Policy briefing

RCN toolkit for school nurses

Read our policy briefing on an updated school nursing toolkit from the RCN.

Read our policy briefing on an updated school nursing toolkit from the RCN


Essential facts

School nurses or specialist community public health nurses (SCPHNs) are qualified nurses or midwives with specialist graduate-level education in community health and the health needs of school-age children and young people.

School nurses were employed within NHS community services from 1974. Since then the role has become more autonomous, with such nurses leading public health initiatives for school-age children and working in schools and the community, according to the RCN.

In 2004 the Nursing and Midwifery Council approved standards for registration in specialist community public health nursing across the UK.

The four nations of the UK have different policies relating to school health provision, but school nurses deliver the Healthy Child Programme (HCP) for those aged 5–19 in England and equivalent programmes in Scotland, Northern Ireland and Wales.

School nursing and health visiting have been administered by local authorities since 2015, a change designed to align children’s public health with social care and education, and improve multi-agency working.

What’s new

The RCN has published an updated toolkit for school nurses that provides them with information, examples of good practice, templates and useful websites to support and develop professional practice.

It includes templates for documents including a school nursing individual health needs assessment, a form for referrals to child and adolescent mental health services, how to set up a drop-in service, and a specimen job advert for a school nurse.

As well as practical guidance for nurses, the toolkit also sets out challenges facing school nurses. Government figures show the number of school nurses fell by 15% in England between 2010 and 2016, leaving 1,208 nurses to support approximately nine and half million children and young people. Time spent with each child varies. The RCN cites an average of 12 minutes school nurse time for each child seen per year.

The toolkit says the RCN has raised concerns regarding inequalities across the UK in accessing school nursing services, and that many school nurses are faced with limited capacity to promote the resilience and well-being of children and young people.

Implications for nurses

The toolkit sets out the role of the school nurse and key public health domains for specialist community public health and school nurses, and also addresses leadership and management issues.

The document sets out information developed last year by Public Health England on the 4–5–6 model for school nursing. Based on four levels of service, five health reviews for school-age children and six high impact areas of practice, it highlights key areas for school nurses in building resilience, safeguarding and maximising learning and achievement.

The toolkit highlights the importance of assessment of individual children, and says any assessment should be undertaken by a school nurse who may then delegate ongoing support or interventions, including a referral to another service or professional. The document maintains it is important for school nurses to understand how local services are planned and commissioned.

Expert comment

fionaFiona Smith, RCN professional lead for children and young people’s nursing

‘The toolkit has been revised to include up to date policy and practice as well as examples for day-to-day practice for school nurses, whether working for independent schools or in the mainstream. Many of these individuals may be the only nursing practitioner within the school’s staff and may be isolated.

‘There are also case studies around school profiling and role descriptions for school staff to use along with lots of links and other resources. It is important that school nurses are able to clearly articulate their service and the needs of students in the school where they are working.’

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