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Press Release - new SAPHNA Executive Lead Officer

Cherylynn Wray - Sunday, December 09, 2018 -

We are delighted to announce that Maggie Clarke has been appointed to our new role of Executive Lead Officer. This to take effect from March 2019 when our current Chair, Jill Beswick, will be retiring. We are sad to see Jill go, thank her for her invaluable work for SAPHNA and for her 40+ years in promoting the health and well-being of children and young people. We welcome Maggie into this new role and look forward to a renewed vision and leader!

 

Sharon White OBE CEO SAPHNA

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Position Statement On School Nursing: Potential To Impact On Prevention Agenda And Mental Health Outcomes

Cherylynn Wray - Tuesday, November 27, 2018 -

Position Statement on School Nursing: Potential to impact on prevention agenda and mental health outcomes

 

 

 

 

 

 

 

 

 

 

 

Introduction and Background

Public health is at the forefront of transforming population health for all communities and across the lifespan. The importance of building on the support in the early years and sustaining this across the life course for school-aged children and young people to improve outcomes and reduce inequalities has been recognised (1). The Chief Medical Officer articulated the crucial role of School Nurses in delivering a proportionate universalism approach, with a range of services from universal to universal plus and beyond (2). The Healthy Child Programme from 5 to 19 years old provides an evidenced based framework to support local public health delivery for children and young people and is led by school nursing services, providing place-based services and working in partnership with education and other providers (3). ‘All Our Health’, key to the NHS Five Year Forward plan, highlights the growing importance of taking action to improve health outcomes and tackle inequalities and provides examples of topic areas where School Nurses are key contributors (4).More recently Matt Hancock, Minister for Health and Social Care, has recognised the unique position of School Nurses as the professionals with the first and most frequent

interaction with children and young people and in a position to influence their lifestyle choices, and to spot when helped might be needed (5).

 

The Role of the School Nurse

School Nurses are registered nurses/midwives, with additional degree/post graduate training in specialist public health nursing leading to Nursing and Midwifery Council (NMC) recordable qualification as Specialist Community Public Health Nurse (SCPHN). Their aim is to improve the health and wellbeing of children and young people, supporting children and young people in making healthy lifestyle choices, enabling them to reach their full potential and enjoy life. The nature of their work requires clinical input and effective leadership.

 

School Nurses are;

The single biggest workforce specifically trained and skilled to deliver public health for school-aged children (5-19), trusted and valued by children and young people,

The key health professionals who provide a link between school, home and the community, uniquely positioned within community and education settings to support multi-disciplinary teams, with relationships within primary and secondary care,

Skilled in managing the relationships between child, family and school settings,

Clinically skilled in providing holistic, individualised and population health level assessment and intervention. (6)

 

The facts:

 

The evidence listed above clearly demonstrates the impact on health outcomes alongside the return on investment of providing prevention and early intervention in a child’s life and sustained into adulthood. And yet, although the Chief Medical Officer emphasised the importance of maintaining and building on the progress made through the transfer of commissioning to local authorities, the trend is one of disinvestment (7). The figures are stark: -

Between 2010 and 2017 there has been a 16% decrease in the number of full time School Nurses while we have seen a rise of 450,000 of school aged pupils,

14% of the total public health funding cuts in 2016-7 fell on services aiming to improve children and young people’s health. The proposed cuts for 2019-2020 will have a further significant impact.

 

These cuts are coupled with a complex picture of workforce and service delivery with some local authorities wholly decommissioning school nursing services, with decreases in the commissions and uptake of SCPHN training (8).

 

The School Nurse is ideally placed to tackle the wider determinants of health, combining our safeguarding role and prevention/early intervention role to reduce the impact of adverse childhood experiences (ACES).The School Nurse is in a position to identify risk factors, promote health and disrupt exposure to further risk and support the children and young people and their families to recover, with a particular opportunity during times of adolescent neuro-development.

