A survey by the children’s commissioner, Anne Longfield, found school nurses spent twice as much time on paperwork than on direct work with children in schools, which could be reducing their ability to identify children at risk of neglect or abuse.
There was also evidence that time pressures were compromising their role in supporting and promoting children’s health and wellbeing, mental health, relationships and sex education.
The survey of nearly 800 primary and secondary school nurses revealed a concerning picture of paperwork eating into the time nurses had to spend with pupils, said the commissioner.
Many school nurses described how bureaucratic and reactive work was impacting on their ability to build relationships with children and help advise them about their health and wellbeing.
This was a cause of “frustration and concern” among many in the profession, noted the commissioner in a report on the research, published today (see attached PDF below).
One school nurse in the North West, who responded to the survey, said: “We have very little contact with children due to drop-ins being stopped.”
Another working across several schools in the East of England added: “We could be much more effective if we were able to get into schools more often and allow time with the pupils. A majority of my work is behind the scenes writing reports and following up on safeguarding issues.”
Meanwhile, a fifth of school nurses felt that their child protection case load was limiting their capacity to perform other activities.
On average, school nurses attended one case conference a week, which took up around 4.5 hours of their time. However, 8% were attending four or more case conferences.
The commissioner highlighted that, ironically, this meant school nurses had less time for the preventative work to spot the signs of abuse and help prevent problems developing.
In addition, school nurses reported that increasingly high thresholds operated by local children’s services had meant making successful referrals about children had become more difficult.
Such thresholds also resulted in school nurses picking up early child protection work and developing support activities for rejected cases – work previously done by social workers.
Ms Longfield said: “School nurses have vital role to play in schools protecting children as well as promoting their well-being. Being available for children for face to face time is irreplaceable.”
“It is clear from this research that school nurses face significant barriers in working directly with children and young people, with paperwork getting in the way. The support they offer needs to be better promoted and new ways to enhance their engagement with children explored.”
Fiona Smith, Royal College of Nursing professional lead for children and young people’s nursing, said: “Despite the importance of the role, this report echoes what many RCN members have been telling us for some time – school nurses do not have the time or resources to carry out their roles as effectively as they would like to.
“A major part of the problem is that the number of school nurses is dropping all the time – despite the vital importance of what they do,” she said. “Children and young people are bearing the brunt of these public sector funding cuts with potentially serious consequences for the future.”
She added: “Prioritising and valuing school nurses’ expertise would go a long way towards helping the government fulfil its obesity and mental health aims as well as protecting the health and wellbeing of the generations to come.”
Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, said: “Councils want to see school nurses being able to work directly with children, rather than spending too much time on paperwork, and many local authorities are looking at new models by redesigning what school nurses can do.
“It is important to note though, that paperwork is generally not generated by commissioners, but as a requirement of the safeguarding process,” she said.
“School nurses can play a really important role in the early identification of any child protection issues, but for proper safeguarding to be carried out, there needs to be more investment by government in local services,” she added.
Survey results in summary:
- Almost half 42% of those who responded to the survey said they spend four hours or more a day filling in paperwork
- When we asked school nurses about the barriers to them raising awareness and doing proactive work in schools around health, mental health and sex education, half said they had limited capacity or time to do this type of work.
- 8% of school nurses said they were going to four or more case conferences on average a week
- In relation to barriers they face making referrals about children they were concerned about, 41% of school nurse said that child protection thresholds are too high.
- 41% of school nurses said that they were unsatisfied with the outcome of at least half of the referrals they make