to the Caroline Walker Trust for providing the Panel with early access to information on their 2005 standards

Executive Summary




Context





  1. The health advantages of well-cooked, well-presented meals, made from good-quality ingredients to accepted nutritional standards, by school caterers who are confident in their skills and valued by the school community, are inestimable. The benefits of good school meals go beyond high quality catering. They also produce social, educational and economic advantages.

  2. The Panel repeatedly heard head teachers and others from schools where food had already been improved speak of associated improvements in behaviour: of calmer, better behaved children, more ready to learn. Improving food in schools may contribute to improved attainment and behaviour.

  3. School children of all ages should look forward to and enjoy their school meals, should learn about where their food comes from, and also take an interest in how it is produced. Improved food knowledge should include practical cooking skills so that children and young people who are now at school can, in their turn, look after themselves and their own families in a way which meets their health needs and their food preferences, enhancing their self esteem and self confidence. Transforming school food is as much about these aspects as about nutritional standards.

  4. What children receive at home will always be more important than what they eat at school. But the school is crucial for modelling healthier choices and schools are a vital setting. Whilst they can help children learn and establish healthy eating patterns which will last for life, they can also introduce and reinforce habits which will slowly but surely erode children’s health.

  5. Children fed a monotonous diet of poor quality, predominantly processed food do not thrive. The statistics are striking. In 2002, 22% of boys and 28% of girls aged between 2-15 years were overweight or obese1,2 and these figures are continuing to worsen. It is estimated that obesity already costs the NHS directly around £1 billion per year3 and the UK economy a further £2.3 to £2.6 billion pounds in indirect costs.4 It has been estimated that, if the present trend continues, by 2010 the annual cost to the economy would be £3.6 billion pounds a year.Error: Reference source not found Conservative estimates suggest that one third of girls and one fifth of boys will be obese by 20105 – and many more will be overweight. The risks of this happening are greater in lower income households6. We have yet to witness the full implications of the obesity epidemic in children. The chronic disease consequences come later – particularly diabetes, heart disease and many cancers7. The stark reality is that this generation of children faces the prospect of more ill-health and disability during their lifetimes unless radical steps are taken now.

  6. There is no doubt that what children eat and the level of their activity8 are at the core of the problem, yet survey after survey continues to highlight school children’s poor eating habits9. They are “grazing” on foods which are high in fat (particularly saturated fat), sugar and salt, yet shunning the very foods their bodies need for good health, such as fruit and vegetables.

  7. The current crisis in school food is the result of years of public policy failure. Financial pressures and the fragmentation of school catering, together with a lack of strict standards, have resulted in the type of school meal we see too often today. The Panel is delighted that the Government has recognised the crucial importance of healthier school food. There is also now a groundswell of public opinion that we need to improve the quality of school food. This represents the best opportunity to upgrade the quality of food in schools since regulations were removed in 198010

  8. It is clear that schools can transform the food they offer to children. Many have already begun to do so. There is now an opportunity to ensure that every child has access to healthier school meals. This is an exciting, yet complex challenge: to transform school meal provision in over 20,000 schools. Responding to this challenge must involve the whole school community, the food industry and school meal providers.

  9. It is within this context that the School Meals Review Panel was asked by the Secretary of State for Education to review existing standards and make recommendations to Government.

  10. We believe our recommendations will lead to the consumption of healthier combinations of lunchtime foods by primary and secondary school children. This improved quality will clearly mean some increased costs; but these costs should be set against the health and other benefits. Redressing the imbalance in children’s diets will contribute towards a reduction in obesity and diseases like tooth decay in young people. In the longer term, the changes we recommend now should reduce the chances of young people suffering from various chronic diseases later in life. But more than that, new standards can set the scene for holistic changes in the way young people perceive food and health, and can pave the way for wider changes in our food culture.

The Report


  1. This report summarises the deliberations and presents the recommendations of the Panel. This multi-disciplinary expert group included headteachers, governors, school caterers, trade unions, people with practical experience in implementing healthy eating initiatives in schools, registered dietitians and nutritionists, public health experts, consumer and environmental group representatives, parents and representatives of the food industry. This report represents a collation of views and ideas from a wide range of people and interest groups: whilst not achieving unanimity on every matter, the report should be seen as a consensus view of the majority of members.

  2. During the course of our work we considered evidence from a variety of sources including published scientific studies, evaluative projects and lessons learnt from schools and local authorities which have taken innovative steps to improve their school meals.

