Agenda item

Report of the Director of Public Health

Lynne McNiven, Consultant in Public Health, presented the report updating the Board on the current position of School Nursing following a recent review and restructure when the service became the responsibility of Public Health.

The following points were highlighted:

(a)  there are 57,000 young people aged 5-19 years old in the City;

(b)  universal services are available to children from the time they enter Reception Year at school and can include support for complex conditions, mental and emotional health, and sexual health;

(c)  Public Health are working with CityCare to develop a demand led model, having considered the differing needs in each area of the City;

(d)  across the City, 16 school groupings have been identified through health and social care profiles. These groupings are not in line school organisations;

(e)  the review found that some school nurses were well valued by schools but they needed to be more approachable and clearly accessible to pupils and parents;

(f)  it was clear that some schools and pupils were not accessing full range of support available;

(g)  CityCare divided the School Nurses into teams to target school areas, with senior nurses as team leaders for each area. This ensures that there is a continuity of care for children starting school in Reception Year, until they leave secondary school;

(h)  leaflets were distributed to pupils and parents to ensure it is understood what School Nurses can do and offer;

(i)  the 3 areas on which nurses will focus on are healthy weight, sexual and relationship education and support, and emotional health and well-being. However, school nurses will also offer support with highly complex issues and circumstances, liaising with the Domestic Abuse Referral Team (DART), Child and Adult Mental Health Services (CAMHS) and contributing to, Common Assessment Frameworks (CAFS);

(j)  the new model was launched in September 2014 and to date it appears to be working well;

(k)  some schools feel they have lost their school nurse as they are not necessarily based at a specific school but it is not possible to provide a nurse for each school. Instead there are between 30 and 33 whole-time school nurses, within band 6, working across the City to provide equitable services for each school. There has also been an issue of staff retention due to other areas of nursing undertaking large scale recruitment;

(l)  it is predicted that there will be a period of transition for pupils, parents and school staff to adjust to the new model. However once the Lead Nurse of each team becomes known, relationships will improve.

Sean Kelly, Principal of Top Valley Academy, informed the Board that school nurses are highly valued and that parents and young people did not like the referral based service that is now in place, added to which, this current model complicates the role of the Child Protection Officers in schools. Previously school nurses were part of the school team and were able to establish relationships with pupils which then made them more approachable when pupils had issues or concerns.

Academy staff are concerned that although Headteacher groups may have been involved during the development of the new model, Academy staff were not consulted and had not been informed of the new structure prior to its implementation. Now that the structure has been explained, and with the Academy’s emphasis on ‘improving health to improve education attainment’  the opportunity to consider a co-funded school nurse position would have been preferable to meet the needs of the pupils on roll at the Academy.

The questions and comments of the Board were responded to as follows:

(m)  it is proposed to consult those pupils and parents/carers who do not access school nurse services, to find out whether there is a lack of understanding for what is available, or if services have not yet been required;

(n)  school nurses will be available at each school at least once or twice a   week;

(o)  a ‘whole school approach’ is to be developed to engage all school staff and ensure that pupils and parents/carers can be directed to access services and support via school nurse;

(p)  some schools already buy-in services such as counsellors and peer supporters but this needs to be tracked to enable need to be gauged and successful practices to be shared.

The Chair of the Board considered that dual funding for posts is worth pursuing as this has worked in other areas and enabled services to expand.

RESOLVED

(1)  to note the key findings of the review and recognise the value of School nursing in improving health and educational outcomes;

(2)  to support the development of the new needs led model of delivery;

(3)  for a future reports on the progress of implementing the school nursing development action plan to be brought to the Children’s Partnership Board.