Consultation on the Curriculum and Assessment (Wales) Bill
Evidence submitted to the Children, Young People and Education Committee for Stage 1 scrutiny of the Curriculum and Assessment (Wales) Bill.
Organisation: Resuscitation Council UK (RCUK)
1. The Bill’s general principles
1.1 Do you support the principles of the Curriculum and Assessment (Wales) Bill?
Yes
1.2 Please outline your reasons for your answer to question 1.1
(we would be grateful if you could keep your answer to around 1500 words)
Resuscitation Council UK supports the general principles of the Curriculum and Assessment (Wales) Bill (the Bill). RCUK welcomes the principles of the new Welsh curriculum, particularly the third and fourth purposes of the Bill. We support the intentions
To enable pupils and children to develop as ethical, informed citizens of Wales and the world.
To enable pupils and children to develop as healthy, confident individuals, ready to live fulfilling lives as valued members of society.
We are also pleased to see the additional emphasis on health within the Health and Wellbeing Area of Learning and Experience (AoLE). In particular, the recognition within the guidance of the behaviours, conditions and situations which can affect physical health, and the inclusion of the skills to be able to safely intervene when others’ physical health is at risk.
RCUK recognises that the new curriculum outlined in the Bill is designed to be flexible. We also appreciate that the Health and Wellbeing AoLE provides Welsh schools with the opportunity to teach first aid and lifesaving skills. However, RCUK would like to emphasise the need for a stronger commitment to the teaching of lifesaving skills in all Welsh schools. This remains compatible with giving each school in Wales the flexibility to decide how best to teach lifesaving skills, according to the resources available to them.
This will ensure Welsh pupils receive the same opportunity to learn these vital life skills as their English and Scottish peers, in light of the recent commitments to teach CPR at secondary school level in both England and Scotland.
The explicit inclusion of crucial lifesaving CPR skills is essential to fully implement the fourth principle and enable all pupils in Wales to respond confidently in an emergency.
Learning how to do cardiopulmonary resuscitation (CPR) and other important first aid skills will help children and young people to become healthy and confident individuals and ethical, informed citizens because it will help them to ‘know how to find the information and support to keep safe and well’. By learning crucial first aid and lifesaving skills such as CPR, pupils will be well prepared to keep both themselves and others safe and well, by
knowing what to do in an emergency like a cardiac arrest.
1.3 Do you think there is a need for legislation to deliver what this Bill is trying to achieve?
(we would be grateful if you could keep your answer to around 500 words)
Yes, RCUK agrees that legislation is necessary to deliver the aims of this Bill, particularly regarding the fourth purpose outlined above, and also to establish the Health and Wellbeing AoLE. Crucially, legislation is needed to ensure that all children in Wales have access to training; something that is not guaranteed with voluntary adoption or suggested topics for training.
We welcome the reference to lifesaving skills in both the progression steps for the Health and Wellbeing AoLE, and the curriculum guidance, which acknowledges the importance of teaching children CPR and lifesaving skills in Wales.
We are pleased to see this recognition of the benefits of these crucial lifesaving skills. However, RCUK is keen to ensure that every pupil in Wales has an equal opportunity to learn these skills, and as such, would urge the committee to go further to ensure that all pupils in Welsh schools are given the opportunity to learn CPR to guarantee this.
The Bill could be amended to ensure universal provision of CPR and life-saving skills in either of the following two ways:
(a) The Health and Wellbeing AoLE could include the word ‘must’ when referring to teaching of first aid and life-saving skills.
b) Life-saving skills could be included as a cross-cutting theme for curriculum design, like sex and relationships education, to ensure universal delivery.
2. The Bill’s implementation
2.1 Do you have any comments about any potential barriers to implementing the Bill? If no, go to question 3.1
(we would be grateful if you could keep your answer to around 500 words)
CPR education has been adopted successfully in both England and Scotland with no declared barriers. Omitting CPR and lifesaving skills from the subjects taught universally in Wales presents a barrier to the Bill’s aim of ensuring the safety of the Welsh population, both now and in the future.