What is ‘good’ school nursing: Evidence, outcomes & potential for return on investment

 

Public Health England (PHE) monitors a range of health and wellbeing indicators however data systems remain in their infancy and many of the outcomes are relatively long term. However, PHE commissioning guidance outlines performance and outcomes measures for school nursing services across the six high impact areas and is an example of how improvements and outcomes can be realised:

 

Building resilience and emotional wellbeing

Reducing risk from harm and improving safety

Maximising learning and achievement

Improving lifestyles

Supporting complex and additional health and wellbeing needs

Seamless transition and preparation to adulthood (9)

 

Although data systems are immature there are many narratives that do demonstrate the impact of school nursing across England. The examples of good practice and how and what School Nurses achieve are plentiful, some of these examples are evidenced below.

 

Young people wanted their school nurse to offer accessible, visible and confidential services (10).In response, School Nurses have offered more traditional services such as ‘drop in’s’ in schools or other settings offering advice and support on a range of health issues. This is alongside embracing innovation and extending reach using technology. For example, ChatHealth text messaging service are used by 32 areas across England and in October alone School Nurses provided over 1500 episodes of care.

 

Supporting children and young people in vulnerable groups. School nurse service have pathway approaches that allow those not accessing mainstream education to have the same access to support that those in school receive. These pathways are incorporated within services or might be offered as part of specialist team. For example, https://vivbennett.blog.gov.uk/2016/11/01/supporting-vulnerable-groups-by-heidi-ferrier-hixon/. Young Carers are particularly hidden group and School Nurses have lead the way in supporting these young people

 

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/299270/Young_Carers_pathway_Interactive_FINAL.pdf

An increasing number of children and young people have complex needs, long term medical needs and/or special educational needs. School nurse play a crucial part in supporting these children and young people to access education, learn and achieve. Many school nurse services provide training for schools to enable them to support pupils with medical needs. https://www.ncb.org.uk/sites/default/files/uploads/documents/Research_reports/Nursing%20in%20Schools%20-%20Final.pdf

 

Staying healthy is a key priority. Many School Nurses services are crucial in providing the National Child Measurement Programme (NCMP) and extend their provision through providing intervention which support healthy weight and physical activity. For example, Warwickshire School Nurses delivered interventions to improve healthy eating and physical activity https://vivbennett.blog.gov.uk/2017/08/25/breakfast-and-activity-can-children-be-encouraged-to-enjoy-both/. Dental health is another priority area. School Nurses in Hampshire targeted oral health as part of wider public health prevention within the community that they service https://vivbennett.blog.gov.uk/2015/09/29/oral-health-jane-levers/


•School Nurses are key to the delivery of positive sexual health messages and achieve this through interventions such as ‘clinic in box’ and providing high quality sexual health and education in schools Examples of good practice can be found in Bath, Oxford and Doncaster https://vivbennett.blog.gov.uk/2016/11/01/teenage-pregnancy-and-young-parents-the-key-contribution-of-school-nurses-by-alison-hadley/

 

The impact of the school nurse on promoting emotional health and wellbeing

 Children and young people’s mental health and well-being has been recognised as a rising issue, gaining wider publicity from the public and political agenda; resulting in publications such as Future in Mind (11) and the most current Green paper, ‘Transforming Children and Young People’s Mental Health Provision’ (12).

 

All policies advocate tackling the wider determinants of health and wellbeing inequalities, however fail to acknowledge the significance of the school nursing team contribution within the public health setting.

 

It is extensively documented that School Nurses are well placed to identify and support young people who are at risk of having problems with their emotional health and well-being and offer emotional support and education (13, 6, 11).

 

The priority afforded to interventions targeting positive mental health and emotional health and wellbeing has led to the development of a national pathway guidance showcasing many examples of our practice

 

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/299268/Emotional_Health_and_Wellbeing_pathway_Interactive_FINAL.pdf.

 

Walsall school nursing service offer targeted interventions using evidence-based CBT packaged and training wider children’s workforce to deliver interventions

https://vivbennett.blog.gov.uk/2016/11/04/building-resilience-in-children-and-young-peoples-and-their-families-sallyann-sutton/

 

The intrinsic link between emotional wellbeing and other health outcome priorities must be explored when the School Nurse impact on emotional health and well-being is considered; more notably in adolescence as the causative or consequential factors of poor mental health.

