How we made the decision

We check our guidelines regularly to ensure they remain up to date. We based the decision on surveillance 8 years after the publication of NICE's guidelines on social and emotional wellbeing in primary education (NICE guideline PH12) in 2008 and social and emotional wellbeing in secondary education (NICE guideline PH20) in 2009.

For details of the process and update decisions that are available, see ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual.

Surveillance update decisions for NICE guideline PH12 are on our website here and for NICE guideline PH20, can be found here.

New evidence from 8-year surveillance review on NICE guidelines PH12 and PH20

One literature search was undertaken:

  • A quantitative search strategy considered intervention only studies around resilience, mental wellbeing and transitioning in children, from 2012 onwards.

All relevant abstracts were assessed for their impact on the recommendations within NICE guidelines PH12 and PH20.

Topic experts provided advice. We also checked for ongoing and newly published research from NIHR and Cochrane as well as new policy developments. A number of ongoing research trials were found that related to reducing bullying, anxiety and depression, and improving resilience, health behaviours and mental health.

See the appendix for NICE guideline PH12 and the appendix for NICE guideline PH20 for references and assessment of the abstracts for all new evidence considered.

Consideration of the evidence

We found a total of 57 new studies through surveillance of this guideline. During this 8-year surveillance review a considerable amount of evidence (systematic reviews and randomised controlled trials [RCTs]) was identified which assessed the efficacy of a range of intervention types for decreasing and preventing anxiety, depression, negative thoughts and emotions and improving resilience, coping skills, self-esteem and mental health awareness. Although there were limited descriptions of interventions (based on the content of study abstracts) the evidence base appears to have moved on since the publication of NICE guidelines PH12 and PH20 with a range of interventions described across the new evidence. There are a number of approaches reported across the studies which focus on mindfulness, parenting programmes and teacher led training.

New evidence from RCTs also identified interventions that successfully tackled cyberbullying. These included a number of whole school approaches targeting bullying and victimisation.

During this 8-year surveillance review a topic expert suggested that there was a need to make recommendations on preventing and tackling bullying (both physical and virtual) in the guidance.

Topic expert feedback indicated that the following factual corrections should be actioned:

  • Two of the national Initiatives referred to are no longer in use and their contents have been archived: Social and Emotional Aspect of Learning (SEAL) programme and Healthy Lives Brighter Futures.

  • Any reference to primary care trusts (PCTs) should be amended to local authorities or commissioners.

No other new evidence was identified that would impact on any other areas of the guideline.

Previous surveillance reviews

There was a surveillance review of NICE guideline PH12 in 2013. This recommended that the guideline should be updated due to the following considerations:

  • Recommendations could be strengthened by a level of detail of evidence that wasn't available when the evidence for this guidance was originally collated.

  • There were a number of other areas that could be included in the guidance or developed separately.

  • There was a need to ensure the continuity of programmes aiming to promote the social and emotional wellbeing of children and young people was assured by use of a life course framework.

  • Stakeholders commented during the surveillance process that more should be incorporated into the guideline around media safety.

There was a surveillance review of NICE guideline PH20 in 2013. Stakeholders responded that there was little within the recommendations around mental health and anxiety management and that this should be addressed.


There has been nothing identified through implementation feedback that would indicate a need to update the guideline. Feedback from the NICE Adoption and Impact team stated that there was no data in regard to the uptake of NICE guidelines PH12 and PH20 recommendations.

Anti-discrimination and equalities considerations

There has been no evidence to indicate that the guideline does not comply with anti-discrimination and equalities legislation.

Implications for other NICE programmes

None have been identified.

Views of topic experts

We considered the views of topic experts, including those who helped to develop the guideline and Public Health England leads. Two topic experts responded, one believed that NICE guideline PH20 should be updated due to:

  • The reorganisation of the NHS.

  • A need to encourage a whole school approach.

  • A need to strengthen the recommendation around bullying and focus on virtual bullying.

  • A need to consider online fora like social media when discussing children's social and emotional wellbeing.

The other respondent provided references that were used during a meta-analysis in the guideline on the effects of school-based, universal social and emotional learning programmes on outcomes such as pro-social behaviour, conduct problems, emotional distress, academic achievement and emotional competence.

One topic expert responded on NICE guideline PH12, stating that they were 'unsure; as to whether the guideline should be updated'.

Public Health England were supportive of an update of these guidelines, in particular in the areas of building emotional wellbeing and resilience and prevention of poor mental health.

Overall decision

After considering the guideline content, the views of internal teams within NICE and external experts, the Surveillance team recommend that the NICE guidelines on social and emotional wellbeing in primary education and social and emotional wellbeing in secondary education are amalgamated and updated.

NICE Centre for Guidelines Surveillance project team

Kay Nolan
Associate Director

Emma McFarlane
Technical Adviser

Charlotte Haynes
Senior Technical Analyst

Victoria Axe
Technical Analyst

The NICE project team would like to thank the topic experts who participated in the surveillance process.

ISBN: 978-1-4731-2775-3

This page was last updated: 21 December 2017