Caring for you...closer to home School Nursing scrutiny panel 23 rd February 2012

Caring for you ...closer to home

School Nursing scrutiny panel 23rd February 2012


Challenges• Capacity to deliver services equitably• Expectations of schools• Responding to national agendas• Consistent data - information• Relationships with schools – impact on service

delivery.• Inequitable staffing across the county – training

concerns, no national workload tool.• Caseload complexity• Changing education ‘landscape’


• 2 key challenges• Staff training• Complexity of workload• Safeguarding• CLA• Mental health


How the service prioritises….• Priority Safeguarding, vulnerable children, LAC, immunisation

programmes, School entry health assessments & screening, support for children with complex health needs, Domestic Abuse, targeted A&E work.

• Core additional work to the priority work including the provision of open access Drop-in sessions, continence services, A & E follow up, support for children with complex needs at health reviews.

• Non urgent new parent’s evening, secondary transfer, PSHE, NEET.


Staff

• Recruitment - nationally low numbers of trained school nurses.

• Number of training places in Hertfordshire. • Historically lower level of investment.• Frustration at level of National focus on HV

recruitment.• Inability to offer full public health role for

which they are trained because of capacity • Low Morale/High level of commitment.


Complex workload

• Impact of loss of extended schools programme and level of outreach work.

• Thresholds for social care involvement

• Numbers of children in school with complex health and social needs.


Caseloads• South: 15095; Primary 31; Secondary 7; WTE SN 1:5.3 • East: 27123; Primary 73; Secondary 13; WTE SN 1:8.48• North: 16121; Primary 49; Secondary 6; WTE SN 1:6.76• Welwyn & Hatfield: 14129; Primary 41; Secondary 6; WTE SN

1:10• Stevenage: 15661; Primary 33; Secondary 11; WTE SN 1:6.8• Watford & 3R: 27081; Primary 62; Secondary 8; WTE SN 1:9.3• St. Albans & Harpenden: 28886; Primary 47; Secondary 13;

WTE SN 1:11.32• Hertsmere: 16832; Primary 34; Secondary 6; WTE SN 1:7.54• Dacorum: 20000; Primary 60; Secondary 8; WTE SN 1:11.5


Mental health• Increasing number of children with mental

health issues are presenting in schools, ranging from anxiety related conditions as a result of family breakdown to diagnosed mental health conditions.

• School nurses often support school staff in engaging strategies to help.


CLA• School nurses undertake health reviews on

Children Looked After, working with colleague in CLA teams and local authority to promote the best health outcomes for these children.

• School nurse teams ensure that CLA are up to date with their immunisations, this can be a real challenge as records etc are sometimes incomplete.


Safeguarding• School nurses work closely with schools to

support children with protection plans.• School nurses are ideally placed to

coordinate support.• School nurses attend case conferences for

children in Hertfordshire schools even when the children may live outside of Hertfordshire.


CLA• School nurses undertake health reviews on

Children Looked After, working with colleague in CLA teams and local authority to promote the best health outcomes for these children.

• School nurse teams ensure that CLA are up to date with their immunisations, this can be a real challenge as records etc are sometimes incomplete.


Actions.• Development group to promote and

standardise good practice • Capitalising on passion and commitment of

school nurses to develop the service. • Ongoing training to support key areas of the

role e.g. mental health • Improving local links with colleagues in social

care• Working with commissioners to clarify

specification.

Documents

Caring for you...closer to home School Nursing scrutiny panel 23 rd February 2012