School Nursing Service for Children and Young People – May 2012Theresa Bradley, Service Manager

Background and Structure

• The School Nursing within Somerset service is provided to the school aged population i.e children and young people and their families/carers aged 5 -19 years.

• School Nursing teams act as an effective bridge between education, health and social care, supporting work on health issues in school and making health services more accessible to pupils, parents, carers and staff

• The teams are based in 6 bases across the county:– Taunton– Williton– Bridgwater– Wells– Chard– Wincanton

• Each Secondary School and the feeder Primary Schools has a Named School Nurse

Legacy Issues•Establishment of one Somerset PCT

•4 previous organisations

•4 previous service models

•Less that 20 WTE

•Until very recently no defined role

•Lack of commissioned training places

Current EstablishmentBanding Head

CountWTE

Band 6/7 (Qualified School Nurse)

7 5.15

Band 6 6 3.1

Band 5 13 8.62

Band 4 (Nursery Nurses)

2 1.24

Band 3 (Admin)

1 0.46

Band 2 (Admin)

2 0.63

Total 31 19.2

School Nurse Development programme

• Released in March 2012 alongside Getting it right for children, young people and families: Maximising the contribution of the school nursing team: Vision and call to action

• The School Nurse development programme builds on health visiting programme for 0-5s, thus providing the opportunity for synergy between the public health input initiated within early years and provision for school-aged children. This programme of work would support the development of a strengthened and well-equipped school nurse workforce, who would deliver public health and health care support to school-aged children.

• The specific aim being to develop a service model for school nurse contribution to:

• Child young people and family public health delivery• Educational inclusion through supporting children and

young people with, long-term conditions or disabilities including mental health problems in both school and community settings.

The programme will……

maximise the school nursing team contribution to;

• increase the focus on school nursing and the health of children and young people 5-19;

• provide information for Public Health England/Local Authorities on the contribution of school nurses to both public health and the care and support of children with disability/illness in school.

• raise the profile of school nursing as a career and the profession

• raise the profile and opportunities of the current workforce as leaders, co-ordinators and delivers of public health to children and young people

School Nursing for improved health and wellbeing for children and young people

SAFEGUARDING

Services and pathways

Services led by qualified School Nurse and delivered in a range of settings: School Primary care Youth and Community Other education settings Home and residential settings

Developing Pathways Transition from HV – SN Complex needs (School setting) Safeguarding (including DV and sexual exploitation) Youth Justice

* Additional pathways may include LAC & CAMHs

.

Quality standards

The service provided should encapsulate the You’re Welcome Quality Criteria

Accessibility Publicity Confidentiality and consent Environment Staff training, skills, attitudes and values Joined-up working Young people’s involvement in monitoring and evaluation of patient experience Health issues for young people Sexual and reproductive health services

*BYC 2011, DH May 2011

Outcomes: School Nurses leading & contributing to ‘

Healthy Happy children and young people’

Improved health outcomes and a reduction in health inequalityReaching and influencing the wider community, promoting health lifestyles and social cohesionImproved planning of local services to reduce health inequalitiesReduction in the variation in quality of service provision and coverage of the HCP 5-19Children and young people feel supported and able to make positive changes to their health and wellbeingChildren, young people and families are offered preventative services tailored to their needs and all families can access evidence-based programmes.Young people reporting a high level of satisfaction with the school nursing service provided.Improved mental health and well being including bullyingEarly identification of need and appropriate response to meet needA reduction in rates of obesityReduction school absence due to poor healthIncrease in sexual health screening and reduction in rates of Under 18 conceptionA reduction in proportion of young people who frequently use illicit drugs or alcohol or smokeImproved access to support for emotional health and wellbeing Consistent training delivered to school staff Seamless support and MAT provision to support pupils with complex health / and /or additional needEarly identification and support for Parental needs (e.g. mental health concerns)

Developing the services for an effective Healthy Child Programme 5-19

The role of the qualified school nurse:To improve children and young people’s health and wellbeing by:• Leading, delivering and evaluating universal Public Health programmes for school-aged children and young people, both within school and within community settings •Referring and delegating within the team to maximise resources and utilise expertise of other skilled professionals Managing seamless transition into school, from primary to secondary school and transition into adulthood Leading for support children and young people with complex and/or additional needs including support, education and training for families, carers and school staff Providing proactive ‘early help’ and leadership as part of a multi-agency team, with a main focus on children, young people and families with multiple problems (link to contribution to big society – young offenders/gangs)supporting vulnerable children including children in care and support for their carers (including YP in contact with Youth Justice service)Evidence based approach to delivering cost effective programmes or interventions to contribute to children and young people’s health and wellbeing e.g. reductions in: childhood obesity and teenage pregnancy rates

Skills and knowledge:

Graduate workforce Children and young people Public health specialist skills in;

-assessment-needs analysis / population data-evaluation and review-Developing and implementing care plans

