Project health resilience
Project health resilience (PHR) is a cross-organisational initiative delivered by doctors in educational settings designed to enhance health literacy among young people in London, aged 16-19. Initially piloted in Camden, the programme has been rolled out more widely across London as part of a wider pilot initiative through the NHSE Legacy and Health Equity Partnership. PHR has partnered in this programme with:
- UK Health Security Agency (UKHSA)
- Camden Council
- Association of Directors of Public Health (ADPH)
- Partnership for Young London
- London School of Hygiene and Tropical Medicine (LSHTM)
- Asthma Innovation Research
- Thrive LND
- Barts Health NHS Trust
- Imperial College Healthcare NHS Trust
- North Central London GP Training Hub.
Initiative
The PHR programme aims to address the gap often found in young people’s understanding of health services and their ability to engage with healthcare effectively. By embedding health literacy education into school and youth settings, through educational presentations from trust clinicians, it seeks to empower young people with the knowledge, confidence, and trust needed to navigate the healthcare system independently. Young people were identified as a key age group to target as they are transitioning through their development and will likely be expected to independently engage with healthcare services for the first time during this period.
At the heart of PHR is an evidence-based approach, shaped by collaboration, codesign and extensive consultation with educators, young people, and healthcare professionals. Following an initial pilot in a Camden sixth form, the success of the scheme secured funding to roll out the programme across nine London boroughs from April 2023 to March 2024.
This expansion involved recruiting and training clinicians – termed ‘PHR ambassadors’ – who deliver interactive and engaging health literacy sessions in educational and youth settings. The ambassadors, comprising doctors and public health professionals, received comprehensive training in the session content, facilitation skills, and cultural sensitivity to ensure the programme was both informative and accessible to a diverse range of young people.
Multiple London NHS trusts and GP practices supported the project by enabling the involvement of PHR leads and ambassadors. The project’s medical emergencies lead and mental health lead joined from Barts Health NHS Trust and Imperial College Healthcare NHS Trust respectively, both incorporating roles as education fellows. They were able to bring valuable insights from their role within the trust, contributing meaningfully to the project. In turn, the experience of adapting content for different audiences within the project helped to inform and enhance their ongoing work at the trust. Similarly, the access to healthcare lead was recruited as part of the North Central London GP SPIN/Fellowship scheme.
Partnerships with the NHS trusts were further utilised to help recruit the voluntary PHR ambassadors. The opportunity was advertised to doctors through specialty specific teaching sessions, and the trusts would support them through approving study leave to attend training and the delivery of PHR sessions.
The PHR curriculum is structured around four core health literacy modules covering:
- mental health resilience
- dealing with medical emergencies
- accessing health services
- screening and immunisations.
These modules were evaluated in collaboration with LSHTM and were refined based on feedback from students and educators. Each session is delivered in person by either subject specialists or trained PHR ambassadors, with a focus on interactive learning methods. Activities such as digital engagement tools (e.g., Mentimeter for real-time polling and Q&A), scenario-based discussions, and group exercises ensure that students are actively involved in their learning. The sessions are capped at 30 participants to allow for meaningful engagement and are provided free of charge, with a staff member from the host setting present to support integration into existing educational structures.
Beyond increasing health knowledge, PHR is designed to foster trust in healthcare professionals by providing young people with direct interaction with clinicians in a nonclinical setting. This direct engagement has aimed to bring down barriers to accessing healthcare, particularly among young people living in areas of high deprivation who may have lower baseline levels of trust in the NHS overall.
Critically, the initiative not only benefits students but also enriches the training and cultural competency of participating NHS professionals. By engaging with young people in community settings local to where they work, the programme hopes for PHR ambassadors to develop a deeper understanding of the barriers faced by young people in accessing healthcare, enhancing their ability to deliver patient-centred care in their NHS roles.
Evaluation and impact
PHR has demonstrated significant impact in enhancing health literacy, building trust in healthcare professionals, and improving confidence among young Londoners in navigating health services and contributing to broader health equity goals. The programme’s structured evaluation, conducted with ethical approval from LSHTM, utilised quantitative and qualitative elements, incorporating pre- and post-session questionnaires, semi-structured interviews, and focus groups with participants, educators, and facilitators.
Key findings
During the one-year pilot (April 2023 – March 2024), PHR delivered:
- 68 sessions across 13 different educational and youth settings.
- Over 1,000 pupil attendances across nine London boroughs, ensuring broad reach and engagement.
- Delivery to young people from diverse ethnic backgrounds, and a higher-than-average proportion of students on free school meals.
The preliminary findings of an evaluation revealed substantial improvements in young people’s health literacy, confidence, and trust in healthcare professionals:
- Increase in confidence in accessing healthcare following participation in the ‘Accessing Health Services’ module.
- Increase in participants knowing which mental health services were available following the ‘Mental Health Resilience’ module.
- Increased confidence in dealing with a medical emergency.
- The proportion of those who strongly trusted in healthcare professionals almost doubling.
These preliminary findings suggest that PHR not only equips young people with knowledge but also fosters a greater sense of self-efficacy in managing their own health, a crucial factor in reducing long-term health disparities.
Sustainability and next steps
The success of the programme has created strong demand for further roll-out and long-term integration within London. The programme is currently looking to secure sustainability and address operational challenges before resuming delivery.
PHR have established a set of priorities to achieve success, which includes:
- secure long-term funding and ensure financial sustainability
- scale to meet demand following the strong reception of sessions, while maintaining quality
- recruit and train more clinicians to become PHR ambassadors, offering shadowing opportunities for the next generation
- enhance training quality and support through a framework outlining facilitation skills, content expertise, and the understanding of patient need
- create an efficient, user-friendly booking system to maximise access, and
- prioritise the most vulnerable young people and ensure an equity-focused approach.