 

Key indicators such as healthy weight, sexual health and drug and alcohol misuse are vital triggers for school nursing teams to initiate contact with young people who may be struggling with their emotional health. Drop in sessions at high school are the main domain for School Nurses to provide advice and support and a study carried out by Kay et al (2006) (14) found that the majority of consultations carried out by the school nurse were concerning issues relating to emotional wellbeing and mental health such as low mood, anxiety, depression and self-harm. Kelly et al (2005) (15) identified that parents and teachers perceived School Nurses to be invaluable when delivering mental health interventions, partly due to the skills and attitudes they possess but also because of their ability to liaise with multi agencies.

 

The School Nurse can also be the neutral, supportive adult to children suffering the impact of parental mental illness helping build resilience, and contributing to emotional wellbeing.

 

Our View

As outlined by key government documents, which create the framework to which school nursing provision is modelled, early intervention is key and the universal service we provide to the school age population is well timed and strategic in meeting their needs (DH 2009, DH 2014).

There are key opportunities at the current time for Government to support both the physical and mental health of children and young people through well-resourced School Nursing services.

 

The current level of disinvestment in the provision of school nursing services as part of wider public health services for children and young people is a threat to the maintenance and ability to build on the progress made in improving health outcomes for our children and young people. In response to these concerns we ask that the expertise of School Nurses, as public health practitioners is recognised, and appropriate funding streams identified to maintain and develop this highly skilled workforce.Also to recognise the crucial role and contribution School Nurses make to high impact areas which support health and wellbeing through the Government reflecting the contribution of school nursing within current policy.

 

We also ask that consideration is given to reviewing mandation of core school nursing activity in conjunction with health visiting.The current inequity in the system leads to opportunity for dilution of school nursing resource in 0-19 services in order to meet currently mandated contacts.

 

 

References

 

1.Fair society, healthy lives: The Marmot Review: strategic review of health inequalities in England post-2010. (Marmot, 2010)

2.https://www.gov.uk/government/publications/chief-medical-officers-annual-report-2012-our-children-deserve-better-prevention-pays

3.https://www.gov.uk/government/publications/healthy-child-programme-5-to-19-years-old

4.https://www.gov.uk/government/publications/all-our-health-about-the-framework/all-our-health-about-the-framework

5.https://www.gov.uk/government/publications/prevention-is-better-than-cure-our-vision-to-help-you-live-well-for-longer

6.Maximising the school nursing team contribution to the public health of school-aged children - Guidance to support the commissioning of public health provision for school aged children 5-19 (DH, PHE, 2014)

7.Return on investment of public health interventions: a systematic review. Masters Journal of Epidemiology & Community Health 2017; 71(8):827-834.

8.https://www.rcn.org.uk/-/media/royal-college-of-nursing/documents/publications/2017/may/pub-006200.pdf

9.https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/754796/overview_of_the_6_early_years_and_school_aged_years_high_impact_areas.pdf

10.https://www.nursingtimes.net/Journals/2011/11/30/l/y/d/British-Youth-Council-Our-School-Nurse-FINAL.pdf

11.https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/414024/Childrens_Mental_Health.pdf

12.Transforming-children-and-young-peoples-mental-health-provision-a-green-paper (DHSS 2018)

13.Day, P (2016) ‘Motivating Teen Spirit: Early metal health intervention’ British Journal of School Nursing, Vol 11 Issue 2

14.Kay, C M. Morgan, D L. Tripp, J H. Davies, C and Sykes, S (2006) ‘To what extent are school drop-in clinics meeting pupils self-identified health concerns? Health Education Journal 65 (3) pp 236-251

15.Kelly, N Greaves, C Buckland, L Rose, J (2005) ‘School nurses: well placed to address challenging behaviour’. Community Practitioner 78 (3) pp 88-92

16.ChatHealth https://apps.beta.nhs.uk/chathealth/

http://emahsn.org.uk/impact-reports-new/chathealth/

17.Rt Honourable Matt Hancock and DHSC 2018: New technology is key to making NHS the world's best https://www.gov.uk/government/news/matt-hancock-new-technology-is-key-to-making-nhs-the-worlds-best

18.“The Adverse Childhood Experiences (ACE) Study”. cdc.gov. Atlanta. Georgia: Centers for Disease Control and Prevention.National Center for Injury Prevention and Control.Division of Violence Prevention.May 2014.Archived from the original on 27 December 2015.

