Shared learning database

 
Organisation:
Skcin – National skin cancer charity
Published date:
April 2021

NICE guideline Sunlight exposure: risks and benefits (NG34) highlights recommendations for strategies for implementing educational messaging to the public in relation to sun exposure. Skcin has adopted these recommendations into much of their wider work. The NICE guideline  NG44 Community Engagement recommendations has also been adopted and utilised with our national Sun Safe Schools accreditation

Skcin is a specialist skin cancer charity, founded in 2006 in memory of Karen Clifford (the ‘KC’ in Skcin) who lost her courageous battle to melanoma, aged 61.

We know that 86% of skin cancers are preventable this includes melanoma and non-melanoma skin cancers and armed with this fact Skcin has made their key objective to raise awarness of skin cancer and promote early detection/diagnosis and sun safety by working with at risk and influential groups.

Melanoma skin cancer risk | Cancer Research UK

Educational intervention must be the key to tackling this problem, not only to reduce skin cancer statistics, but also mitigate the huge burden of costs to the NHS. Skin cancer is in the top 5 most common cancers globally and skin cancer rates in the UK have grown by 45% in the last decade.

Skin cancer rates rocket by 45% in 10 years | Cancer Research UK

This much needed mass educational intervention needs to be broken down by demographic and targeted specifically to ‘at risk’ groups with the relevant education and messaging style / content to suit the relevant audience.

Skcin has always believed that a key ‘at risk’ group for consideration when tacking this mass market education needed to be children of primary school age. In 2016, ‘school children’ were highlighted in the NICE NG32 guideline and that ‘schools settings’ should be considered for mass marketing and messaging. Schools also feature in  all our nationwide communities and prime to engage key audiences and are key for cascading information to the wider community.

Our ‘Sun Safe Schools’ national accreditation programme was developed to be the community engagement method to covey sun safety education to primary aged school children. A website was developed to support teachers in making their settings ‘Sun Safe’. Schools have duty of care to keep children in their care safe, and this includes safe from the risk from over exposure to UV. The ‘Sun Safe Schools’’ website hosts a wealth of information to assist teachers in implementing not only a Sun Safe Policy, but teachings to children and cascading vital information the wider community of parents / carers.

The accreditation contains the UK’s most comprehensive FREE resource to assist primary schools in; creating a suitable sun protection policy, communicating this with parents to gain support and raising awareness across the wider school community; and educating pupils on the importance of sun safety, to influence behaviour and prevent skin cancer. The accreditation is free for all schools to take part and accessible via the online web site www.sunsafeschools.co.uk

To gain their Sun Safe Accreditation, schools must complete a 4-step process, providing feedback on-line following completion of each step. Extensive resources have been provided to help schools achieve each step effectively and efficiently, with maximum impact and confidence and with minimum strain on teachers’ valuable time and resources.

The accreditation was developed to be a robust solution to educational teachings on sun safety in primary schools. 

Does the example relate to a general implementation of all NICE guidance?
No
Does the example relate to a specific implementation of a specific piece of NICE guidance?
Yes

Example

Aims and objectives

Educational intervention and mass messaging to a key ‘at risk’ audience was our overriding objective consistent with NICE NG32 guideline and delivering this in a Community setting as per guideline NG44. The mission is to embed the seeds of sun safety into the children of today with the aim of evoking behaviour change for the next generation by which we can combat the rising statistics and mitigate the huge burden of treating skin cancer patients to the NHS - a long-term goal for the future.

Via community engagement at primary school’s, the aim was to reach a key ‘at risk’ audience with key sun safe messaging in effort to evoke behaviour change on a national scale. Key for the programme has been providing a solution that is free, accessible to all primary schools, robust in its comprehensive content and most of all provide longevity via an ongoing campaign with primary schools annually.

The objectives for the schools scheme: 

  • To raise awareness of the importance of sun safety and UV awareness for primary teachers, school staff, pupils and their parents and carers.
  • To reward primary schools for implementing sun safe policies and teachings in place.
  • To provide consistent learnings that are revisited and embedded annually via accreditation renewal.
  • To provide a wide selection of fun engaging curriculum linked resources, from lesson plans to assembly presentations to Y6 workbook using a selection of styles to engage children, from song, rhyme and storytelling. A one stop shop for all teachers.
  • To raise the profile of Skcin/Skin Cancer UK as a source of information on sun safety and skin cancer amongst the target market (primary teachers, school pupils and parents).
  • Provide continual development of resources and materials to support the scheme.
  • Provide case studies, positive outcomes and shared successes.
  • To work with regional PH and Councils for collaboration and participation to the scheme and review measured outcomes.
  • To engage with MPs and Government to lobby for national support.
  • To engage with Dept of Education to see sun safe teachings included in the national curriculum.
  • To provide a much sought-after solution to sun safe teachings to support a national initiative.
  • To improve functionality and reporting of school’s data for use with third parties
  • To secure professional and financial support into research for evaluation of the Sun Safe Accreditation.