  3. The core recommendation made is for school lunch provision (in both primary and secondary schools) to meet:

  • 14 nutrient standards which are very similar to those released by the Caroline Walker Trust11

  • 9 food-based standards which maximise access to healthier foods (like fruit, vegetables and bread) and remove the availability of less healthy foods (like confectionery, pre-packaged savoury snacks and high-sugar or sweetened fizzy drinks).

  1. In formulating these standards we considered children’s needs across a broad spectrum: physical, social and educational. We paid attention not only to purely nutritional requirements but also to the wider issues: what children learn about preparing food themselves; lifelong cooking skills; the social benefits of sitting down to a shared meal; and the importance of an approach which is environmentally sustainable. As a consequence the report also contains 34 broader recommendations to promote coherent, “joined-up” thinking about healthy eating across the school day and to support schools and caterers in meeting these new standards.

Delivering Change


  1. Experiences drawn from schools indicate that the standards recommended within this report are achievable. We acknowledge that they are challenging, particularly in secondary schools which presently offer a very wide range of food choices. The sample menus included in this report illustrate the level of change which schools will need to work towards. We have recommended a phased introduction of the standards, with essentially the food standards met by schools by September 2006, and then the nutrient standards met fully in all primary schools by September 2008 and in all secondary schools by September 2009.

  2. A common thread in achieving change is controlling the range of choice, and we clearly and firmly advocate this. The new School Meals Review Panel (SMRP) standards are designed to drive the replacement of foods consumed at lunchtime which are low in nutritional value with foods which support children’s health.

  3. The Panel therefore agreed that confectionery, pre-packaged savoury snacks and high-sugar or sweetened fizzy drinks have no place in school lunch provision and other school food outlets12. The standards for these foods and drinks are proposed as a statutory requirement of school lunch provision. In addition, we were very clear that, with appropriate modifications, they should be applied to other food outlets within the school and reflected in school policies for food brought into school. We concluded that it is by constructively controlling choice that we will widen children’s food experiences. A greater variety of foods will help children to a healthier future.

  4. This principle of ‘choice control’ has been shown to be effective not only for school lunches, but also in promoting healthier eating from other food outlets within schools. Successful ‘healthy vending’ projects in schools have already demonstrated that this can be done, particularly with the advent of refrigerated vending machines which enable a wider range of options such as sandwiches, fresh fruit, juices and milk to be made available to children in school.

Working Together


  1. The implications of these SMRP standards and recommendations are far reaching. They will require people to work together in partnerships.

  2. Examples of successful school food improvement underline the importance of school leadership and a partnership approach, from pupil participation at school level right through to local authority strategic level. Transforming school food is as much about people, skills and commitment as it is about nutrients and ingredients. Implementing the new SMRP standards will mean changes for all. Caterers will need to change their recipes and cooking practices; kitchen staff will need more time to prepare meals; local authorities, governors and school heads will need to prioritise food; parents and carers will need to support the changes; children themselves will need to choose the new options. In short, it will require a whole-school approach. The examples of successful transformations which have already been achieved have depended on all these elements being in place.

  3. The transformation of school food should also create jobs. The use of more fresh, locally produced and unprocessed food will require more kitchen staff working more hours, and will have wider benefits to local economies. This must be expected and built in to workforce planning. All staff will require training. Since so few real cooking skills have been required of many kitchen staff in recent years it will also be necessary to train many school catering staff in new techniques and skills, and to give help with menu design and procurement planning. Resources devoted to this must be a priority.

Financial Implications


  1. The additional cost to local authorities, schools and parents and carers of implementing our recommendations over a three-year transition period is in the order of £167m in the first year and £159m in subsequent years. These figures are the best estimates we can make using the currently available information, and the time available to us, and they assume no increase in uptake or efficiency savings. They provide a very useful indication of the level of additional money that needs to be levered into the school meals service. In March 2005 the Department for Education and Skills (DfES) committed transitional funding of £220m over three-years to support a transformation of school meals by local authorities.

  2. We estimate that over two-thirds of the estimated additional costs will go towards food on the plate and will bring expenditure on ingredients into line with the Caroline Walker Trust (CWT) recommendations. The Panel recognised that steep increases in prices to parents and carers could lead to a decrease in uptake. This could even call into question the viability of the school meals service in some areas. We are also concerned about the impact of any price increases on low-income families who sit just above the threshold for Free School Meal (FSM) entitlement. We urge the Secretary of State to take note of our concerns and investigate options for mitigating these risks.

Conclusion


  1. It is time to reverse the regrettable move away from high quality standards of school food. It is time to ‘turn the tables’. We believe our recommendations will lead to the consumption of healthier combinations of lunchtime foods by primary and secondary school children. This in turn will contribute towards a reduction in obesity and in the longer term reduce the chances of our young people suffering from various chronic diseases later in life. We also believe that there will be educational gains for schools and children. Further, the changes in school food which we recommend should help bring about a healthier food culture, in which young people and adults enjoy the experience of eating healthy, nutritious food together. We commend our report to the Secretary of State and to the wider public.

