Policy briefing

Guidance on school nursing during the COVID-19 pandemic

Advice on how school nursing services in England can operate during restrictions imposed due to COVID-19
Boy texting

Advice on how school nursing services in England can operate during restrictions imposed due to COVID-19

Credit: iStock

Essential information

Schools across the UK were closed in March 2020 to all but vulnerable children and those from key workers’ families, as part of efforts to halt the spread of COVID-19.

Some primary schools in England reopened to some reception, year 1 and year 6 pupils from 1 June. Secondary school pupils in years 10 and 12 were due to start returning for some sessions in schools in England from 15 June.

The vast majority of primary and secondary schools pupils will not return to school until at least September.

Even before the pandemic, many school nurses delivered services via text, email and online drop-in clinics. They have continued to work remotely during the pandemic while schools have remained closed, carrying out consultations by phone, video call or text.

What's new?

The RCN, the Community Practitioners and Health Visitors Association, the Institute of Health Visiting and the School and Public Health Nurses Association have produced guidance, Delivering the School Nursing Healthy Child Programme During the COVID19 Pandemic. It is aimed at school nurses and other staff who work within health visiting and school nursing services for those up to the age of 19 in England.

The guidance looks at the practicalities of deciding when a virtual contact is appropriate, or inappropriate, text messaging, implementing online consultations, record keeping and online safety when contacting families.

It also covers preventing the spread of COVID-19 through dealing with direct transmission such as sneezing or coughing, and indirect transmission such as touching contaminated surfaces, as more children return to school.

The guidance suggests a range of approaches and actions to be taken, including ensuring that pupils who are unwell are kept away from school and providing advice to parents about isolating if they or their child have COVID-19 symptoms.

‘Concerns such as domestic violence and abuse, negative social media interactions and caring responsibilities may escalate’

Nurses should also encourage pupils and teachers to wash their hands frequently and to cough or sneeze into a tissue and throw it into a bin, as well as helping with social distancing to prevent the spread of the virus.

The guidance also emphasises that owing to the lockdown there may be an escalation in safeguarding issues and concerns such as domestic violence and abuse, negative social media interactions and caring responsibilities. 

Expert comment

Picture of Sharon White, chief executive of the School and Public Health Nurses AssociationSharon White, chief executive of the School and Public Health Nurses Association

‘School nurses have gone above and beyond the call of duty during this pandemic, rapidly adapting through solution-focused approaches.

‘Their advanced technology skills and experience of working with children and young people and their families through remote methods such as texts, emails and virtual drop-in clinics has stood them in good stead and is proving invaluable for some of our families, particularly those most vulnerable and for many reasons not attending school.

‘The downside of this is increased demands on already much-depleted school nursing services. However, in times of such uncertainty, it is heartening to be able to offer virtual contact through a range of mediums.

‘We are now looking at what revised service delivery should and could look like, reflecting on what has and has not worked so well and, most importantly, what our children and young people, families and partners think.’


Key points for nurses 

Consider when a COVID-19-related contact is appropriate, including:

  • If a school nurse is self-isolating themselves.
  • The child, young person or family has COVID-19 or is self-isolating.
  • For remote cover for sickness, some schools may be closed and no appropriate safe space available.
  • If there is a preferred contact method agreed with the child, young person or family.

Consider when virtual contact could be inappropriate, including:

  • If a child or young person is assessed as having a compelling need for a home visit – such as safeguarding concerns, caring responsibilities, mental health and well-being – that requires face-to-face assessment, or there are significant concerns for their well-being.
  • If a child or young person has co-morbidities that affect their ability to use videoconferencing or texting.
  • If a child or young person has serious anxieties about technology.
  • For some hard-of-hearing children and young people.

Note also:

  • Mental health and well-being should be considered at every contact.
  • Consider the whole family and signpost to guidance on support.
  • The well-being of practitioners is also essential to enable provision of safe and effective care.

View our COVID-19 resource centre

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