Sharon White explains why school nurses were already ahead of the game when it came to using technology during lockdown.
The NHS Long Term Plan was published on 7 January 2019. The plan details ambitions for improvement in health services over the next decade, underpinning the importance of technology in the future NHS, setting out the critical priorities that will support digital transformation and provide a step change in the way the NHS cares for its citizens. A dedicated hub captures some of the rapid advancements in the use of technology during Covid-19.
School nursing is no stranger to the use of technology and over the last decade has, in many cases, led the way in using this to engage and work with children, young people, families and stakeholders to good effect such as ChatHealth, The Lancaster model, School Screener, text, e-mails, online immunisation consent etc. During Covid-19, this has stood them in very good stead insofar as they have been able to build upon this and further enhance their offer, particularly to those not attending school (circa 80% of our children and young people), and to conform with social distancing requirements.
The digital offer includes:
- ‘E-clinics’, replacing the usual face-to-face community-based drop-ins, health assessments and brief interventions via platforms including Microsoft teams, FaceTime and WhatsApp
- Health education/promotion lessons, video’s and resources ranging from hand/respiratory hygiene to puberty, transition to high school and, sadly, food poverty.
- Training for school staff regarding medical conditions in schools, such as asthma, and diabetes, and, critically, safeguarding meetings via a range of digital platforms.
It is early days in terms of evaluating the success of the changes to the school nursing offer, however, we can make some intelligent and assumptions and factual conclusions based on feedback thus far.
Many young people tell us they often prefer a virtual contact than face to face, especially when it offers flexibility in terms of appointment times; they least prefer early mornings.
The virtual nature has, in some cases, also allowed the disclosure of sensitive issues which, they say, they would have felt much less likely to do in a face-to-face situation. A young man became ‘red flagged’ via an online platform due to his questions to the school nurse for advice; he is now receiving urgent help for an eating disorder and anxiety issues.
A young mum disclosed via an online document to the school nurse that she was a victim of domestic abuse and urgent help was given to remove her and her children to a place of safety
A school nurse was able to trigger an immediate multi-agency response to prevent the suicide of a young man whilst in a text conversation with her.
Many looked after children report feeling much more able to discuss personal matters in a virtual assessment. Parents are also delighted to have contact with a health professional and someone from the outside world.
This often takes up much more of a school nurses time but is time well spent on gaining a holistic view of the child and family health needs.
Our young carers really appreciate the time they are given by the school nursing service, and the support given to them and their loved ones.
Schools and partners have welcomed the speedy and solution focused contact but it is also important to acknowledge that virtual interventions should not be seen as the panacea solution to all; face to face brings many benefits especially in building trusting relationships, promoting confidence, self-care, body language and much, much more.
SAPHNA is hosting a range of webinars, events, training and capturing case studies so that we, alongside our commissioners, Public Health England, the Department for Health and Social Care, NHS England and Improvement, and Department for Education and others can begin to reflect on the fabulous effort of school nurses so far with technology, and look to build on this in the future.