Nursing in Schools

School nurse workloads risk undermining essential support for children with long-term health conditions

Posted by Stephanie Broad | October 06, 2016 | Health & wellbeing

• #nursing-in-schools
• #national-childrens-bureau
• #health-conditions
• #workload
• #asthma
• #epilepsy
• #diabetes
• #anaphylaxis
• #eczema
• #anna-feuchtwang

The confidence of schools nurses to provide essential support to children with long-term health conditions like diabetes and asthma risks being undermined by high workloads and having to work across numerous schools, suggests research published by the National Children’s Bureau. 

Nursing in Schools looked at school nurses confidence in managing five highly prevalent long-term health conditions: asthma, epilepsy, diabetes, anaphylaxis and eczema.

With the exception of diabetes, there were positive findings: over half of the school’s nurses surveyed were confident in offering treatment and advice for each of these conditions. Nearly three-quarters (73%) of school nurses felt confident or very confident in supporting pupils with asthma – important because this is the most common long-term health condition facing children and young people. Even higher numbers (82%) were confident in treating anaphylaxis.

However, the survey, completed by one in eight of the school nurses working in England, found that 90% said high workloads and limited time and resources challenged their ability to support children with long-term health needs. Nearly four-in-ten school nurses work across 10 or more schools, and these nurses are significantly less confident in providing help to pupils with serious health conditions compared to those working in fewer schools.

Alongside their support of pupils with serious health conditions and disabilities, school nurses are increasingly called on to provide vital expertise on child protection, mental health, sex education and bullying - Anna Feuchtwang, National Children's Bureau Chief Executive  

The lack of confidence was particularly acute when it came to providing support to pupils with diabetes – a condition with increasing prevalence because of childhood obesity. Only 42% of schools nurses were comfortable helping to treat this condition, suggesting an urgent need for better training.

Nursing in Schools is published as the number of school nurses is falling, with some estimates suggesting that just 2,606 NHS school nurses support the 8.4 million school-age children in England. This is despite their work being highly valued by children, parents and school staff, and there being a duty on schools to support pupils with medical conditions. A Department of Health target for every secondary school to have a qualified school nurse is currently not being met.

The research also indicated a lack of understanding amongst parents about the role of the school nurse, and that poor communication with parents was a barrier to them supporting children.

Anna Feuchtwang, Chief Executive of the National Children’s Bureau said, “The day-to-day work of school nurses is varied and vital. Alongside their support of pupils with serious health conditions and disabilities, school nurses are increasingly called on to provide vital expertise on child protection, mental health, sex education and bullying. This is on top of their more traditional roles in providing vaccinations and raising awareness of healthy lifestyles.

“We need the Department of Health to adequately fund local authorities’ public health work, so they can recruit and train school nurses in sufficient numbers to ensure their unique contribution to the health of children is protected.”

The report calls for:

• Government to secure and develop the recruitment and training of more school nurses to service the needs of an expanding role and a larger school population.
• Government should maintain funding for public health services at a level that enables local authorities to commission the required numbers of school nursing alongside other services.
• Local authorities, providers of school nursing services and schools should provide information about the role of the school nurse to pupils, parents and carers and school staff, including how to access the school nursing service.
• The Department of Health, Public Health England and Health Education England should ensure school nurses are provided with, and supported to access, training to maintain and further develop their skills and confidence to support pupils with additional health needs.

Nursing in schools: how school nurses support pupils with long-term health conditions is available at: www.ncb.org.uk/nursinginschools