School nursing services at ‘breaking point’, government told
More than 80% of school nurses have said there are not enough staff to deliver an effective school nursing service in their area, a new report has revealed.
The School and Public Health Nurses Association (SAPHNA) has this week published The Forgotten Frontline, which has laid bare the challenges facing school nursing services.
“School nurses are critical to the health and wellbeing of our children, but they are being stretched to the breaking point”
Sharon White
The report was presented at the House of Lords this week, to lobby policymakers and healthcare leaders to take swift action to address the growing crisis in school nursing.
The report presents findings from SAPHNA’s inaugural survey of 278 school nurses and their teams across the UK.
It has highlighted the growing health needs of school-aged children, and the severe workforce shortages that have left the school nursing sector struggling to meet the demand.
Some 82% of respondents indicated that there was not enough staff to deliver a “high-quality, safe and caring” school nursing service in their area.
The survey noted recent government data, which found that the average school nurse in England cares for more than 4,000 pupils.
This figure is significantly worse across some parts of the country, with a school nurse in the south west of England caring for more than 9,000 pupils and in the south east more than 6,600 pupils.
Many school nurses indicated that they were now “reactive rather than proactive” due to increasing numbers of children and young people (CYP) on child protection and child-in-need plans.
More than a third (38%) of respondents said they spent over half their time supporting children on these plans, who are children who are most at risk.
Meanwhile, school nurses reported a significant increase in the prevalence of most health issues.
They said CYP were presenting with more complex needs and that parents, carers and schools required more support to meet the needs of these children.
Almost all (96%) of school nurses said they had seen an increase in mental health issues, while 86% reported seeing an increase in self-harm and suicidal behaviour.
In addition, 72% noted an increase in overweight and obesity issues in children and 70% said there had been an increase in dental health issues.
Data from the survey also revealed that there is an ageing school nurse workforce, with 46% reporting to be aged 51 years and over.
Some 37% of these indicated that they planned to retire in the next three years, and most said they do not plan to return to the profession.
While the NHS Long Term Workforce Plan has committed to training more school nurses by 2031-32, the report said it was “questionable” as to whether it would be sufficient.
It called on the government to publish more detailed workforce plans for school nursing, which extends beyond training places and makes commitments to funded roles.
In addition, the report called for a “refocus on promotion, prevention, protection and early intervention”.
Among the recommendations, SAPHA urged ministers to “reclaim” decommissioned elements of school nursing delivery, including immunisation programmes, continence care and special schools.
Chief executive of SAPHNA, Sharon White, said: “This report paints a stark picture of the current state of school nursing in the UK.
“School nurses are critical to the health and wellbeing of our children, but they are being stretched to the breaking point.
Sharon White
“We urgently need to invest in this workforce to address the growing health inequalities faced by our young people.
“ Our children deserve better, and the time for action is now.”
Over the last year, SAPHNA has been leading the ‘school nurse in every school’ campaign, which has lobbied the government to reverse the cuts to the school nursing workforce.
SAPHNA hand-delivered the petition, which has gathered widespread public support, to 10 Downing Street following the event at the House of Lords.
Ms White added: “This petition, and our findings in the report The Forgotten Frontline, reflects the urgent need for government action.
“Every child deserves access to a school nurse for ongoing support in mental, physical, and emotional health.”
A Department for Health and Social Care spokesperson said: “Too many children are not receiving the start in life they deserve so we will fix the NHS and create the healthiest generation of children in our history by shifting focus from treatment to prevention.
“School nurses will play a critical role in this and we are committed to growing training places for school nurses and providing specialist mental health support for children and young people in every school.”
