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School Nursing scrutiny panel 23 rd February 2012. Challenges. Capacity to deliver services equitably Expectations of schools Responding to national agendas Consistent data - information Relationships with schools – impact on service delivery.
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School Nursing scrutiny panel 23rd February 2012
Challenges • Capacity to deliver services equitably • Expectations of schools • Responding to national agendas • Consistent data - information • Relationships with schools – impact on service delivery. • Inequitable staffing across the county – training concerns, no national workload tool. • Caseload complexity • Changing education ‘landscape’
2 key challenges • Staff training • Complexity of workload • Safeguarding • CLA • Mental health
How the service prioritises…. • Priority Safeguarding, vulnerable children, LAC, immunisation programmes, School entry health assessments & screening, support for children with complex health needs, Domestic Abuse, targeted A&E work. • Core additional work to the priority work including the provision of open access Drop-in sessions, continence services, A & E follow up, support for children with complex needs at health reviews. • Non urgent new parent’s evening, secondary transfer, PSHE, NEET.
Staff • Recruitment - nationally low numbers of trained school nurses. • Number of training places in Hertfordshire. • Historically lower level of investment. • Frustration at level of National focus on HV recruitment. • Inability to offer full public health role for which they are trained because of capacity • Low Morale/High level of commitment.
Complex workload • Impact of loss of extended schools programme and level of outreach work. • Thresholds for social care involvement • Numbers of children in school with complex health and social needs.
Caseloads • South: 15095; Primary 31; Secondary 7; WTE SN 1:5.3 • East: 27123; Primary 73; Secondary 13; WTE SN 1:8.48 • North: 16121; Primary 49; Secondary 6; WTE SN 1:6.76 • Welwyn & Hatfield: 14129; Primary 41; Secondary 6; WTE SN 1:10 • Stevenage: 15661; Primary 33; Secondary 11; WTE SN 1:6.8 • Watford & 3R: 27081; Primary 62; Secondary 8; WTE SN 1:9.3 • St. Albans & Harpenden: 28886; Primary 47; Secondary 13; WTE SN 1:11.32 • Hertsmere: 16832; Primary 34; Secondary 6; WTE SN 1:7.54 • Dacorum: 20000; Primary 60; Secondary 8; WTE SN 1:11.5
Actions. • Development group to promote and standardise good practice • Capitalising on passion and commitment of school nurses to develop the service. • Ongoing training to support key areas of the role e.g. mental health • Improving local links with colleagues in social care • Working with commissioners to clarify specification.