School nurses play an essential role in promoting the health and wellbeing of children and young people in the UK (Sutton and White, 2024). They can be employed by various organisations, including local health authorities, primary care trusts, community trusts or sometimes directly by the school. This means their employment and oversight can vary depending on the region and specific needs of the school or community. School nurses offer a wide range of services, including delivering health and sex education, conducting developmental screening, performing health assessment and administering immunisation programmes. These nurses are highly skilled professionals, educated to postgraduate level. Their approach to care considers the biological, psychological and social factors affecting the health and wellbeing of children and young people.
The school nurse serves as a unique bridge between the school, home and community. When school nurses are present, they support students from the beginning of primary school through secondary school and into young adulthood. During these years, they guide and support students, promoting good physical and mental health. School nurses are uniquely positioned to use their public health expertise to promote safety and prevent harm, and have a key role to play in safeguarding.
Despite the crucial role that these health professionals play in the health and wellbeing of children and young people, their number across England has decreased by 33% since 2009 (College of Medicine et al, 2023). However, this headline figure masks significant variation: in some local authority areas, school nursing services are no longer commissioned at all. The steady decline in the number of school nurses is a reflection of the impact brought about by changes in commissioning arrangements in the context of a challenging financial environment. This financial strain has forced many areas to prioritise immediate needs over long-term investments in child health – for example, a disproportionate amount of school nurses' time is often spent on child protection and addressing ‘child in need’ cases (College of Medicine et al, 2023).
The Healthy Child Programme (Office for Health Improvement and Disparities, 2023) is a key public health initiative in England and school nurses have a pivotal role in its successful delivery through prevention, early intervention and health promotion. For the Healthy Child Programme to achieve its full potential, there must be consistent investment in school nursing services. All children, regardless of where they live, should have access to the support they need to thrive.
Every school needs a school nurse and that school nurse should sit on the school board (College of Medicine, 2021). Ensuring that our children and young people (our greatest assets) achieve their greatest potential requires access to specialised school nurses who are proficient in public health and early intervention strategies. The withdrawal of investments in school nursing services has resulted in an unacceptable patchwork of service delivery, which not only hinders the effective execution of the Healthy Child Programme, but it is also compromising the ability to address critical public health priorities. The goal of safeguarding the health and wellbeing of future generations is seriously jeopardised.