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School nursing services in ‘very vulnerable position’

School nursing services in ‘very vulnerable position’

Some local authority areas within the UK are being forced to cut vital school nursing services because of ongoing funding issues, the chief executive of the School and Public Health Nurses Association (SAPHNA) has told.

In an exclusive interview with Nursing in Practice, Sharon White said school nursing services across the country were in a ‘very vulnerable position’ regarding funding.

Ms White said SAPHNA was aware of three local authority areas in the UK that are potentially decommissioning school nursing to some degree because of the public health grant – used to provide preventative services that help to support health – has not increased enough over the years.

In 2023/24, the government’s total public health grant given to local authorities to support children’s health services, sexual health services, smoking cessation, drug and alcohol services, and other public health support will be £3.529bn

But according to analysis from The Health Foundation thinktank, published earlier this year, this grant has been cut by 26% on a real-terms per person basis since 2015/16.

While Ms White was unable to provide the location of these local authority areas due to the ‘political sensitivity’ of the matter, she was able to confirm that one area was considering decommissioning school nursing entirely. She added that another was set to decommission these services partly, and the third would be making ‘radical cuts’ to its school nursing provision.

Should more areas cut services, Ms White said that children, young people, and families would lose access to vital assessments, early identification and early help.

‘If we get to see a young person before the issues start, often with a brief intervention we can nip that in the bud,’ she said.

‘Without that what we continue to see is the escalating scale of complexity for either mental health or safeguarding.

‘What I’m worried about is that there will be no person to spot those early signs, and that there is no early help.’

The issue was compounded by workforce shortages – something Ms White described as the ‘biggest challenge’ for the coming year.

‘The workforce is more important because one feeds into another,’ she said.

‘If tomorrow [the government] gave us the funding we need, where on earth would we magic these people from?’

The NHS Long Term Workforce Plan announced targets of increasing training places for school nurses by 28% by 2028/29, and more than doubling the number of places to 650 per year by 2031/32.

Despite this, Ms White said she finds it ‘frustrating’ that school nurses had ‘won the battle but not the war’.

Ms White said it was ‘fantastic’ to see school nurses recognised in the long-term workforce plan but warned that behind the numbers ‘there is no money and no plan about how its’s going to happen’.

She noted that the sector had ‘lost a lot of our fabulous workforce’ during the Covid-19 pandemic.

‘The reality is that we’re down 30% and struggling to recruit and retain,’ she added.

Ms White highlighted that workforce difficulties had been especially pronounced during the summer holidays, when school nurses are ‘thin on the ground but demand is through the roof’.

‘When schools are open, we’ve got other professionals doing some of this work, so when schools are closed demand for our services are bigger. We’ve never been so busy,’ she added.

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