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School nurses forced into child protection work

High thresholds for children’s services means school nurses are increasingly taking on child protection work, children’s commissioner report finds

Woman doctor using a stethoscope on talkative boy patient

School nurses are being forced to undertake child protection work because local authority thresholds are so high they cannot refer on to children’s services.

A survey carried out for the children’s commissioner found that when school nurses identified children of concern, four in 10 said they were unhappy with the response they received from children’s services on at least half of the referrals they make.

“School nurses reported that increasingly high thresholds operated by local children’s services had meant making successful referrals about children had become more difficult,” said the report. “These 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.”

Safeguarding and child protection processes have become a substantial part of school nurses’ work. A fifth of school nurses felt that their child protection caseload was limiting their capacity to perform other activities. On average, school nurses attended one case conference a week, which including travel and paperwork took up around 4.5 hours of their time. However, 8% were attending four or more case conferences, indicating they were spending at least half their working week attending these meetings and completing tasks associated with them.

As a result, this means that school nurses have less time for the preventive work to spot the signs of abuse and help prevent problems developing.

The research highlighted that school nurses are spending twice as much time on paperwork than on direct work with children in schools which is reducing their ability to identify children at risk of neglect or abuse. Time pressures meant their role in supporting and promoting children’s health and wellbeing, their mental health, healthy relationships and sex education was being compromised.

Some school nurses are responsible for the health and well-being of 1000s of children but a survey of nearly 800 primary and secondary school nurses revealed a “concerning picture” with paperwork eating into the time these important school staff had to spend with pupils.

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.

Anne Longfield, Children’s Commissioner for England, said: “School nurses have a vital role to play in schools protecting children as well as promoting their well-being.

“They are one of the professionals at the front-line identifying abuse or neglect, as well as supporting children with a host of other issues – whether that’s mental health, age-appropriate relationships and sex education or healthy eating. 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.”

See the full report here.

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