PaperworkA report by the Children’s Commissioner for England has revealed the extent to which paperwork duties are threatening the vital role of nurses in schools.

800 nurses working in primary and secondary schools took part in a survey aimed at uncovering the extent of children’s access to school nurses, as well as what might be done to improve their wellbeing and protect them from harm.

The nurses’ answers indicate that time pressures are compromising their role in supporting children’s health and wellbeing, promoting healthy relationships, and delivering sex education. With some school nurses responsible for thousands of schoolchildren, evidence shows that paperwork is increasingly eating into the time that these important school staff have to spend with pupils.

As part of the survey, the participating nurses were asked questions about referrals they had made to Children’s Services relating to either children in need or child protection, as well as any barriers they had faced when making these referrals.

Four in ten nurses said they were unhappy with the response to at least half of the referrals they made to Children’s Services when identifying a child at risk. Those taking part in the survey drew attention to the rising thresholds operated by local children’s services, which they said make successful referrals of children increasingly difficult.

Many school nurses bemoaned the amount of bureaucratic and reactive work they have to do, which hampers their ability build relationships with, and deliver support and education to, their students.

One nurse working in the north-west of England said: “We have very little contact with children due to drop-ins being stopped.” Another based across a number of different schools in the east commented: “We could be much more effective if we were able to get into schools more often and allow time with the pupils. A majority of my work is behind the scenes writing reports and following up on safeguarding issues.”

Safeguarding and child protection issues now feature regularly in the workload of school nurses, but one in five believe this is limiting their capacity to perform other tasks. The average length of time taken up by attending a case conference, including travel and associated paperwork, is 4.5 hours. Although school nurses attend one a week on average, research found that 8% attend four or more, meaning over half their working week is taken up by these events.

A majority of the survey participants noted that the children and young people who attend the schools they work in are largely unaware of the school nursing service. A 13-year-old young carer said: “School nurses are really important. I was picked up by my school nurse and they referred me to my local young carers’ project; if it wasn’t for them I wouldn’t know about my young carers group and get the support I do now.”

The Children’s Commissioner report does highlight a number of recent initiatives aimed at helping children and young people get in touch with their school nurse, including digital and texting services. However, the more bureaucratic work a school nurse has to do, the less time they have to dedicate to helping their students, building relationships, and identifying those at risk of harm.

Anne Longfield, Children’s Commissioner for England, had this to say: “School nurses have a vital role to play in schools protecting children as well as promoting their wellbeing.

“They are one of the professionals at the frontline identifying abuse or neglect, as well as supporting children with a host of other issues – whether that’s mental health, age-appropriate relationships and sex education or healthy eating. Being available for children for face-to-face time is irreplaceable.”

“It is clear from this research that school nurses face significant barriers in working directly with children and young people, with paperwork getting in the way. The support they offer needs to be better promoted and new ways to enhance their engagement with children explored.”