Agenda item

Julia Mason introduced the report on the School Nursing (SN) Review and Service Redesign. The tri-borough review had found that services in Hammersmith & Fulham were effectively delivering the core requirements of the Healthy Child Programme 5 – 19 years (vision and hearing screening and health assessments), the national child measurement programme, immunisations and safeguarding, but had insufficient capacity to provide a comprehensive preventative and early help service to schools. The SN service needed to be part of an integrated school health model to address changing priorities and new technologies.

The report proposed options for a new service model, within the current financial envelope, which made best use of SN resources and skills. Nationally there was only a small pool of registered school nurses, and the workforce would need to be supplemented by staff nurses, nursery nurses and school nurse assistants.

As NHS England was the responsible commissioner for school aged immunisation, additional capacity would be released when the new service was in place (scheduled to be in place by September 2015).

The report set out the components of the service model, together with two workforce options. Option 1 included a number of lead or specialist roles, and option 2 deployed qualified SNs where they were most needed.

Councillor Vaughan queried how the immunisation service would be monitored. Ms Mason responded that NHSE would have access to the Child Health information system for collation of the data. Performance would be monitored and any variances in uptake would be taken seriously. Public Health would work with NHSE when arising. SNs would continue to have a role in promoting immunisation. There would also be a follow up as part of the review of commissioned services.

Stuart Lines stated that the MMR vaccination was of particular concern. Public Health intended to set up a task and finish group of key players across the whole system, including the CCG to encourage uptake.

It was noted that, in respect of Child Protection Conferences, SNs were, by default, asked to attend, and this was a considerable onus.

Dr Susan McGoldrick queried whether the sharing of SN information with other health bodies had been considered. Ms  Mason responded that SNs did identify relationships and  information sharing. Paediatric hubs had been developed. It worked better where specific issues had been identified and professionals came together in a multi-disciplinary way.  

The consultation had indicated that children and young people wanted a wide range of SN services, from confidential advice and support to the provision of health information. They had stated a preference for individual face to face consultations, but also text and web based information.

Councillor Holder queried the equality implications and work with different communities. Ms Mason responded that clearly there were equality implications, and that it would be possible to bring a full report  as the model and specification developed. The workforce was not large enough to undertake work with different communities. Equality implications could be addressed through better support and access in schools.

Members considered the two options. Whilst option 1 would spread SNs fairly evenly across schools, option 2 would put  the most qualified SNs where most needed, supported by other staff. Where needs were not so high, visits from a SN once/twice a week might be adequate.

Dr Spicer queried whether the option was what SNs were available or where SNs were needed. Ms Mason responded that it was a combination.  SNs were deployed to the highest level of need, whilst other staff might have the skills to provide intervention in different settings Mr Christie added that it was not just a question of the number which could be afforded but also the number available. Nationally, there was a small number of SNs.

RESOLVED THAT:

The HWB recommended Option 2, subject to conversations with the School Community.