A strategy for school nursing

Written by: HTU | Published:

The government has published its long-awaited strategy for the future of school nursing. Caroline Voogd, editor of the British Journal School Nursing, offers her analysis

The government has recently published its new vision and model for school nursing, Getting it Right for Children, Young People and Families, plans for which were set out in the 2010 Public Health White Paper – Healthy Lives, Healthy People.

This new strategy is part of an on-going development programme for school nursing and aims to provide a framework for the service and clarify school nurses’ role and remit. The paper sets out a four-level approach to school nursing services:

• Community: a public health leadership role in the school and community. For example, working with young people and school staff to promote health and wellbeing within the school setting.

• Community Universal Services: delivery of the Healthy Child programme to children and young people aged five to 19 years (the programme sets out the recommended framework of services to promote optimal health and wellbeing).

• Universal Plus: Early help and extra support for children, young people and families who need it. For example, care packages for children with additional health needs.

• Universal Partnership Plus: On-going additional services for vulnerable children, young people and families requiring long-term support.

• Safeguarding and child protection will be a core part of all four levels of service.

The document also highlights the need for visible, accessible and confidential services. Children, young people and parents who have been involved in the development of the strategy felt that school nurses needed greater visibility in schools.

One of the recommendations from the British Youth Council, one of those organisations involved in the strategy’s creation, said: “School nursing teams and school staff should make sure that all young people know how they can access the school nurse without being expected to refer their enquiry to a teacher or school staff member such as a receptionist.”

Technology is one of the paper’s proposed ways to ensure a more confidential and accessible service. Hannah, 17, who is a member of the UK Youth Parliament for Wolverhampton and who helped to develop the British Youth Council proposals, said that being able to use technology would reduce the perceived stigma of going to the school nurse.

She added: “School nurses should promote themselves more in school by doing PSHE lessons and assemblies. This way young people would know that someone is there to provide support.”

To support the implementation of the new vision, the paper also sets out a series of necessary actions, including “strengthening local working” between health and education services.


It is essential that school staff and school nurses work together to ensure that services are adequate and meet local needs. Health education and promotion for instance can greatly benefit from shared work. For example, teachers may be aware of needs specific to their school or area and by sharing these with school nursing services a joint strategy can be developed on issues such as drug misuse or forced marriage.

As part of the Health and Social Care Bill, which recently received Parliamentary approval, school nurses will no longer work for primary care trusts but for local authorities under the guidance of directors for public health.

In light of the changes to the state school system and the current government’s drive for free schools and academies, which are removed from local authority control, one of the concerns would be a consistent level of access to school nursing services in these new schools.

However, Wendy Nicholson, a professional officer at the Department of Health, said: “The school nursing model outlines an ‘offer’ to the child or five to 19 population rather than an offer to a school. The school nursing service is well placed to lead and deliver the Healthy Child Programme (five to 19) to the child regardless of the school status; this may require new and innovative approaches to service delivery.”

Another concern for the plans is feasibility. Although it is encouraging to see the government’s vision and model for school nursing and its aim to have visible and accessible services, especially using technology, this cannot be delivered in most areas under the current staffing conditions. The latest NHS census data shows a total of only 1,165 full-time equivalent qualified school nurses in England.

For it to be a success we need the right numbers of qualified school nurses with the right skills and the right targets. Without these and incentives for local areas to commission the services, it is likely that the strategy will remain only a wish list.

It is therefore crucial that schools and educationalists are aware of the services that the children and young people in their care could be receiving and work to encourage local authorities to commission them.

You can download the government's strategy for school nursing services online.

• Caroline Voogd is the editor of the British Journal of School Nursing, a Headteacher Update sister title.

• For more primary education best practice and advisory articles from Headteacher Update, click here.

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