Please ensure Javascript is enabled for purposes of website accessibility Impact of COVID-19 on education and children’s services response - Impact on Urban Health
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COVID-19 Childhood obesity

Impact of COVID-19 on education and children’s services response

3 August 2020
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10 min read

Our response to the House of Commons' Education Select Committee

Introduction

Note: Impact on Urban Health is part of Guy’s and St Thomas’ Charity.

 

Guy’s and St Thomas’ Charity is an urban health foundation, exploring how living in cities impacts on people’s health. We take an applied approach, testing whole-system solutions to complex health issues. We focus our efforts in inner-city London and work in areas that experience the widest health inequalities.

We have an ambitious 10-year programme aimed at tackling childhood obesity. Our goal is to close the ‘childhood obesity inequality gap’: to reduce childhood obesity rates in lower income areas to closer to those in wealthier areas. To achieve this, food options available to children and families in inner cities need to fundamentally change. Nutritious food needs to displace the huge prevalence of unhealthy food as options that meet families’ need for food that is affordable, convenient, tasty and healthy. We work with partners in the private, statutory and third sectors to achieve this mission. ​

The World Health Organisation has said that childhood obesity is one of the most serious public health challenges this century1. The impacts of obesity in childhood are lifelong: overweight or obese children are more likely to be overweight or obese as adults, are more likely develop health conditions such as diabetes, heart disease and cancer, and are more likely to die earlier2.

Tackling childhood obesity should not just be viewed as a matter for health services. Childhood obesity is strongly linked to some of the main social determinants of health, including living in an urban environment, financial deprivation and ethnicity, and so requires a whole systems approach. Education and early years settings have an important role to play in ensuring children have access to affordable, nutritious food.

We know that the environments children spend their time – their home, school and streets – are key drivers of eating and physical activity3. COVID-19 has already had unprecedented impact on all three of these environments, reducing household incomes, temporarily closing schools and affecting food supply and local retailers, including destabilising school food catering provision in many areas. The consequences of these increases in inequality have potential to be long-term and severe, such as rising rates of childhood obesity.

Summary

Our submission to the Education Select Committee inquiry on Food Supply during the COVID-19 pandemic is founded in our expertise in childhood obesity, and our lens as an urban health foundation working to tackle health inequalities. The submission draws on existing evidence, as well as new research we are undertaking to understand the current and likely future impact of COVID-19 on food and diet.

In this submission, we draw the Committee’s attention to the significant impact that COVID-19 and school closures have had on access to healthy, affordable food for families on low incomes in particular. This has exacerbated avoidable challenges — like the poor design of voucher schemes. Targeted and timely action from Government, working closely with schools, businesses and communities themselves, will be essential to ensure the pandemic does not widen even further the childhood obesity gap between the richest and poorest families.

Our submission focusses on the following questions in the inquiry’s terms of reference:

  • The financial implications of closures for providers (including higher education and independent training providers), pupils and families
  • The effect on disadvantaged groups, including the Department’s approach to free school meals and the long-term impact on the most vulnerable groups (such as pupils with special educational needs and disabilities and children in need)
  • What contingency planning can be done to ensure the resilience of the sector in case of any future national emergency

We draw the Committee’s attention to the following pressing issues:

  • Free School Meals (FSM)
  • Plans for school food catering in September 2020

Recommendations

Long-term

  • The thresholds for FSM should be urgently reviewed, and the application process streamlined to make it as simple as possible for all families whose situations have changed due to COVID-19 to access FSM support.
  • The eligibility for FSM should be extended to all families with no recourse to public funds on a permanent basis to help mitigate the long-term impact of COVID-19 on inequalities.
  • Steps should be taken to address the gaps in FSM provision for nursery-aged children.

Short-term

  • Provision should be put in place for such families who have not been able to prove eligibility before the deadline to apply for the COVID Summer Food Fund, or who become eligible over the summer holidays, to be granted access to this support.
  • Government should work with retailers to ensure that families receiving FSM vouchers are supported and able to use the vouchers to buy nutritious food.
  • The range of retailers participating in the FSM voucher scheme should be broadened to include convenience stores and low budget supermarkets.
  • Families should be provided with clear information for families about how to access the COVID Summer Food Fund, with particular attention to any tailored communications that may be targeted at groups where uptake is particularly low.
  • Administrative challenges in accessing the FSM voucher scheme, such as problems with the website used to administer the scheme, should be addressed.
  • The digitalisation of the Healthy Start scheme should be brought forward.
  • Government should support schools and caterers to prioritise the provision of hot, nutritious meals for as many children as possible in the Autumn Term.

School meals

For over 1.3million children from the most deprived backgrounds, Free School Meals (FSM) are an essential guarantee of a regular, nutritious hot lunch4. As FSM currently don’t cover breakfast, many schools also offer breakfast as part of their extended hours childcare provision. The impact on school closures on children’s diets has therefore been significant. It is encouraging that national Government has continued funding for FSM in England through schools and supermarket channels during school closures, and has committed to the COVID Summer Food Fund5.

However there remain some pressing issues to be addressed. At an overarching level, it is vital that initiatives such as the FSM voucher scheme don’t solely address food insecurity, but also ensure that families on low incomes have access to nutritious food during this period and as the longer-term, economic impacts of the pandemic are felt.

