The government must reverse the ‘substantial and damaging’ decline in school nurse numbers to help better protect the sexual health of young people, a new report has urged.
The report from the Women and Equalities Committee (WEC) examines the prevalence of sexually transmitted infections (STIs) in young people and other high risk groups following high levels of STIs such as syphilis and gonorrhoea.
It outlines how school nurses are a ‘valuable resource’ and ‘trusted’ professionals who can direct children to relevant sexual health services and reduce demand on hospital services and risks to long-term health.
It comes as Office of Health Improvement and Disparities’ (OHID) data on gonorrhoea, syphilis, and chlamydia diagnoses by local authority in England and Wales found that since 2017 almost all councils (97%) had seen an increase in the diagnosis rate for gonorrhoea.
The rate of gonorrhoea had also tripled in 10 local authority areas, while 71% reported an increase in syphilis and the chlamydia rate had also risen in over a third (36%) of areas, it said.
Within its report, the WEC stressed the importance of the school nursing workforce in tackling the rise in STIs.
‘School nurses are a valuable resource. They are a trusted adult who children can turn to, they can pick up on safeguarding concerns, and trends in problems such as STI prevalence in a community,’ the report said.
With this in mind, the committee stressed the government should ‘set out plans to reverse the recent substantial and damaging reductions in the number of school nurses’.
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The report also noted that relationships and sex education (RSE) lessons in schools were being ‘inconsistently delivered’ and with ‘few opportunities’ for peoples to ask questions, according to a 2022 survey by the Sex Education Forum.
In response to the report, the government said it ‘partially accepts’ the WECs recommendation on boosting the number of school nurses.
The government recognised the ‘fundamental’ role of the school nursing workforce in improving health and wellbeing of families throughout the school years.
‘They [school nurses] utilise their clinical judgement and public health expertise to identify health needs early, determining potential risk, and providing early intervention to prevent issues escalating,’ the government said.
The 10-Year Health Plan
The government also accepted that having a strong school nurse workforce will be key to achieving the goals of the government’s upcoming 10-Year Health Plan, which is expected to be published in the coming months.
‘A central part of the 10-Year Health Plan will be our workforce and how we ensure we train and provide the staff, technology and infrastructure the NHS needs to care for patients across our communities,’ it said in its response.
‘[We must] ensure we have the staff we need, so that children, their carers, and their families are cared for by the right professional, including school nurses, when and where they need it.’
Improving HPV vaccine uptake
As part of its report, the WEC also urged the government to ‘step up its efforts’ to increase the uptake of the human papillomavirus (HPV) vaccine among young people.
The roll-out of the HPV vaccine was undermined by the Covid-19 pandemic and, as of this month, uptake remains significantly below 2019 levels and far short of the NHS target of 90% coverage by 2030, it said.
This is despite the vaccine being ‘extraordinarily effective’, according to the report.
The WEC is urging the government to target the cohort of children who may have ‘missed out’ on HPV vaccination during the Covid-19 pandemic.
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‘It is a tragedy that not all children are receiving the vaccine,’ the WEC said.
Latest figures have shown a decrease in HPV vaccine uptake in some local authorities, with post-pandemic vaccine catch-up activity only having been completed in 62.3% of local authorities.
Although it marked a slight increase in uptake in the year 8 cohort, overall, only 72.9% of female and 67.7% of male year 8 students have received the HPV vaccine.
A spokesperson for the School and Public Health Nurses Association (SAPHNA) said the association was ‘delighted’ by the WEC’s recognition of the role school nurses play in sexual health promotion and early intervention.
‘School nurses have a long history of providing visible, accessible, and confidential services for children and young people and, as such, are respected and trusted by them,’ they said.
‘Their role is crucial in increasing the uptake of human papillomavirus (HPV) vaccine, supporting the development and delivery of good quality, effective relationship, and sex education, and providing support to individual children and young people, identifying and working with those with additional vulnerabilities,’ they said.
In its response to the report, the government also ‘partially’ accepted the WEC’s recommendations on improving uptake, accepting the ‘short-term fluctuations in vaccine uptake, as occurred during Covid-19 pandemic’.
‘The expectation is for all regions to achieve 90% HPV vaccine coverage for both males and females’, the government added.
Chair of the committee, Sarah Owen, said the WEC ‘welcome’ the government’s acceptance or partial acceptance of the report recommendations, but cautioned that levels of HPV vaccine uptake ‘remain concerning’, especially in deprived areas.
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‘It is alarming that a significant proportion of children are not receiving a vaccine that is safe and extremely effective in reducing the risk of a range of cancers,’ she said.
‘It is also troubling that children are missing out on the vaccine simply due to non-return of consent forms. I urge the government to allocate more resources to pursuing consent and to ensuring as many people as possible are able to benefit from the protection HPV vaccination delivers,’ Ms Owen added.
Last month, the UK Health Security Agency warned that antibiotic-resistant gonorrhoea cases are rising in England.
