School nursing services in Birmingham are only to be targeted at communities in the city that need them the most, under wider local council plans aimed at making £123m of annual savings by 2022.
From this April, the services for five- to 18-year-old children will switch from a “universal” to a “targeted” approach, according to proposals by Birmingham City Council that have been criticised for being “futile” by nurses.
“Moving to a targeted approach makes no economic, let alone ethical and moral, sense”
Earlier this week, the local authority agreed its new budget for 2018-19 and beyond, which includes £52.9m of cuts this year, followed by annual savings of up to £123m by 2021-22.
As part of this, the council will cut its public health budget by £1.6m in 2018-19, and by a further £2.36m in 2019-20, by £3.86m in 2020-21 and by £2.85m in 2021-22.
This is on top of £4.78m of cuts forecast for 2019 onwards due to estimated reductions to the public health grant the council receives from the government.
The local authority did not confirm to Nursing Times how much of its public health budget is currently spent on school nursing, or how far the savings would need to come from the service for five-to-18-year-olds.
“This is a worrying change to the school nursing service and one that will not be able to deliver the required universal healthy child programme”
But as part of plans it agreed to on 27 February, the council – which commissions school nursing from a local trust – said that while school-age children would still be able to access the service, it would from next year be “focused on communities of greatest need”.
The service is currently provided by Birmingham Community Healthcare NHS Foundation Trust, which was awarded the £4.2m per year contract in 2016.
As reported by Nursing Times at the time, this represented a 10% budget cut by the council compared with 2015 and the service was redesigned under a new name, the school health advisory service. It is due to be re-commissioned again this July.
A spokesman for the trust told Nursing Times that the organisation had worked closely with the local council to discuss the changes put forward in its budget for 2018.
“Birmingham Community Healthcare NHS Foundation Trust is keen to continue to provide this vital service and gain a deeper understanding of the impact of the proposed changes not only on the school health advisory service, but also on other local services for school-aged children across the system,” he said.
“This includes education, mental health, early help services and special educational needs and disability services, and the implications of the proposed savings on the improved outcomes we all strive to deliver for families,” he added.
The move to a targeted service has been labelled as “worrying” and “futile” by a group representing school nurses, which warned the change will mean children miss out on public health checks to which they are entitled.
“Birmingham Community Healthcare Foundation Trust is keen to..gain a deeper understanding of the impact of the proposed changes”
Spokesman for Birmingham Community Healthcare FT
“This is a worrying change to the school nursing service and one that will not be able to deliver the required universal healthy child programme to which all children and young people are entitled,” said Sharon White, chief executive of the School and Public Health Nurses Association.
“Whilst recognising the need to manage budget cuts and, therefore, target spending according to need, this model is futile,” Ms White told Nursing Times.
“Health assessments, accessibility, visibility and confidentiality from school nursing across the child’s life-course offer critical opportunity for early identification and help, including key delivery of public health messages,” she said.
“Moving to a targeted approach makes no economic, let alone ethical and moral, sense to improving the significant health needs of the population of Birmingham’s children and young people,” added Ms White.
Nursing Times approached Birmingham City Council for comment.