Guy’s and St Thomas’ Charity have funded an emergency schools COVID-19 response project in Lambeth and Southwark. By week eight of the project, breakfast boxes had been delivered to families at 101 different schools, with enough food for 236,730 healthy breakfasts. Hampers had been delivered across eight schools providing 25,200 lunches.

The scale of the demand for this support has far outstripped the official numbers of families eligible for FSM. A major driver of this is the increase in families experiencing financial hardship and food insecurity due to COVID-19: evidence shows that families on low income have been hit hardest by job insecurity and unemployment due to COVID-19. This increase in eligible families raises urgent challenges:

  • Increasing uptake of the FSM voucher scheme: Uptake of the FSM voucher scheme remains low. Three weeks into school closures, over a third of households eligible for FSM were not accessing the voucher scheme6. This means that over 507,000 children who normally benefit from free school meals were not accessing any alternative provision. The factors behind this low uptake need to be explored and addressed. For example, the FSM voucher scheme is not yet available in some budget supermarkets more likely to be used by families with low income. Likewise, the Association of Convenience Stores have expressed willingness to participate in this scheme, but EdenRed (the scheme administrator) have cited administrative capacity as an obstacle to this
  • Families newly eligible for FSM: Schools in Lambeth and Southwark have told us that many families who are newly eligible for FSM due to COVID-19 related unemployment are yet to appear as eligible for the local authority, which is jeopardising their chances of registering for the COVID Summer School Fund. Anecdotal evidence indicates that this is true particularly where families have only recently registered for Universal Credit and there is a delay in the local authority receiving all the necessary information to be able to grant access to FSM. It is important that provision is put in place for such families to be granted access to this support after the deadline
  • Restrictive eligibility criteria for FSM: There are concerns that existing thresholds for FSM eligibility are too restrictive in the current climate, where more families are experiencing sudden changes to their financial situation and uncertainty over their employment status. For example, one inner-city London primary school reported that there had been 69 new applications for FSM from families during lockdown, of which 45 had been rejected. However, with support from the school, some of these families had been successful in challenging the decision. Similarly, schools have reported increasing numbers of families who are facing financial uncertainty, but who are not eligible for Universal Credit or other benefits, who are turning to schools for support in the absence of other services. It is vital that the thresholds for FSM are reviewed, and the application process streamlined to make it as simple as possible for all families whose situations have changed due to COVID-19 to access FSM support
  • Families with no recourse to public funds: The Government’s decision to temporarily extend FSM provision to more families with no recourse to public funds is welcome. However, there are a significant number of families with insecure immigration status who are still excluded from accessing FSM provision7. Moreover, the extended provision is only available until schools fully re-open (September 2020), after which families who have temporarily been granted FSM will have this provision revoked. We urge the Government to extend eligibility for FSM to all families with no recourse to public funds on a permanent basis to help mitigate the long-term impact of COVID-19 on inequalities

As we enter the summer holiday period, the COVID Summer Food Fund needs to address these challenges to ensure as many families as possible are benefitting from this support. Guy’s and St Thomas’ Charity would be delighted to support this work, for example by convening retailers and other interested stakeholders to model solutions. Actions should include:

  • Broadening the range of retailers participating in the voucher scheme to include convenience stores and low budget supermarkets
  • Ensuring clear information for families about how to access this support, with particular attention to any tailored communications that may be targeted at groups where uptake is particularly low
  • Addressing administrative challenges in accessing the scheme, such as problems with the website used to administer the scheme8
  • Ensuring the FSM voucher scheme supports families to access nutritious food: There are currently no restrictions (other than alcohol and tobacco) on what the FSM vouchers may be used for. Research published in July showed a significant decrease in fruit and vegetable intake by children eligible for FSM during lockdown9. Government and retailers could do much more ensure that families are encouraged and able to use the vouchers to buy nutritious food, for example through the use of promotions on fresh food and suggested ‘food packs’ that demonstrate both value for money and nutritional balance
  • Lack of provision for nursery-aged children from low-income families: Steps should be taken to address the gaps in provision for nursery-aged children from particularly vulnerable families. All children in nurseries get a free lunch through Universal Infant Free School Meal provision, however, eligibility for the COVID Summer Food Fund does not extend to families with younger children10

Healthy Start vouchers do provide welcome support for families with pre-school aged children (and pregnant women) in England, Northern Ireland and Wales, enabling access to dairy or formula milk, and fresh fruit and vegetables for those who are eligible for other benefits. The scheme is due to be digitalised in October 2020, but at present uses printed vouchers. Extended periods of social distancing mean that families without access to a printer may not be able to continue accessing this scheme.

We recommend that the digitalisation of the Healthy Start scheme is brought forward.

School catering

COVID-19 and school closures have highlighted the fragility of the school food catering market in many areas. As school food caterers have struggled with financial uncertainty and workforce shortages due to COVID-19, early evidence indicates that the nutritional quality of school food has taken back seat. For example, many schools have been reliant on packed lunches as opposed to hot meals as they re-open to pupils, due to social distancing guidelines. Our own engagement with schools indicates that this may continue as schools fully re-open in September.

It is vital that schools and caterers are supported to prioritise the provision of hot, nutritious meals – shown to be healthier than packed lunches in most cases11 – for as many children as possible in the Autumn Term.