The charity has over 4800 primary schools / nurseries registered to the scheme and has seen the growth in registrations annually supported by 100s of positive testimonials from primary schools. The campaign is now reaching over 750,000 pupils and their families that are engaged via the programme. As the scheme is online, it has no restriction of locality and Skcin has over 120 schools internationally taking part.

Due to Skcin’s consistent lobbing and campaigning with Government, we are enormously pleased to share that our lobbying with the Department of Education for five years has proved successful and that sun safe teachings are now to be made mandatory on the curriculum for all English primary schools as of September 2020. We expect significant growth in participation in 2021/22 and schools will be need of such support of the Sun Safe Accreditation to help fulfil their PHSE (Personal Health Social Education) obligations in relation to Health education.

 


Reasons for implementing your project

Children spend almost half their childhood at school, with approximately 8 hours per week spent outdoors. During the hotter months of the year children are exposed to UV radiation from the sun, the majority of which is when UV penetration is at its strongest. Without adequate protection, a child's delicate skin can burn within minutes, causing irreparable damage. This can significantly increase a child’s risk of developing skin cancer in later life. One blistering sun burn before adolescence doubles a person’s risk of skin cancer later in life.

Before the launch of Sun Safe Schools, we conducted a baseline assessment with a cohort of local schools to measure what educational teachings existed and alarmingly the results ranged from no education being undertaken to a small selection of schools that were delivering some ad hoc lessons. Primary schools did not have access to quality teaching resources or afforded any help to deliver such education.

After extensive research of the effective work undertaken in schools Australia, a country with a national problem with skin cancer, Skcin set upon developing our own Sun Safe Schools Programme in 2013 to fill a much-needed gap in education and support for primary schools. Since its launch, the registrations have increased year on year. The accreditation is providing a much-needed service to schools.

In the Summer months, the charity can receive more than 50 emails a day from teachers and / or parents posing questions about policy or needing advice. Skcin’s work attracts an increasing amount of, not only national interest, but international interest and participation with schools from around the world signing up, highlighting the need for a global solution to a global health concern.

 

There are over 28,000 primary schools in the UK, and this is the target market for promotion of the Sun Safe Schools Programme. This sector is the best demographic group for evoking behaviour change, starting with the next generation, and embedding the sun safe practices and knowledge early. Skcin’s work in this area is one key route where significant changes can be achieved in evoking behaviour change. Skcin by working with schools in nationwide communities can be effective for maximising reach of the audience concerned.

It is well reported that behaviour change is best achieved by a consistent multi stakeholder approach. Behaviour change is part of an interacting system. Behaviour change takes time: it is an ongoing process that requires continued reflection and support to embed the change. Small changes in intervention have the potential to have a great effect, more so when coupled with targeted messages to targeted audiences.

Professionally published research papers from overseas highlight that sun safety education in schools is effective, however the challenge still exists of how to measure this over a longer period of time i.e. 5-10 years or even a generational period of time. More government funding and a focus by PHE is required to achieve this and Skcin will continue to campaign for this.


How did you implement the project

Skcin over the course of our 14 years of existence has acquired a significant amount of knowledge and expertise in skin cancer education and early detection and prevention. Our main website is one such example www.skcin.org.

Skcin is supported by a team of expert advisory members who review our work and assist us with NICE consultations. However, the work around the Sun Safe website and the accreditation programme has been achieved by the charity single handily. We engaged with educational experts to review the best teaching methods and style to deliver our messaging and then tailored this by designing our framework to deliver these teachings and tackling key challenges at schools, in addition to developing our own comprehensive teaching resources.

