School nurses to be trained to spot signs of eating disorders

Integrated care boards (ICBs) have been asked to ensure school nurses and those in relevant roles across general practice and other community settings are given training to spot the signs of eating disorders in children and young people.

New commissioning guidance published by NHS England today sets out the need for ICBs to create and strengthen routes into local community eating disorder services.

A key objective is to ensure appropriate training is given to relevant staff working in health, social care, education, charities and wider community settings who may encounter children and young people with eating disorders.

The guidance suggests staff must be trained to recognise eating disorders and the factors which can contribute to a child or young person facing a higher risk of developing one, and to understand the local referral pathways to specialist community eating disorder services.

It is up to ICBs to decide which training works best, but the guidance places emphasis on local training, voluntary, community, and social enterprises (VCSE) sector support and a wider pre-established e-learning programme, which has been developed with charity Beat and the Royal College of Psychiatrists.

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NHS England said it has not placed restrictions on which staff access the training but noted in particular that school nurses, GPs and teachers would be among those offered it.

And the guidance goes further by suggesting that training should be provided to staff working in general practice and other relevant community settings.

Nurses ‘integral’ to school safeguarding

Jane Graham, a school nurse and member of the School and Public Health Nursing Association (SAPHNA) expert advisory board, told Nursing in Practice that SAPHNA ‘welcomes this guidance’ and has long advocated for the management and support of pupils experiencing eating issues to be part of a school nurse’s core skill set.

‘In order for this concept to work, there needs to be a school nurse in every school, in addition, nurses should be integral to a school’s safeguarding team so that the care of the child is holistic with medical professionals, the school and the family,’ Ms Graham noted.

She added: ‘This has the potential to detect and support those with early warning signs of eating issues as well as support the management of more severe or ongoing issues in the school setting.

‘It is imperative that the government act on this and ensure the implementation of this goal.’

‘Step in the right direction’

Tom Quinn, director of external affairs at Beat, stated that demand for eating disorder services has increased sharply since the pandemic, while access to care continues to differ significantly across regions.

He described the release of the new guidance as ‘an encouraging step in the right direction’, as it aims to improve equity in eating disorder treatment nationwide.

‘Moving forward, the government must not allow this guidance to be left in limbo and ensures it is implemented promptly.

‘We need the right staffing for this to work, and so recruiting – and keeping – staff should be a key priority. It’s imperative that funds are made available nationally and locally to deliver on this ambitious guidance and begin to tackle the growing crisis in eating disorder services,’ Mr Quinn said.

‘Significant pressures’ on young people

Dr Adrian James, national medical director for mental health and neurodiversity at NHS England, said: ‘We know the significant pressures young people are experiencing which can be exacerbated by social media bombarding them with content that does not always show realistic body images.

‘And we’re seeing the impact of that with growing numbers of young people turning to the NHS for eating disorder support, but it’s vital that everyone knows how to access this treatment which is why we will be offering training to teachers, GPs and school nurses to spot the signs and refer children for specialist help faster.’

The guidance published today comes as the NHS has overhauled its eating disorder services in response to rising demand with the number of children and young people, with the number rising two-fifths since the pandemic, according to NHS England.

Every local area in England now has a specialist eating disorder service for children and young people, which is a significant rise from a decade ago, it added.

In July 2024, a SAPHA report revealed that the number of school nurses has declined over the past decade, with a 33% fall in the number of school nurses since 2009 across England.

Later in 2024, Nursing in Practice published analysis of the key role school nurses play in supporting children with additional learning needs such as ADHD.