Why commit to universal provision of lifesaving skills in the Curriculum for Wales?
If there is variation in teaching these skills across Wales, this could create differences in capability and motivation to act to help others in an emergency. We would like to see all pupils in Wales consistently being given the opportunity to learn lifesaving skills, to ensure no child is left behind.
Teaching lifesaving skills:
There are a wide range of approaches to teaching this topic. Some schools will already have established links with charities and the voluntary sector, whilst others will prefer to buy in training. How teaching is delivered at a local level can be flexible, according to the resources of each individual school.
The Committee may have concerns that teaching lifesaving skills may be complex or difficult for Welsh schools to undertake. To support its practical delivery in the classroom, RCUK has developed a range of resources for schools, many of which are free to use.(2)
Where resources are tight, resources such as RCUK’s free, award winning and BAFTA nominated interactive training tool Lifesaver(3) and Lifesaver VR(4) are available. Lifesaver allows evidence-based training on basic first aid and CPR to be delivered anytime, anywhere, with little to no prior teacher training or knowledge of first aid required.
As there may be fears related to increased risks of infection, posed by the COVID-19 pandemic, we have recently launched an animation(5) which teaches viewers how to do CPR safely right now, which can address these. There are regional versions for each UK nation, including a Welsh language version created in partnership with Save a Life Cymru.
RCUK is happy to advise the committee further on the range of options available to schools to deliver basic first aid training and how to teach CPR and the purpose of defibrillation within the Health and Wellbeing AoLE, and to make our resources freely available to Welsh schools for educational use.
(2) https://www.resus.org.uk/public-resource/cpr-schools
(3) https://www.resus.org.uk/public-resource/how-we-save-lives/lifesaver-learning/lifesaver
(4) https://www.resus.org.uk/public-resource/how-we-save-lives/lifesaver-learning/lifesaver-vr
(5) https://www.resus.org.uk/watch
2.2 Do you think the Bill takes account of these potential barriers?
(we would be grateful if you could keep your answer to around 500 words)
The barrier of unequal access to CPR training in Wales to achieving a healthy and safe Welsh population can be successfully addressed by the solution outlined above: a clear, legislative commitment to the universal teaching of essential life-saving skills, including how to do CPR and how to use a defibrillator.
As described above, this can be achieved at little to no cost to schools, and training can be conducted virtually. As such, a lack of resources in an individual school or any issues related to COVID-19 should not present a barrier to achieving this.
3. Unintended consequences
3.1 Do you think there are there any unintended consequences arising from the Bill? If no, go to question 4.1
(we would be grateful if you could keep your answer to around 500 words)
If the Bill remains unchanged, Wales will lose this opportunity to give the next generation of young people vital lifesaving skills, which could negatively impact Wales’ out of hospital cardiac arrest (OHCA) survival rates in the longer term.
RCUK is keen to ensure that Wales is not left behind the other nations of the UK, such as England and Scotland, where a universal commitment to teach CPR in secondary schools is now in place. This is important because UK survival rates after OHCA remain stubbornly low, in comparison to other nations where CPR is taught universally in schools.
There is strong evidence to show that teaching young people essential life-saving skills leads to more lives saved in all settings and over many years. In Denmark, where CPR training in schools has been mandatory since 2005, the chances of recovery from an out-of-hospital cardiac arrest are triple those in the UK. In Norway, where CPR is also a mandatory part of the curriculum, survival rates from bystander CPR are an astounding 70%, compared to less than 10% in the UK.(6)
The positive effects of mandatory teaching of CPR in secondary schools alongside a better implemented Chain of Survival have already been seen in Denmark, Norway, and also Seattle. By not following suit and delivering on an improved Chain of Survival in Wales, including universal provision of CPR and lifesaving skills, we not only risk allowing a postcode lottery on educational policy in the UK but also on survival rates from OHCA.
