School Nursing scrutiny panel
23rd February 2012
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What is School Nursing?
Public health nursing – emphasis on the health
and well being of children, families and
communities.
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What School Nurses do.
• Work to achieve positive health, emotional
and psychological well being for all children
and young people through an evidence based
programme of screening, immunisations,
health reviews, health promotion, health
interventions and personal, social and health
education.
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School Nursing – programme
of development
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School Nurse
Development programme
•
Build on HV programme for 0-5s
•
Support the development of a strengthened, well equipped SN workforce
•
To develop a service model for SN contribution to public health delivery to children young people and
families.
•
To develop a service model for School Nurse contribution to education inclusion ( e.g long term conditions,
disabilities, mental health)
•
Increase the focus on the health of children and young people 5 to 19
•
Provide information for Public Health England/Local Authorities on contribution of school nursing
•
Raise the profile of School Nurses as leaders and deliverers of public health to children and young people
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What do parents
and school age children want?
A community that
………………
Services
that……………
A quick response if
we have a problem
and to be given
expert advice and
support by the right
person
To have the right people to help over a
longer term when things are really difficult
To know those people and that they will work
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How will the new School Nursing
service provide it?
Your School – Your Community
Universal
Universal Plus
Universal Partnership services for
children
with illness/disability
Universal Partnership Plus
Skill mix – structure
• School Nurses: experienced qualified nurses with
BSc Specialist Practice degrees (safeguarding
children, health assessments, children, with complex
needs, immunisation, PSHE).
• Staff nurses : qualified nurses. (immunisation, follow
up of targeted work, safeguarding children,
screening).
• Nursery Nurses: support with screening programme.
• School Nurse assistants : unqualified staff who
support the team with clinical and clerical tasks.
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Local Context
• Few areas in Hertfordshire receive full specification
• Prioritisation of workload, focus on safeguarding,
immunisation and NCMP
• Low numbers of trained School Nurses
• Schools requesting higher level of involvement
• Insufficient capacity to focus on the needs of
identified vulnerable groups
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Where the service is delivered from.
• Schools: Screening programmes,
immunisation, liaison with school staff,
individual work with pupils dependent on
need, PSHE.
• Home Visits :safeguarding children work and
on the basis of individual need.
• Clinics: Some drop in health access,
immunisation follow up.
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Service Structure
• Managed by Hertfordshire Community NHS trust,
part of the Children’s Universal Services Business
Unit.
• 6 ‘localities’:
• East and South
• North Herts and Stevenage
• Welwyn and Hatfield
• St Albans, Harpenden and Hertsmere
• Watford and Three Rivers
• Dacorum.
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Team Structure
• 30 teams across the county, each with a team
leader (Health Visitor or school nurse)
• Teams have ‘skill mix’,
• Localities include Community Practice
teachers and students.
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Key Partners
•
•
•
•
•
•
•
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Colleagues in CSF (social care, education)
CAMHS
Paediatricians
GP’s
SLT
Community Nursing Teams
Sure Start Children’s Centres
CLA team
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Commissioned universal pathway
•
•
•
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School entry health assessment
National Child Measurement programme
Immunisation programme
Support for schools in managing children with
specific health needs
• Support for PSHE programmes
• Support for transition
• Supporting children and families to ensure
access to a range of services as needed
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Immunisation
• Important public health role. Opportunity to
raise wider health issues.
• School based programmes effective and
efficient , popular with parents
• BCG: universal screen with immunisation
where indicated
• HPV: girls in year 8
• DTP: booster for all before leaving school.
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Health assessment and
screening
• School entry, key transition point to review health.
• Addresses issues which may prevent a child fulfilling
their potential
• Parents have opportunity to discuss concerns.
• Assess growth, development, vision, hearing and
immunisation status
• Assess developmental or emotional health issues
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NCMP
• Measurement of children’s weight and height
in reception year and year 6
• Provision of feedback of results and general
advice/information to parents if requested
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Student support
• Confidential advice for young people to
encourage them to manage their own health
needs.
• Understanding of how and where to refer for
specific needs
• Advocacy for young people.
• Parental support
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Example of universal work
• Bright stars ………..
• Immunisation programmes
• School links
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Commissioned targeted work
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•
•
•
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Safeguarding
CAF/TAF
CLA
Emotional Health and wellbeing
Assessments (ADHD)
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SAFEGUARDING
• Anecdotal rise in volume and complexity
of role for school nurses.
• Attendance at case conferences and
core groups
• Effects of changing thresholds
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CAF/TAF
• School Nurse frequently the lead
professional
• Closer involvement with family
• Improved opportunity for integrated
working
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Looked After Children
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Annual health assessment
Opportunity to ensure health needs are met.
Liaison with designated teachers in schools.
Preventative work
Sensitivity to requirements of the young
person.
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Emotional Health and Wellbeing
•
•
•
•
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Rise in requests for support
Training and support for School Nurses
Step 2
Preventative work.
Ensure parents and carers can access
advice and support
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Assessments
• Carry out assessments for secondary referral
(ADHD, Child Development Centre, CAMHS)
• Recognise when this is appropriate
• Close liaison with parents and schools
• Ongoing support and advocacy following
referral
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Teacher case study/evidence
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Summary
• Long established interface with
Education and social care
• Knowledge communities and integrated
working
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