The recent NHS 10-year plan received blanket coverage, with its broad approach to improving patient care – focusing on prevention and inequality – widely welcomed. But for one school in the west of England there was a critical oversight: schools barely got a mention.

Budehaven community school, in north Cornwall, is one of a handful in the country to integrate health and education. Specialist health centres on school sites allow young people to access a comprehensive range of services, from contraception advice to support with mental health, drug and alcohol abuse and complex family situations.

The scheme has had startling results. According to one of the brains behind it, Barbara Vann, a former headteacher and now chair of the Cornwall Foundation Health Trust, anyone serious about transforming outcomes for young people would “write the words ‘integrated health centre’ (IHC) in the margin all the way through the 10-year plan”.

The idea came into being more than 10 years ago amid concerns about young people’s health in Cornwall, where children’s life expectancy was going down while problems such as childhood diabetes were increasing.

A grant from the Duchy Health Charity was agreed to funded three school health centres, in Bude, Truro and Hayle, if the schools agreed to take on the running costs.

Young people were surveyed about the support they needed and have been in joint control of the provision ever since, as part of a student management group. Critical to the scheme is adherence to NHS – rather than school – standards of confidentiality: there is no obligation to inform parents of pupils’ involvement.

So at Budehaven, pupils can walk across the school site to a converted building (formerly the caretaker’s house) known as The Haven to discuss problems in complete confidence, avoiding issues around identification and parental involvement in the tight-knit community.

“This was imperative from the start,” says Vann. “The young people didn’t trust services outside schools because Cornwall is like a big village. You can be seen going in the chemist to get birth control; you may need parents’ help to get access to the sorts of provision that are only available in large towns or cities.”

This involved a “big conversation in schools”, Vann says, about issues such as dispensing condoms, including for pupils under 16, which the schools do through the government’s C-card system and a visiting nurse from the sexual health charity, Brook.

All the IHCs have been tightly evaluated from the start, and researchers have seen a direct effect on attendance among the most hard-to-reach pupils, as well as reduced involvement in youth offending teams.

Left to right: Budehaven’s integrated health centre manager Lizzie Brock, headteacher Tracey Reynolds and the headteacher of Wadebridge school, Tina Yardley. Photograph: Peter Flude/The Guardian

Budehaven has logged 55,000 visits since it opened in 2010, which also include some parents and students from other schools, former students and a students taking part in a vaccination programme. Its IHC works with around 70 external professionals and, as parents and the community have seen the direct benefits to young people, concerns about confidentiality have reduced.

The manager of Budehaven IHC, Lizzie Brock, believes this is mainly because pupils can immediately find someone to talk to outside home and the classroom when their life feels out of control. This can be an incentive for those who struggle to get into school, especially if there are problems such as domestic abuse, friendship issues, exam stress, or gender identity anxiety.

“Pupils sometimes just need an ear, a tissue and a hot chocolate. Often they will discuss a concern with me and I can then make an appropriate referral,” she says.

For the heads, commitment to the scheme means finding money to cover running costs at a time of cripplingly tight budgets and when cuts are being made elsewhere.

But Budehaven’s head, Tracey Reynolds, is adamant the scheme must continue: “We would cut elsewhere to keep it going,” she says. “This community relies on seasonal, part-time work, there are many families on benefits, and food banks are well used. We provide a haven for young people who are suffering because of cuts. Why force them to go all over the place when they can seek help here?”

The NHS has now committed to opening a further three centres in the county. Tina Yardley, headteacher at Wadebridge school, whose IHC opened in 2017, says: “The idea that health works in isolation is crazy. If this service didn’t exist there would be pupils staying at home, possibly remaining in a bad friendship group and getting in to trouble. Kids are with us six hours a day. We can bring in expertise we don’t have. If they are attending school, that will help their academic outcomes.”

But possibly the best champions of the scheme are the students themselves, who take it for granted that they have a safe space where they can get everything from contraception to counselling.

Matt Cleave, sixth form president at Budehaven, describes the IHC as the “first port of call”. “It is a huge relief knowing you can just pop in here and speak to someone who doesn’t know you. Many pupils live in isolated villages where the doctor is a long drive away. I have friends and family in other schools and I know they have to travel very long distances to get the same help.”

The garden area at Budehaven community school’s integrated health centre Photograph: Peter Flude/Guardian

A fellow year 13 pupil, Emily Skipp, says she benefited from the scheme from her first day in year 7: “I came from a school without any other friends and it was scary so they opened The Haven garden for me as a safe place. It helped me slowly become more confident.”

According to Vann, the constant evaluation means schools can adjust provision: “We are not just holding a finger in the wind. We are looking at trends and patterns,” she says. For example, the rapid rise in teenage mental health concerns has already prompted adjustment at a time when the child and adolescent mental health service (Camhs) is under intense pressure.

In addition to the IHCs, the Cornwall Heath Foundation Trust is recruiting and training associate psychologists (currently used in GP practices in Scotland) for every one of the county’s 31 secondary schools to support with assessment and referral to Camhs.

The obvious question for anyone visiting Budehaven is: why can’t every school have this? Why not have the NHS fund something similar in every school?

But not every school wants it, Vann says. “Heads and governing bodies have to embrace this. It is not only about money; it requires a change of attitude and a different way of thinking. Some may fear loss of control to the students. Some heads have just got used to doing their own thing, or believe education should be kept separate from other public services.

“There are specific reasons why we wanted to do it here in Cornwall but it could be applicable around the country. In that sense we are years head of the NHS 10-year plan.”