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School nurses increasingly taking on child protection work


Overstretched school nurses are increasingly taking on child protection roles, according to a survey published last week.

A survey of 1,145 school nurses, commissioned by the RCN, found that two-thirds felt ‘overstretched and unsupported’ – with the average state school nurse having to look after more than 2,500 children.

Additionally, extra responsibilities have added to the pressure with nearly three-quarters of respondents saying they now spend a significant amount of their time dealing with child protection issues, compared with around half in a similar survey carried out in 2005.

RCN general secretary Peter Carter said: ‘The numbers of school nurses working and being trained are simply not keeping pace with the level of demand. If nurses are to take on an increasing role in child protection, the risks of not having enough staff are too high to contemplate.’

He added: ‘In the wake of Baby P, logic must suggest there’s a huge problem out there that we are not aware of. We become aware of it when there’s tragic consequences.’

Last week the Care Quality Commission published a report into the care provided to Baby P by the NHS, concluding that a catalogue of failings meant a series of opportunities which could have saved the child’s life were missed.

The toddler had 35 ‘contacts’ with a range of NHS professionals and settings, including visits by health visitors and visits to a GP practice, child health clinic, A&E and walk-in centres.

The regulator said system failure meant medical records were not shared between services, and NHS workers did not properly alert social services and police to their concerns.


Readers' comments (3)

  • Until recently I worked as a school nurse, but regretably had to leave owing to the tremendous stress and lack of support from the PCT with regard to the child protection caseload. At one point, myself (part-time) and another P/T colleague were looking after a caseload of around 8000 children, 56 of whom were on the child protection register. It got to the point where I didn't even know the families who social workers were contacting me about, never mind having any health inforamtion on them. In my area, the system is in utter crisis, and it wouldn't surprise me if another 'Baby P' situation was to recur, as horrendous as that sounds. We are doing a tremendous dis-service to children such as Baby P and Victoria Climbie by having such insufficient numbers of health professionals involved in their care and protection. Each case needs a huge amount of time dedicated to it in order for the work to be done thoroughly and accurately, but this is seen as a luxury in school health. School nurses, many of whom are are part-time but have full-time equivalent caseloads, are having to fit this work in around the more routine but important work such as sexual health promotion, immunisations and routine health advice. A lot of thes problems would be resolved by employing more school nurses or employing nurses specifically for child protection, given the current volume of work, allowing the rest of the school nurse team to get on with tackling the other health issues which they came into the job for.

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  • I completely agree with the previous comment. As a school nurse I am beccoming more and more frustrated at the amount of work exected to be done with fewer and fewer staff. Child protection is increasing as is the number of LAC, we have just been told we will be doing the 3 years of HPV from september with literaly no more staff and yet still be expected to provede a good service as laid out in our new SLA to the schools. I find myself constantly looking for a new job as I am very stressed.

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  • I worked as a school nurse until 3 years ago. My caseload was small in comparison to some but had a very large child protection caseload which accounted for a large percentage workload. My total caseload was around 1500 children with up to 50 on the child protection register and a further 20 in the looked after system. The time demands to attend conferences and core groups is high though it is also the emotional inpact on the named school nurse that needs to be considered as well. The role of the School nurse has developed greatly especially in the last decade moving towards a greater health prevention and promotion role. The 'nitty nora' image has been replaced with a health professional who is an expert in a variety of areas. The skills and knowledge required for this role is extensive. With the increasing demands imposed by Government initiatives they are still the poor relation in the nursing world. There needs to be good support systems in place with more staff and financial incentives.

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