Without a universal commitment to teaching CPR in all Welsh schools, communities in Wales where CPR is not taught will be left behind, if this is dependent upon the choice of individual schools. As it is known that ‘people in deprived communities are more likely to suffer from cardiovascular diseases and OHCA and are less likely to survive than people from more affluent areas’, this could impact the most disadvantaged in society most of all.(7)
The universal teaching of CPR in Welsh schools could enable Welsh young people to act as changemakers, embedding a culture of lifesaving amongst the next generation in Wales. By sharing their new first aid knowledge with their families and friends, other members of the wider community can also be trained.
This would also enable the Welsh Government to deliver on the 2017 OHCA Plan for Wales’ commitment to Chain of Survival:(8)
Early recognition and call for help to prevent cardiac arrest
Early CPR to buy time
Early defibrillation to restart the heart.
(6) Böttiger BW et al. Kids save lives: School children education in resuscitation for Europe and the world. Eur J of Anaesthesiol 2017; 34: 792-96.
(7) Out of Hospital Cardiac Arrest Plan: Improving the care of people with an out of hospital cardiac arrest (OHCA) in Wales. NHS Wales/Welsh Government, 2017. P. 2.
(8) Ibid, P. 3.
4. Financial implications
4.1 Do you have any comments on the financial implications of the Bill (as set out in Part 2 of the Explanatory Memorandum)? If no, go to question 5.1
(we would be grateful if you could keep your answer to around 500 words)
Resuscitation Council UK does not have an answer for this question.
5. Powers to make subordinate legislation
5.1 Do you have any comments on the appropriateness of the powers in the Bill for Welsh Ministers to make subordinate legislation (as set out in Chapter 5 of Part 1 of the Explanatory Memorandum). If no, go to question 6.1.
(we would be grateful if you could keep your answer to around 500 words)
Resuscitation Council UK does not have an answer for this question.
6. Other considerations
6.1 Do you have any other points you wish to raise about this Bill?
(we would be grateful if you could keep your answer to around 1000 words)
CPR and lifesaving skills are crucial skills for life in all Welsh communities:
CPR and other elements of basic first aid are crucial lifesaving skills. Evidence demonstrates that where CPR is taught in schools, this can improve survival rates after out of hospital cardiac arrests, by increasing rates of bystander CPR, which have remained persistently low in the UK.
These skills are needed across all Welsh communities to give all citizens of Wales the best possible chance of survival. This is particularly important in rural areas with longer ambulance response times. Empowering the next generation with the skills and confidence to know how to respond and to act in an emergency is crucial to improving cardiac arrest survival rates.
CPR training can be delivered flexibly by individual schools in a way that meets their pupils’ particular needs, and as such making a universal commitment to CPR education remains compatible with the flexible approach which shapes the design of the new Curriculum for Wales.
To make the teaching of CPR and lifesaving skills as easy as possible for all schools in Wales, RCUK have developed free resources such as our Lifesaver and Lifesaver VR training tools, a new animation and other resources suitable for schools UK wide.
We look forward to continuing this work, but this would undoubtedly be more effective and lead to a substantive change in OHCA survival rates alongside a commitment from Welsh Government to universal provision.
RCUK urges the Welsh Government to take this opportunity to follow England’s example of making health education compulsory in English schools from September 2020, and the work done at local authority level to put CPR on the curriculum in Scottish schools. By joining England and Scotland in making CPR education universal, Wales can help to avoid the creation of a fragmented UK where Welsh pupils do not get the same opportunity to learn crucial lifesaving skills as their English and Scottish peers.
Public support:
Those who responded to a 2018 CPR education survey conducted by RCUK offered many messages of support for the inclusion of CPR within the curriculum, for example:
“I have taught CPR and first aid to children age 10-11yrs for 15 yrs in a hospital environment unfortunately our program was stoped [sic] due to lack of funding. We have proof it has saved lives”.
“I was trained in first aid & CPR back in 1993 at the end of Yr 6. I have had cause to use those skills many times both in my social and private life as well as professionally…I've seen the huge difference this small amount of knowledge can make and the only way to perpetuate this is to continue educating children and encouraging them through adulthood to further develop those skills”.
“My eldest daughter is 11 and is very sensible, going to and from school alone/with friends, playing out/ socialising with friends, it is possible that she may end up in a situation where there is no adult and it would benefit them greatly to have this knowledge, it would put parents minds at a little more ease if they knew an older child could help themselves and others if any situation were to arise”.
