A dedicated school nursing service has been set up in Northumberland and North Tyneside to support SEND schools. The team provides on-site nursing provision to seven schools across the area to pupils with specialist health needs. This case study showcases the important role of school nurses in the education system.
‘Every child deserves support from a school nurse’
There is no standard approach to providing nursing support to SEND schools. In some areas there are specialist services commissioned solely by the NHS, sometimes in partnership with the council. But in other areas, it is the core school nursing or children’s community nursing service that provide this support.
In Northumberland and North Tyneside, the two CCGs commission Northumbria Healthcare NHS Foundation Trust to provide a dedicated special school nursing service. The trust provides an on-site service at seven schools that educate children and young people with profound physical and learning disabilities. Outreach support is also provided to other schools with more moderate needs.
Service Team Leader Elaine Davies said: “All children deserve access to the Healthy Child Programme – and that is what our service ensures and more thanks to the investment made in Northumberland and North Tyneside. But sadly, this is not the case everywhere.”
The nurses, many of whom have a background as specialist community nurses, support children and young people in the schools with their specialist health needs, which include physical and learning disabilities, tube feeding, respiratory issues, diabetes, continence and complex epilepsy. The team also provides emotional and behavioural support, health education and promotion, training to school staff, such as on tube feeding, and assessment and care planning.
“It has been particularly challenging during the pandemic,” said Ms Davies. “Many of the children were shielding and families were very concerned about COVID. Attendance has now returned to normal.
“We provided fit testing for education staff to be fitted with the correct PPE for aerosol generating procedures and we supported schools with testing. We proactively worked with families about the individual needs of children, to support their health needs during the pandemic, and for them to safely attend school.’’
“Children missed a lot of schooling, and we are beginning to see some of the fallout from the pandemic – children with mental health needs and anxiety and family breakdowns. For some it is manifesting itself in escalation in behavioural issues and exploitation. We work with children’s social care, CAHMS and the community learning disability team who have access to psychologists and specialist services to support these children.”
How the team makes a difference
Alongside this, there is also bespoke support available for those at different stages of their school life, including for those transitioning to adulthood as well as young children just starting school. Thanks to new investment pupils starting nursery and primary school are now offered health needs assessments by the nurses as soon as their school place is confirmed. Bespoke support for the family, training for education staff and care planning is then put in place in advance to allow the child to start school with all preparations in place as soon as the term begins.
Ms Davies said: “We were finding that for some children the start of school was problematic - this is helping to alleviate that. Families and schools are greatly appreciating this enhanced support.”
The support put in place is making a huge difference to individual families. For example, the school nurses recently helped an 11-year-old girl who had become anxious and upset about a planned operation she was due to have for bladder and stoma surgery. She was getting so upset in lessons that she had to be sent home and was missing school.
The nursing team started to meet with her every week in the lead up to her surgery, talking about what the operation would involve and how feeling different emotions was only natural. They also watched age-appropriate videos of the surgery with her, helping her to understand the procedure. She became more settled and was able to stay in lessons and concentrate on school again.
In another case a child with a range of learning disabilities, including cerebral palsy, had developed problematic dry skin. It transpired that she was struggling to have a regular full body wash because an adapted bathroom had not been completed at her home because of COVID restrictions. After discussions with her family, the school nurses worked with the community nursing team to arrange a carer to help her shower at her school’s adapted bathroom.
Ms Davies said examples such as these that illustrate the importance of supporting these vulnerable children. “By working closely and having the expertise, a dedicated school nursing team can have a major impact on children with special education needs and disabilities, helping to keep them in school and healthy and well.”