Background School food policy forms part of national strategy for addressing obesity, poor health and food insecurity in children. However, recent evaluation indicates that national school food policy (e.g. school food standards) in England is poorly implemented and lacks impact in secondary schools, highlighting a need to improve policy and its implementation in these settings. In this study, we aimed to co-develop and prioritise actions for improving school food policy from the perspectives of a diverse range of stakeholders using participatory approaches. In the initial phase, we conducted workshops and from the resulting data generated 26 action areas for improving school food. Here we report on the prioritisation of these action areas with a group of stakeholders with an interest in school food policy.

Methods We convened a group of ten key individuals representing national and local groups/organisations with expertise/interest in school food policy, incorporating youth (n=2), parent (n=1), school leadership (n=1), food education (n=1), catering (n=1), local authority (n=2), academic (n=1), and charity (n=1) representatives. Through a series of meetings and tasks based on Nominal Group Technique, undertaken October-November 2023, the group scored, discussed and ranked the 26 identified action areas, resulting in a list of 10 priority action areas on secondary school food policy. Qualitative thematic analysis was conducted to explore the group’s perspectives during the prioritisation process.

Results Actions for government were identified as a key priority, including increasing funding for, and national joined-up leadership on school food. School leadership and policies, investing in/developing catering staff and student engagement were recognised as important at the school level. Changing food service arrangements and adapting the food offer to increase quality and meet students’ needs, whilst improving monitoring of school food standards compliance, were also prioritised. Addressing the wider food system and environments also ranked highly as a priority action. Qualitative analysis highlighted that although the group felt that all 26 action areas were important, broader and more long-lasting effects would be achieved by addressing the prioritised actions first, due to the systemic nature of school food. It was felt that actions can be taken at multiple levels, but strong political impetus is key for driving forward change.

Conclusion These findings provide an evidence-informed starting point for policy makers to take effective action to make positive changes to secondary school food. A limitation is that the composition of the prioritisation group may have influenced which actions were prioritised.