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Always and Tampax 'About You' Healthy Relationships Campaign

Cherylynn Wray - Monday, October 22, 2018 -

Always & Tampax set to educate teenagers about healthy relationships

Brand new education programme for 13-14-year-olds comes with hundreds of thousands of free pads and tampons

Always & Tampax have launched new Healthy Relationships resources for 13-14-year-olds and aim to distribute over 300,000 free tampons as part of the ‘About You’ education programme for secondary schools.

Free downloadable resource packs, videos and interactive activities will help teachers explore with students what it means to have healthy relationships with themselves and others, focusing on how to maintain confidence and self-esteem throughout the emotional and physical challenges of adolescence.

Developed in collaboration with teachers, female students and SAPHNA (School and Public Health Nurses Association), the curriculum-linked resources help tackle tricky topics such as self-esteem, body image, rights and responsibilities around consent, and periods.

 

“By having the programme and the samples, it gave me the confidence to demonstrate how the samples worked and to be able to talk freely about a 'taboo' subject that can be difficult for girls to speak about. As the sessions went on, the girls became much more confident to ask different questions. Very pleased that I signed up for this!”

Rhian Spence, Heysham High

 

 

Following a pilot programme in June this year, 97% of educators said they would recommend the Healthy Relationships resources to a colleague.

 

Hundreds of schools have already registered their interest in the new resources, which complement the existing puberty education resources for 11-12-year-olds, and requested their free products and leaflets for parents and girls. Secondary schools in the UK and ROI can access free sample packs of pads for 11-12-year-olds and now tampons for 13-14-year-olds by registering their details on the National Schools Partnership website: https://nationalschoolspartnership.com/initiatives/about-you-and-endperiodpoverty/

 

Plus, Always release more free pads to help end period poverty

Always have also announced they will be donating more free pads to schools this term as part of their #EndPeriodPoverty initiative, to help keep girls in school that can’t afford sanitary protection. The initiative, launched in March 2018, was inspired by their research which revealed over half of women who have experienced period poverty believe it has had a direct effect on their success, confidence and happiness.

If you are a teacher at a UK state secondary school with at least 1% of girls eligible for free school meals, you will be entitled to receive free Always pads to help keep your girls most in need in school (in addition to any you receive for your 11-12-year-olds as part of the About You programme.

State secondary schools could be eligible for over 3,500 free pads for girls most in need

You can register for free pads as part of the #EndPeriodPoverty initiative at the same time as registering for the About You education programme and free products on the National Schools Partnership website, simply tick the box when you’re asked on the form.

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SAPHNA Conference 2018 Presentations

Cherylynn Wray - Wednesday, August 01, 2018 -

Presentations from the Conference including the workshops held during the afternoon of the 12th June 2018:    Read More

***SAPHNA Conference - 12 June 2018***FULLY BOOKED

Cherylynn Wray - Monday, May 07, 2018 -

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SAPHNA AGM - Friday 13 October 2017

Cherylynn Wray - Tuesday, October 10, 2017 -

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SAPHNA Conference Presentation - Close and Summary - Sharon White OBE, Professional Officer, SAPHNA

Cherylynn Wray - Thursday, November 17, 2016 -

To access the following video use code SAPHNA999:

 

https://vimeo.com/user41997654/Close-and-Summary

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SAPHNA Conference Presentation - Motivation for Change - Worries - Rosie Glossop and Oliver Scheidt

Cherylynn Wray - Thursday, November 17, 2016 -

To access the following video use code SAPHNA999:

 

https://vimeo.com/user41997654/Motivation-for-change

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SAPHNA Conference Presentation - Education As Co-Commissioners Of School Nursing Services - Kirsten Ellmore

Cherylynn Wray - Thursday, November 17, 2016 -

Kirsten Ellmore, School Nurse Manager - Shropshire Community NHS Healthcare Trust and local partner Head Teacher

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SAPHNA Conference Presentation - A Dynamic Model Of School Nursing Service Provider - Kath Lancaster, Rachel Bundock and Kate Sahota

Cherylynn Wray - Thursday, November 17, 2016 -

Kath Lancaster, SCPHN SN, Rachel Bundock, Director of Compass and Kate Sahota, Commissioning Lead, Children's Public Health, Warwickshire

 

To access the following video use code SAPHNA999:

 

https://vimeo.com/user41997654/A-dynamic-model


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