The long awaited Public Health Grant for 2020/2021 was announced by the Government yesterday.
It was a positive move in contrast to the repeated previous years of budget slashing resulting in the decimation of many school nursing services, including a huge loss of experienced and dedicated staff.
We now need the Spending Review to recognise and support the rebuilding and rebooting of our services, with adequate long-term investment, so that we are even better prepared and able to address some of the resulting stark health inequalities outlined in the recent Marmot Review and the downward trajectory of health outcomes for children, young people and families cited in the RCPCH State of Child Health report.
Right now, of course, this very workforce is responding, as always, to the huge public health threat of coronavirus. Most services are proactively educating schools populations up and down the country in hand and respiratory hygiene, ensuring they have the most accurate and up-to-date information to guide best practice, advising/supporting and responding to worried and depletion of school staff; to parents and carers trying to allay the very real fears of many, including children and young people themselves.
Additional resource is also being targeted at our most vulnerable including those with additional and complex health needs, chronic health conditions, those out of school, traveling communities, asylum seekers, teenage parents, teenage pregnant, young offenders, those looked after by the local authority, young carers, homeless and those suffering in poverty. For children and young people with mental health issues, school nurses are also in demand to help reassure and provide resources/techniques for them, schools and families, to cope with additional anxiety that this is causing.
School nurses are also in every day conversations with schools and partners in, for example, education, police, social care to define a new way of working to offer optimum safeguarding as they recognise that when schools do close, this will leave many children and families even more vulnerable, such as those on the child protection register; those in receipt of free school meals; those in poverty.
Health protection and health promotion is a key role for school and public health nurses and one which they are very practiced at, firstly as qualified (post-graduate) nurses and secondly through competence and confidence. Hand and respiratory hygiene is not a new phenomenon, rather, it is part of many services core offer to their schools.
Surveys show that school nurses are recognised and valued by their stakeholders and especially by children and young people themselves. We know that, for example, compliance with asthma management, is much more likely to happen when there is respect and trust between the health professional and the client. Therefore, whilst many school nursing services are at breaking point, the reach and impact of the remaining resource cannot and must not be underestimated.
And all the while this is going on, they are advised and encouraged to prepare for redeployment to areas of most need in the nursing of patients. This, naturally, is causing unrest and concern in the profession. Although many will have transferable skills and some will only have recently moved into the community from the acute sector, the majority have not nursed in clinical/hospital settings for decades. This will need very careful management and support and is an added burden placed on their heavy shoulders.
However, I think we’d struggle to find another workforce so willing, able, adaptable and amenable to step up as demonstrated in previous public health outbreaks of measles, meningitis and flu. Regardless of the pressures, school nurses are, as ever, ready and willing to don their super herocapes and do whatever it takes in our war against coronavirus.