To fulfil the NICE recommendations NG32 and NG44 we developed a four-step process that Primary schools needed to achieve to become accredited. These steps were in place to ensure the vital components of sun safety in a school setting were addressed. A sun safe policy is vitally important in schools. Equally, as important is teachings for pupils and communicating the sun safe policy to parents and providing and education to the wider community via the distribution of our sun safety and skin cancer booklets. The four steps to complete the accreditation are as follows:

4 STEPS TO GAINING A SUN SAFE SCHOOLS ACCREDITATION

STEP ONE: CREATE A SUN PROTECTION POLICY

Our on-line policy maker makes it easy for schools to tailor and download their own Sun Protection policy. This process ensures schools have considered and covered all essential guidelines and recommendations and can be confident that they are implementing a suitable policy to protect their pupils and present to parents. This also includes provision for shade referenced in NICE PH32: Skin cancer prevention.

STEP TWO: COLLABORATE WITH PARENTS

In accordance with a school’s tailored policy, a personalised letter is automatically generated to download and present to parents along with their policy and Sun Safety information to reinforce key messaging at home. This ensures schools are requesting the required level of support from parents, advising them correctly about Sun Safety and doing great work to increase vital knowledge about skin cancer prevention and early detection across the wider school community.

STEP THREE: CONDUCT A WHOLE SCHOOL ASSEMBLY

A range of bespoke resources including assembly plan, presentation slides with script, music and song are all available to download, helping schools to conduct their assembly, engage children of all ages and reinforce the importance of Sun Safety.

STEP FOUR: CONDUCT INDIVIDUAL CLASS LESSONS

A comprehensive range of fun and engaging, curriculum linked, educational resources and activities for key stage one and two pupils are provided to introduce, reinforce and increase knowledge regarding safe and unsafe exposure to the Sun and how to prevent skin cancer which forms part of the new PHSE Curriculum. Year 6 pupils are also provided with a bespoke leaver’s presentation, workbook and graduation certificate to extend their level of understanding and ensure they take vital knowledge with them into secondary education and beyond.

Upon completion, schools are awarded their Sun Safe Accreditation Certificate

The accreditation is valid for one year, with a renewal process in place to review their policy, reinforce support with the existing school community, advise newcomers and increase knowledge of sun safety through education.

Engagement with primary schools was our single biggest challenge and how to promote the sun safe school’s accreditation nationally. Schools are exceedingly difficult to engage with via mass email and telephone contact is equally as challenging. Teachers are busy people with heavy workloads and bearing this fact in mind was key to the development of the programme. It was important that the Sun Safe School’s accreditation was not arduous for schools to undertake.

Skcin has persevered in our efforts and built relationships with the Healthy Schools programmes nationally, local councils and public health. Skcin has embraced the use of social media to engage schools. Skcin has invested approx. £30,000 a year over the past 8 years to facilitate the free hard copies resources to schools. The costs for the management and strategic growth of the accreditation were absorbed by the charity.

Key for the charity has been providing a solution that is free of any costs, widely accessible, robust in its comprehensive content and most of all provide longevity and be sustainable for many years to come. Skcin’s was determined for this initiative not to be a short quick hit campaign with a short shelf life, but an initiative that could be sustainable and grow each year. We have built on the work achieved each year and grown participation and engagement to the scheme. The website now has the ability to be sustainable for the future and many years to come. This year due to COVID-19, we have decided to make all the resources digitally accessible to schools.

The Sun Safe School’s accreditation is a solution to implementing NICE NG32 and NG44  guidelines in proving an educational intervention and mass education to key ‘at risk’ audiences in communities nationwide.


Key findings

Skcin has met the objective in providing a solution to many of the mass market communications and recommendations in the NICE NG32/NG44 guidelines. The initiative has reached not only the schools, but all the children attending these schools and the parents/carers.

Skcin has 100s of pieces of self-reported data of positive testimonials left online by our community of school users and the high praise from patients and parents who are delighted we are offering such a unique service for schools.

Skcin acknowledges a need to consider a wider assessment of results and conduct a wider piece of research to compare the knowledge and behaviour change in pupils to schools that have not taken part in accreditation. In the interim, we are hugely encouraged by the feedback from schools.

Schools provide feedback on the steps via the web site. Some testimonials include:

“We feel that the sun safe scheme has been informative, helpful and fun for all of the children.

The children are now so much more aware of sun safety. The scheme has really helped us to

put a policy into place. The resources were really helpful and made the whole process so much

easier. We feel that the scheme is brilliant and couldn’t think of any way to improve it!”

The Richard Crosse CofE Primary School, Staffordshire

“The resources you have provided have been vital in us continuing to develop our messages

about being safe in the sun. They have also allowed us to share ideas as a whole school

community and address the importance of sun safety with the parents. This has linked well

with our National Quality Award for Healthy Schools accreditation, where we were praised for

our curriculum being built around being healthy, including in the sun”.