“… my brother collapsing at school with a heart attack and passing away at 14. CPR may have saved his life”.
Our survey indicates that CPR training in schools would have widespread public support, making it a very popular, as well as important, intervention. This is further supported by the findings of the recent Welsh Government survey, highlighting high rates of interest in CPR training and low rates of confidence to intervene in an emergency amongst the Welsh public.(9) RCUK is liaising closely with Save a Life Cymru on the next steps for their CPR training campaign for Wales.
Supporting Implementation and Evidence session:
RCUK would be pleased to assist the Welsh Government with the plans for the implementation of the Health and Wellbeing AoLE, by sharing our expertise from leading on similar campaigns such as World Restart a Heart Day,(10) a CPR training campaign focused on children and young people which trained over 291,000 people in the UK in 2019.
Resuscitation Council UK would also welcome the opportunity to take part in an evidence session for the Children, Young People and Education Committee, alongside our partners BHF Cymru, the Red Cross and St John’s Ambulance Cymru to advise further.
Summary:
In summary, learning CPR and lifesaving first aid skills as part of the Health and Wellbeing AoLE would help prepare pupils to be healthy, confident, ethical individuals who play their part in society by helping to save lives in an emergency.
RCUK strongly supports CPR training in Welsh schools as part of the Health and Wellbeing AoLE. A commitment from the Welsh Government to the universal provision of CPR education is our best chance to improve OHCA survival rates in Wales. By ensuring that the next generation of lifesavers are trained, the committee will become lifesavers themselves, by ensuring that all residents of Wales finally have the best chance of survival.
Please do not hesitate to get in touch if RCUK can be of any further assistance to the committee:
Rachel Warren, RCUK Policy Officer: rachel.warren@resus.org.uk.
(9) Prosser, N. (2019). Exploring public knowledge, attitudes and behaviours towards bystander CPR and defibrillation in circumstances of Out-of-Hospital Cardiac Arrest. Cardiff: Welsh Government, GSR report number 49/2019. https://gov.wales/sites/default/files/publications/2019-10/exploring-public-knowledge-attitudes-and-behaviours-towards-bystander-cpr-and-defibrillation-in-circumstances-of-out-of-hospital-cardiac-arrest.pdf
(10) https://www.resus.org.uk/get-involved/restart-heart-day
The mission of Resuscitation Council UK (RCUK) (1) is to save lives by developing guidelines, influencing policy, delivering courses and supporting cutting-edge research. Through education, training and research, we’re working towards the day when everyone across the UK has the skills they need to save a life. Our response focuses on the Health and Wellbeing Area of Learning and Experience (AoLE) of the Curriculum and Assessment (Wales) Bill, as our clinical expertise lies in cardiopulmonary resuscitation (CPR) and defibrillation. Resuscitation Council UK is grateful for the opportunity to respond to this consultation. We welcome the recent changes to include reference to lifesaving skills within supporting documents of the Curriculum and Assessment Bill. This includes reference being made in the progression steps for the first learning statement in the Health and Wellbeing Area of Learning and Experience (AoLE) on Developing Physical Health and Wellbeing has Lifelong Benefits, and more specifically, in the guidance for designing the curriculum as a specific consideration for this area. Although we are pleased to see that the Welsh Government acknowledged the importance of current and future generations learning lifesaving skills, the above changes unfortunately do not ensure that every young person in Wales will have the opportunity to learn skills such as CPR to help prevent sudden deaths in the community. RCUK would like to see a clear commitment by the Welsh Government that all schools will provide the opportunity for young people to learn lifesaving skills through the new Curriculum for Wales. In this response we will outline the evidence which shows the benefits of teaching these skills and highlight ways in which this Bill and the guidance for schools can be amended to end the current postcode lottery and ensure the universal provision of life-saving-skills teaching. We would also welcome the opportunity to participate in a joint evidence session for the Children, Young People and Education Committee. (1) https://www.resus.org.uk/