School Nursing scrutiny panel 23 rd February 2012

1. School Nursing scrutiny panel 23rd February 2012

2. What is School Nursing? Public health nursing – emphasis on the health and well being of children, families and communities.

3. 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.

4. School Nursing – programme of development

5. 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

6. What do parents and school age children want? How will the new School Nursing service provide it? Your School – Your Community A community that ……………… Services that…………… Universal Universal Plus A quick response if we have a problem and to be given expert advice and support by the right person Universal Partnership services for children with illness/disability Universal Partnership Plus 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 together and with us.

7. 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.

8. 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

9. 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.

10. 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.

11. 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.

12. Key Partners • Colleagues in CSF (social care, education) • CAMHS • Paediatricians • GP’s • SLT • Community Nursing Teams • Sure Start Children’s Centres • CLA team

13. Commissioned universal pathway • 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

14. 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.

15. 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

16. 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

17. 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

18. Example of universal work • Bright stars ……….. • Immunisation programmes • School links

19. Commissioned targeted work • Safeguarding • CAF/TAF • CLA • Emotional Health and wellbeing • Assessments (ADHD)

20. SAFEGUARDING • Anecdotal rise in volume and complexity of role for school nurses. • Attendance at case conferences and core groups • Effects of changing thresholds

21. CAF/TAF • School Nurse frequently the lead professional • Closer involvement with family • Improved opportunity for integrated working

22. Looked After Children • 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.

23. Emotional Health and Wellbeing • Rise in requests for support • Training and support for School Nurses • Step 2 • Preventative work. • Ensure parents and carers can access advice and support

24. 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

25. Teacher case study/evidence

26. Summary • Long established interface with Education and social care • Knowledge communities and integrated working