Cwrt Rawlin Primary School, Glamorgan

“The policy created and advice was very useful, especially the element of looking at UV levels

with the children. Pupils and staff have increased awareness and we are continuing to develop

our protection procedures. The whole system is great and provides a comprehensive approach

to the protection of children while outdoors”.

Miskin Primary School, Rhondda Cynon Taf

“The resources you have provided have been vital in us continuing to develop our messages

about being safe in the sun. They have also allowed us to share ideas as a whole school

community and address the importance of sun safety with the parents. This has linked well

with our National Quality Award for Healthy Schools accreditation, where we were praised for

our curriculum being built around being healthy, including in the sun”.

Cwrt Rawlin Primary School, Glamorgan

“Fantastic scheme, excellent resources and we have loved using it! The resources and

information have been great for us. I love the idea of the UV Monitor in each class, the song

and the powerpoint assembly plan was great. These were resources were high quality, fun and

engaging as well as reinforcing the key messages. Loved them. Thank you for creating such a

wonderful accreditation scheme for schools”.

Callands Community Primary School, Cheshire.

"The sun Safe schools’ scheme has been hugely beneficial. I feel that we have laid the

foundation which we will need to build on and repeat each summer term. It has been

interesting to hear the children’s attitudes to sun safety before and after. Some children were

saying that they ‘tan well’. After the series of the assembly, lessons and activities they all are

able to explain how dangerous sun tanning is. We are now as a school very strict with sun

safety. Working towards gaining the accreditation has given the school permission to be more

clear and strict with the children and parents around sun safety. The plan given has been fun

and enjoyable as we have gone along with it. We look forward to telling the children that they

have gained the accreditation. Thank you sun safe schools”.

William Gilpin Church of England VA Primary School, Hampshire

“The Sun Safe scheme over the last few years has wholly changed our school’s attitude towards

sun safety, in fact the whole school community’s attitude. Teachers spoke very positively

about the range of resources which were available to use. Children are fully aware of the sun

safe messages aimed at their level”.

Morley Primary School, Derbyshire


Key learning points

Skcin would recommend that with any project it’s important to reach out to stakeholders with the same goal. The behaviour change measurement over a long period of time is a challenge for which many organisations would prefer to not to take any action or commit to long term investment that may be needed over a 10-15 year period. But by providing no action and no educational teachings, we are failing our children’s health and their risks for the future from skin cancer. By children having an educational intervention they are better placed to make important life choices around adopting sun safe behaviours.

The achievement of our charity securing sun safety on the national curriculum for schools should not be underestimated. We now can make a huge difference to skin cancer education by tackling this problem at a grass roots level for the benefit of the nation’s health for many years to come.

In 2018, the DHSC published ’Prevention is better than cure: our vision to help you live well for longer’ highlighting the disparity of how much as a nation we spend in treating the disease as opposed to how much we invest into preventing disease. Considering that skin cancer and melanoma is 90% preventable, sun safety intervention measures should be top of the list to deal with this.

Skcin contributed to the consultation with our Sun Safe Schools work as a case study and direct strategy to tackle prevention of skin cancer. We hope this will be adopted and used by PHE.

The NICE guideline NG32/NG44 provides a positive framework of recommendations that can help us improve the nation’s health via community engagement in relation to safe exposure to uv/sunlight. The Sun Safe Schools accreditation is a positive solution to support the recommendations.

References

  1. Skin cancer rates rocket by 45% in 10 years | Cancer Research UK
  2. Melanoma skin cancer statistics | Cancer Research UK

Contact details

Name:
Marie Tudor
Job:
Chief Executive Officer
Organisation:
Skcin – National skin cancer charity
Email:
marie.tudor@skcin.org

Sector:
Education
Is the example industry-sponsored in any way?
Yes

In 2013 Skcin were fortunate to receive financial sponsorship from a commercial company Superdrug to enable us to develop and launch our Sun Safe Schools web site. As a charity that relies on public donations, such sponsorship was pivotal in getting this programme off the ground. Since 2013 Skcin have invested significant funds into the ongoing development of the Sun Safe Schools website, and over the subsequent years, invested into a comprehensive back office system to enable Skcin to measure school’s participation, performance and outcomes to the accreditation. In addition, for over 8 years Skcin provided hard copies of all the resources to all primary schools taking part nationwide.