We need school nurses now more than ever

School nurses are in a unique position to spot the early signs of abuse in children, but evidence suggests that this aspect of their role is being compromised. 

School nurses are in a unique position to spot the early signs of abuse in children, but evidence suggests that this aspect of their role is being compromised. 

School nurses
Children feel comfortable talking to school nurses about issues that concern them. Picture: Alamy

As highly trained professionals, school nurses can build trusting relationships with pupils over extended periods. This ability can be vital in making children feel comfortable enough to talk about issues that concern them, such as relationships, sex, problems at home or mental health concerns.

Yet the recently published Lightning Review, based on a survey of 800 school nurses, shows how chronically under used school nurses have become. The report highlights missed opportunities to make full use of them to identify children at risk of abuse.


Most victims of abuse and neglect are not known to authorities. The Children’s Commissioner's 2015 inquiry into child sexual abuse in the family network estimated that only one in eight victims come to the attention of police or local children’s services.

School was consistently identified as the location where children were most likely to seek help. Sometimes abuse is detected when children come forward for help with other issues, such as family problems.

However, our research has found a significant number of school nurses spend twice as much time on paperwork as they do on direct work with children.

Case conferences

Ironically, it appears that involving school nurses in extensive child protection and safeguarding tasks, including attendance at case conferences, is restricting their ability to be accessible to children and young people, and to provide important early help and advice to those at risk.

According to the Lightning Review, one fifth of school nurses say that their child-protection caseload is limiting their capacity to perform other activities. On average, school nurses attend one case conference a week, which takes up around 4.5 hours of their time.

However, 8% attend four or more case conferences, indicating that they spend at least half their working week attending these meetings and completing tasks associated with them.


It is worrying that four in ten school nurses said they are unhappy with the response of children’s services for about at least half the referrals they have made and a similar proportion said that local authorities’ child-protection thresholds are too high.

One fifth said they have difficulties contacting social workers and following up children of concern. All too often school nurses are left feeling isolated. 

Most school nurses said that children and young people in the schools they work in are unaware of the service they provide, and the review asks local authorities and healthcare decision makers to enhance engagement between school nurses and children.

This may involve reviewing school nurses’ roles and responsibilities or it may involve finding technological solutions, such as dedicated websites and text messaging.

We all have a part to play in stopping abuse, and school nurses must be empowered to fulfil their vital roles in this process.

About the author

Anne Longfield is children’s commissioner for England


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