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School nurses' support of chronic conditions ‘undermined’ by workloads

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The ability of schools nurses to provide support to children with long-term health conditions risks being undermined by high workloads and having to work across many schools, suggests research.

A report, published today by the National Children’s Bureau, looked at nurse confidence in managing five highly prevalent long-term conditions – asthma, epilepsy, diabetes, anaphylaxis and eczema.

“The day-to-day work of school nurses is varied and vital”

Anna Feuchtwang

With the exception of diabetes, over half of the school nurses surveyed for the report reported being confident in offering treatment and advice for each of these conditions.

However, 90% said high workloads and limited time and resources challenged their ability to support children with long-term health needs.

Nearly 40% of nurses worked across 10 or more schools, and they were significantly less confident in providing help to pupils with serious health conditions compared to those working in fewer schools.

Lack of confidence was particularly poor for providing support to pupils with diabetes. Only 42% of nurses were comfortable helping to treat the condition, suggesting an urgent need for more training.

“There must be more nursing staff in schools – and fast”

Fiona Smith

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.

The study had two main parts – a survey of 344 school nurses, equivalent to one of eight of those currently in England, and a review of existing literature.

The bureau also warned that the number of school nurses was falling, with some estimates suggesting just 2,606 NHS school nurses supported the 8.4 million school-age children in England.

This was despite a Department of Health target for every secondary school to have a qualified school nurse, noted the charity.

The report – titled Nursing in schools: how school nurses support pupils with long-term health conditions – called on the 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.

It also stated that ministers should maintain funding for public health services at a level that enabled local authorities to commission the required numbers of school nursing alongside other services.

In addition, it said local authorities, service providers and schools should provide information about the role of the nurse to pupils, parents and teachers, including how to access the nursing service.

Meanwhile, it called on the Department of Health, Public Health England and Health Education England to ensure school nurses were able to access training to develop their skills and confidence to support pupils with additional health needs.

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,” she said. “This is on top of their more traditional roles.

“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,” she said.

Fiona Smith, the Royal College of Nursing’s professional lead for children and young people’s nursing, said: “School nurses have a major part to play in the health of our children, and this report highlights one of many critical elements of their role.

“School nurses support all children to live healthy lives, both physically and emotionally, however, as workforce numbers plummet, there are limits to how much they can do,” she said. “With nine out of 10 school nurses saying they are limited in time and resources, the health of children is at serious risk.

“There must be more nursing staff in schools – and fast – if we are to tackle any of the mounting health issues facing children today,” she warned.

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