Good health in schools begins with selling fresh fruit in the cafeteria, encouraging the kids to get fit and active, and getting rid of the fizzy drinks machine. But that is just the start.

“When I first got the health remit I thought it was all about PE and home economics and the physical side of being healthy,” says Edith Girvan, quality improvement officer in East Dunbarton-shire. “But there is much more to it than that. What promotes health is very diverse. It’s about people feeling good.

“When I visit schools with our health accreditation team, one thing I love being able to say to headteachers is how happy their pupils and staff clearly are.”

This broad and inclusive interpretation of good health in East Dunbartonshire reflects the national guidance in Being Well - Doing Well, the Scottish Executive’s framework for health-promoting schools: “Health is taken to mean physical, social, spiritual, mental and emotional well-being in relation to oneself, society and the environment,” says the document.

Achieving all that for every pupil and member of staff is a tall order, particularly when it has to be done by the end of 2007. So accreditation of schools around the country is being done through schemes devised by local authorities and NHS boards, and endorsed by the Scottish Executive. These aim to monitor a school’s self-evaluation based on HM Inspectorate of Education quality indicators.

“In East Dunbartonshire we have been working with other authorities such as West Dunbartonshire, Renfrewshire and Argyll and Bute, to develop our accreditation scheme,” says Mary Larkin, quality improvement officer.

“We have already inspected and accredited over half our schools. All of them will be inspected by the end of this year. Then, in each of the next two years, we’ll review what the school has been doing, check any points arising from the inspection, make sure they’ve got them in their development plan if necessary. We will do the full health accreditation for each of our schools every three years.”

Inspection by the health team lasts a day and is not as daunting an experience as a visit from HM inspectors, says Greg Caldow, principal teacher at Millersneuk Primary - although there are similarities. “We had to gather boxes and folders of evidence, showing what health promotion was taking place in our school. Then, on the day, the team came in and studied the paperwork,” explains Mrs Larkin.

“They went on a tour of the school. They interviewed parents. They visited the cafeteria, tasted the lunches and talked to children about the impact health promotion was having on them. It was a very nice day - more relaxed than a visit from the inspectors, although every bit as thorough.”

That depth and thoroughness arises partly from the guidance produced by the Scottish Health Promoting Schools Unit and partly from professional development delivered to members of the East Dunbartonshire accreditation teams, one of whom is usually a practising teacher.

“A lot of it is about helping schools realise what they do already to promote good health - and how they can improve on it,” says Ms Girvan.

“It’s not a big, new thing they have to take on board. So we train people on the teams to get that message across, and to look for good practice in schools.

“We tell them about the quality indicators, the key characteristics they have to look for, the practical aspects of carrying out a visit.”

Mr Caldow volunteered for the training, he says, because Millersneuk Primary was scheduled for a visit from the accreditation team, and “what better way to learn what they were looking for than to get training and experience from the other side of the fence”.

Since then he has been on a health accreditation team visit to a secondary school, which was an eye-opener in terms of the health problems young people face, he says.

“Some things they were doing with eating and exercise were generic, but they also had a lot of counselling and support for the older children’s emotional needs. The pupils had an incredible amount of input to health promotion, and had produced a leaflet themselves which is going out to all our schools.

“I think having a teacher on the accreditation teams says something important to schools - that teachers are a key part of the process, that their input is valued.”

While this is undoubtedly true, the key to health promotion in schools - and to health accreditation of those schools - is collaboration with a range of individuals and organisations, says Ms Girvan.

“Partnership is essential and, for best results, schools should get all their partners involved (nursing staff, psychologists, active schools co-ordinators) right at the beginning, at the planning stage. Active schools co-ordinators, for instance, are particularly good at working with young people to develop playground games.

“Being a healthy school is about embedding good health into everything that staff or pupils do. It’s also about balance. If somebody feels like sugar in their coffee once in a while, there’s nothing wrong with that.

“Personally, I like a fish supper on a Friday night.”