Panel Recommendations



The standards
Recommendation 1: The nutrient and food and drink standards proposed in this Report should be adopted and applied to the provision of school lunches (see paragraph 2.7).
Recommendation 2: Food provided at lunchtime in schools should meet the combination of nutrient and food-based standards over a period of five consecutive school days (see paragraph 2.14).
Recommendation 3: Schools should aspire to achieve the highest quality of provision, which is a hot meal, cooked on-site, from fresh and seasonal ingredients.  Whilst we accept that this level of provision is not possible to achieve in all schools at present, we recommend that schools work towards this (see paragraph 2.24).
Recommendation 4: At present only the school lunch standards are statutory. The Panel recommends that pre-school and children in other settings, should be similarly protected. It recommends that the Government, as a priority, supplements these lunch standards with standards for other food and drink service provision: break-time snacks, breakfast and after school clubs (see paragraph 2.29).
Recommendation 5: The panel recommends to schools that, from September 2006, the food standards (Table 2) be applied to lunch time and that similar standards for 'processed foods'; 'confectionery and savoury snacks'; and 'drinks' be applied to tuck shops, vending and other similar food services.  The panel recognises that meeting the voluntary Target Nutrient Specifications for processed foods will require some product development and therefore may take longer (see paragraph 2.30).
Recommendation 6: School caterers should ensure that choice is available for all children right through to the end of lunchtime service in order that children eating later in the food service are not disadvantaged (see paragraph 2.15).
Recommendation 7: There should be easy access to free, fresh, chilled drinking water throughout the school day (see paragraph 2.32).
Recommendation 8: The procurement of food served in schools should be consistent with sustainable development principles and schools and caterers should look to local farmers and suppliers for their produce where possible, tempered by a need for menus to meet the new nutritional standards and be acceptable in schools (see paragraph 2.25).
Recommendation 9: The standards should be reviewed in 2011. At this time the standards should be applied to food consumption as well as food provision (see paragraph 2.9).
Recommendation 10: The Department for Education and Skills (DfES) should encourage schools to adopt the voluntary target nutrient specifications circulated for consultation by the Food Standards Agency (see paragraph 2.8).
Delivering Change
Catering:
Recommendation 11: Schools and caterers should conduct a needs analysis (skills, equipment, preparation time) and train all relevant staff (including catering staff and midday supervisors) to ensure they are able to support pupils in making healthy choices (see paragraph 3.9).
Recommendation 12: Catering staff need to be central to the whole school approach. Their practical skills should be valued and utilised to the full, and they should be represented on groups like School Nutrition Action Groups (see paragraph 3.5).
Schools:
Recommendation 13: All schools should audit their current food service and curriculum, and develop, implement and publish a whole-school food and nutrition policy. The Panel recommends that schools’ whole-school food policies should be made available to parents and carers and be referred to in the school prospectus and school profile (see paragraph 3.15).
Recommendation 14: All children should be taught food preparation and practical cooking skills in school in the context of healthy eating. Far more emphasis should be placed on practical cooking skills within the curriculum space currently devoted to Food Technology, and the KS3 review should consider this (see paragraph 3.14).
Recommendation 15: Supply links between local producers and schools should be strengthened, with improvements to children’s knowledge about growing and cooking food.  Schools should be encouraged to visit farms, ideally where some of their food is produced (see paragraph 2.26).
Recommendation 16: Whole-school food policies, developed through partnerships, should include consideration of the impact of packed lunches and food brought into school. However, where parents and carers wish to continue with packed lunches, guidance is available from the Food Standards Agency (see paragraph 2.31).
Getting started
Recommendation 17: The introduction of the new standards should be phased in over a period of time to allow the necessary preparation. Implementation will be more difficult in some schools (e.g. where there is a cash-cafeteria food service). The new standards should be fully achieved as soon as possible, and at the latest, for all primary schools by September 2008 and for all secondary schools by September 2009 (see paragraph 3.25).
Recommendation 18: Schools and local authorities should aim for complete take-up of free school meal entitlement; and schools should aim to have at least 10% increase in school meals take-up by the end of the implementation period (see paragraph 3.26).
Recommendation 19: Further tools and guidance need to be developed, tested, and made available as early in the implementation process as possible. The DfES should take the lead on this (see paragraph 2.18).
Recommendation 20: The Food Standards Agency (FSA) should make its food composition data, including any relating to non-milk extrinsic sugars, widely available in an electronic format. This will provide information on foods and nutrients contained in the standards, expressed using analytical or calculation methods which reflect the needs of the standards (see paragraph 2.19).
Financial investment
Recommendation 21: The Secretary of State should take note of our concerns that low income families may be adversely affected by price increases, and investigate options for mitigating possible nutritional and economic risks (see paragraph 4.41).
Recommendation 22: Schools and local authorities must improve transparency and accountability in relation to how much they spend on school meals, including food cost per meal; uptake; free school meal numbers; nature of service; level of any subsidy; and any surplus generated by the service and how it is spent. This information should be presented in the whole-school food policy (see paragraph 4.7).
Recommendation 23: There should be no further degradation of service or provision by individual schools or local authorities from the current position, and kitchens should be a priority under ‘Building Schools for the Future’. The DfES should undertake further work to consider the options for schools which no longer have their own kitchens. Schools and local authorities should be encouraged to reach the highest standards of provision and kitchens should be a priority in all schools’ capital investment programmes (see paragraph 4.30).
Recommendation 24: Guidance on formulaic funding delivered to local authorities and schools should prioritise the renovation and refurbishment of kitchens and dining facilities (see paragraph 4.32).