Leadership Experts for wider health and wellbeing; for prevention and public health; for building family and community capacity Clinical skills Outcome focussed approaches Defined Communication and negotiating skills Coaching and mentoring

Developing the profession to lead and deliver seamless services for child, young people and families

‘The Offer’

Your Community has a range of health services (including GP and community services) for children and young people and their families. School nurses develop and provide these and make sure you know about them.Universal services from your school nurse team provide the Healthy Child Programme to ensure a healthy start for every child (e.g., immunisations, health checks). They support children and parents to ensure access to a range of community services.Universal plus delivers a swift response from your School nurse Service when you need specific expert help (e.g., with sexual health, mental health concerns, long-term conditions and additional health needsUniversal partnership plus delivers ongoing support by your SN team from a range of local services working together and With you, to deal with more complex issues over a period of time (e.g. with charities and your local authority).

SAFEGUARDING

‘‘The Offer’

Your Community has a range of health services (including GP and community services) for children and young people and their families. School nurses develop and provide these and make sure you know about them.

Universal services from your school nurse team provide the Healthy Child Programme to ensure a healthy start for every child (e.g., immunisations, health checks). They support children and parents to ensure access to a range of community services.

Universal plus delivers a swift response from your School nurse Service when you need specific expert help (e.g., with sexual health, mental health concerns, long-term conditions and additional health needs

Universal partnership plus delivers ongoing support by your SN team from a range of local services working together and With you, to deal with more complex issues over a period of time (e.g. with charities and your local authority).

The service

Interactions and community level: building capacity to improve health outcomes and leading the health child (5-19) for a population

Universal services for all children and young people working with school nurses (re transition), building strong relationship and planning future contacts with CYP and leading the Healthy Child programme for CYP between 5-19

Additional services that any CYP may need some of the time, for example care packages for mental health, sexual health – where the School nurses may provide, delegate or refer. Intervening early to prevent problems developing or worsening

Additional services for vulnerable CYP requiring ongoing support for a range of special needs for example disadvantaged CYP, disability, mental health or substance mis-use (risk taking behaviour)

SA

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GU

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DIN

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The Offer• The Community has a range of health services (including GP and

community services) for children and young people and their families. School nurses develop and provide these and make sure young people and their families know about them.

• Universal services from the school nurse team who will deliver the Healthy Child Programme to ensure a healthy start for every child (e.g., immunisations, health checks). They support children and parents to ensure access to a range of community services.

• Universal plus delivers a swift response from the School Nurse Service when specific expert help is required (e.g., with sexual health, mental health concerns, long-term conditions and additional health needs

• Universal partnership plus delivers ongoing support by the SN team from a range of local services working together and with clients, to deal with more complex issues over a period of time (e.g. with charities and local authority).

The role of the school Nurse

Partnershipworking

Collaborationand Negotiation

CommunicationUsing the

evidence base

Early help – intervention, support and referral

Readiness for transition – at primary and secondary school and into further education, training or employment

Delivering the Universal offer

Delivering Public HealthHealthy Child Programme 5-19

The role of the qualified school nurse:

To improve children and young people’s health and wellbeing by:• Leading, delivering and evaluating universal Public Health programmes for school-

aged children and young people, both within school and within community settings • Referring and delegating within the team to maximise resources and utilise

expertise of other skilled professionals• Managing seamless transition into school, from primary to secondary school and

transition into adulthood • Leading for support children and young people with complex and/or additional

needs including support, education and training for families, carers and school staff • Providing proactive ‘early help’ and leadership as part of a multi-agency team, with

a main focus on children, young people and families with multiple problems (link to contribution to big society – young offenders/gangs)

• supporting vulnerable children including children in care and support for their carers (including YP in contact with Youth Justice service)

• Evidence based approach to delivering cost effective programmes or interventions to contribute to children and young people’s health and wellbeing e.g. reductions in: childhood obesity and teenage pregnancy rates

Skills and knowledge: Graduate workforce Children and young people Public health specialist

skills in;- assessment- needs analysis / population data- evaluation and review- Developing and implementing care plans

Leadership Experts for wider health and wellbeing; for

prevention and public health; for building family and community

capacity Clinical skills Outcome focussed approaches Defined Communication and negotiating skills Coaching and mentoring

Outcomes MeasureImproved: • readiness for school; • population vaccination cover; • Emotional wellbeing of looked after children

Reduced: • School absences; • Tooth decay in children aged 5; • Excess weight in 4-5 and 10-11 year olds; • Hospital admissions due to intentional or deliberate

injuries • Under 18 conception rates; • Chlamydia in 15-24 year olds; • Smoking prevalence in 15 year olds; • Alcohol and drug mis-use.

Public Health Outcomes Framework (2012)

Service Priorities• Safeguarding responsibility

• School Based Young Peoples Clinics

• HPV Delivery- Target 90%

• National Child Measurement Programme

• Children in Care Review Health Assessments- Target 90%