The government has pledged to define the role of school nurses more clearly, amid concern about the dwindling workforce and union calls for caseloads to be slashed by 80%.
There were 1,104 full time equivalent school nurses serving a population of more than 6.6 million five to 15 year-olds, equivalent to a caseload of 6,000 pupils each, in September 2010, the most recent figures show.
Unite Community Practitioners and Health Visitors Association (CPHVA) has called for this caseload to be cut to 1,200.
Launching a school nursing manifesto at the CPHVA annual conference last week, Unite head of health Rachael Maskell said there was evidence that the pressure of growing caseloads was leading to increased referral to regulatory bodies and rising sickness levels among school nurses.
The conference heard from many school nurses that the growing safeguarding caseload left little time for other parts of their role.
Ms Maskell said: “We need to see a step change in the number of school nurses: not a little bit more, not let’s do things a little bit differently, not a skill mix solution. That’s all been tried.”
The manifesto calls for one full time school nurse on band six or seven per secondary school, supported by school staff nurses and assistant practitioner community nursery nurses working in primary schools. It recommends a nurse’s caseload should “not usually exceed” 1,200 children.
Addressing the conference, public health minister Anne Milton said a new strategy was being developed to focus on school nursing, in a similar way to the health visitor strategy which aims to grow that workforce by 4,200 over the next four years.
“We are working with you to define your role more clearly, setting out clear pathways and [looking at] where it dovetails with health visiting. We are developing a new school nursing vision,” she said.
“Trusted school nurses need to be visible and well known by pupils.”
She added: “I know some school nurses are very worried the important of their role is overlooked… That is not the case. I know that what school nurses do is vital to all children, including the ones that are most vulnerable.”
The DH has not so far set a target for the increase in school nurses but is asking for views on a service vision. It wants school nurses to be known by pupils, responding swiftly to sexual or mental health needs, dealing with safeguarding, and leading public health programmes including immunisation.
Former school nurse Babs Young, who sits on the Department of Health school nurse development group, told Nursing Times there was high level commitment to increasing the workforce.
She said the government was developing a commissioning framework with clear criteria for what a school nursing service should provide which would determine the numbers needed in each area.