As part of our 10 years of children's public health in local government interviews, Sallyann Sutton, Professional Officer at the School and Public Health Nurses Association shares how school nurses have been innovators in local government and why more funding is needed so they can unleash their potential.
School nursing teams have proved to be innovators in local government from pioneering new digital approaches to supporting mental and emotional health, but investment is needed if that is to continue, says School and Public Health Nurses Association’s Sallyann Sutton.
Sallyann Sutton remembers the move from the NHS to local government clearly. She had just been appointed as a professional lead for a local school nursing service. “I was immediately thrown in to the tendering process – we were up against other NHS services and non-NHS services. It was pretty unsettling for school nurses who were worried whether they would keep their jobs and about their pensions. There was a lot of anxiety and it was very disruptive.”
But there was also hope, said Ms Sutton, who is now Professional Lead for the School and Public Health Nurses Association (SAPHNA). “Despite all that we still had a sense of optimism. We were moving under umbrella of public health commissioning – there was a sense that ‘at last someone will understand what we do’. I’m not sure the NHS had a full understanding and the priority was always hospitals and treatment.”
‘We are stretched’
She said the first few years went well. “There was investment and we benefitted from working closely with education, housing and social care colleagues. But the reduction in the public health grant then started to make things difficult. Councils were having to make difficult decisions about where to spend the shrinking budgets.
“We found competing we were with other priorities – tobacco, vaping and obesity for example. We have seen our numbers fall and that, of course, has had an impact on what we do.”
Last year SAPHNA published a report, the Forgotten Frontline, which spelt out the scale of the challenge and the lost potential. It warned each school nurses now had an average of 4,000 pupils each to care for.
Ms Sutton said: “We are really stretched and that has significantly curtailed our ability to do the preventative work. School nurses are the only health professionals that are universally accessible to all school aged children and young people from when they start school until the age of 19 - or 25 if the young person has additional needs.
“We could be having such an impact on wellbeing, but at the moment we are being stretched with child in need and child protection. While school nurses have a key role in this area, it needs to be when we are the appropriate service to support - often it is not and this takes us away from preventative work and early intervention which is the core of what we are trained to do.
“That is such a waste. In local government school nursing teams have proved themselves to be really innovative when given the opportunity. We have pioneered digital health with text messaging services, dedicated websites and more recently digital assessments. There has been some really good work to support emotional and mental health and supporting those who are home educated as well. We need to back school nursing.”
Much to be positive about
And with greater investment, she said school nurses could help tackle one of the biggest challenges of the moment – non-attendance at schools. “We are really concerned about this. The statistics show that the numbers regularly missing school have gone up since Covid – and those who are eligible for free school meals and have special education needs have much higher rates.
“Of course, maintaining regular school attendance throughout the formative years has a profound impact on a child's health, education and future life prospects. There is much school nurses could do to help tackle this if we were not so stretched.
“The key is early identification and putting support in place. There can be underlying causes, such as long-term health conditions, caring responsibilities and mental health problems. If we know, early measures can be put in place to mitigate the risk. This is the beauty of being in local government – we are tapped into these services.”
But despite the challenges, Ms Sutton is hopeful the next decade will see a renewal of school nursing. With public health nursing now falling under the remit of the chief nursing officer at the Department of Health and Social Care, Ms Sutton believes school nursing has strong leadership.
“The team there have been advocating strongly for the 0-19 service. The Office for Health Improvement and Disparities is producing a 0-19 workforce strategy which we hope will feed into the wider NHS workforce strategy.
“I get the sense we are starting to see a realisation that we need to focus on the health and wellbeing of children more in policy. We have got MPs signing an early day motion calling for a school nurse for every school. It feels like there is some momentum – we have much to be positive about.”
Please note this is an independent article. The content and views reflected within are those of the named contributor and not necessarily those of the LGA.