Recommendation 25: The Government needs to ensure that current Private Finance Initiative (PFI) contracts and ‘Building Schools for the Future’ (BSF) initiatives do not impose barriers to the improvement of school food and also ensure that in future all school PFIs incorporate building specifications which enable the main meal to be cooked on the premises and practical cooking skills to be taught to all pupils. The Government should require all partners in PFI deals to be bound by the new standards. The existence of long-term contracts cannot be allowed to adversely affect the health of pupils in PFI schools (see paragraph 4.33).
Recommendation 26: The Panel suggests that kitchens and dining areas should be given priority within primary capital investment (see paragraph 4.34).
Recommendation 27: The economic costs of the changes should be modelled against the economic benefits. For example the benefits include: sourcing more food from local suppliers will benefit local economies and cut down transport and infrastructure costs; using more fresh ingredients will require longer kitchen assistant hours and this will benefit catering staff; the possible link between better nutrition, educational attainment and associated life-time earnings gain (see paragraph 4.45).
Recommendation 28: DfES has asked all local authorities to revise their asset management plan data by the end of this year. This information should show-up deficiencies in kitchen and dining areas but will not, due to timing, reflect then standards and approach recommended in this report. We recommend that DfES should (i) consider what further work needs to be done to supplement the information gathered from current activity; (ii) use this information to ensure that kitchen and dining areas are a priority in capital spending programmes; and (iii) ensure that all future asset planning takes the new SMRP standards and approach fully into account (see paragraph 4.31)
Recommendation 29: In line with the Government's expectation that the transformation of school meals should be led by local authorities, we recommend that local level discussions recognise the desirability of phased – as opposed to sudden - price increases (see paragraph 4.43).
Recommendation 30: The Government should make school meals a priority during the Comprehensive Spending Review 2007 (see paragraph 4.44).
Monitoring and Evaluation
Recommendation 31: At appropriate intervals (eg. of 4 years) a nationwide evaluation of school food provision should be commissioned by DfES, to assess the types of foods and drinks available, their uptake and nutrient contribution to the overall diet. The evaluation should pay particular attention to provision for children who are nutritionally at risk. This evaluation should be timed for completion before the review of the standards in 2011 (see paragraph 5.23).
Recommendation 32: The main approach to external monitoring and evaluation should be through the regular inspections carried out by Ofsted. This should be supported by evidence gathered from the in-depth inspections of a sample of schools carried out by HM Inspectors, supported by nutritionists. The Panel recommends further work should be conducted by Ofsted and DfES to use the pilot inspections planned for November 2005 to develop the methodology and a rigorous set of tools to support those inspections (see paragraph 5.16).
Recommendation 33: A checklist should be developed, as part of the package of further tools and guidance. It should be piloted to ensure it is effective in bringing about change and supporting implementation of the nutrient and food standards (see paragraph 5.10).
Recommendation 34: Local authorities should be required to collect and report annually on progress in achieving healthy school standards, provision and uptake of all (including free) school lunches, and steps being taken to work towards the achievement of school lunch standards e.g. use of nutrition software, checklists, smartcards, incorporation of standards in contracts. The DfES should collect and collate this data to provide a national overview of progress (see paragraph 5.17).
Recommendation 35: The School Food Trust should hold a database of standards compliant menus for schools to use at their discretion; and standard analysis services which would support schools in providing and analysing their own meals service (see paragraph 5.7).


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