School nursing

Find out why they decided to work in this area, advice for anyone wanting to support children and young people at school, and what they most enjoy about their role.

Name: Charlotte Porter

Job title: Specialist Practitioner School Nurse

Specialty: School Nursing

Organisation: Walsall Healthcare NHS Trust - School Nursing Service

What is the initiative and or project you are involved in? 

The school nursing service has provided support for children and young people with nocturnal enuresis for several years. More recently the service took over a contract to manage continence in children and young people and in response developed a robust pathway with the aim of promoting continence and supporting children and young people for whom continence cannot achieved.

What prompted you to do this work? 

Over 900,000 children and young people within the United Kingdom have a medical condition affecting their bladder and bowel, the most problems are delayed toilet training, bedwetting, daytime bladder problems, constipation and faecal soiling all of which can impact negatively on quality of life (Perez, 2014, Rinald and Mirenda, 2012, Rogers, 2016). The promotion of continence therefore, where appropriate, supports children and young people to maximise their ability and to reach their full potential (DH, 2004).

It had been custom and practice to provide children with continence containment products at a young age which then continued to be issued throughout their childhood with no further assessment being undertaken. However, it is essential for children and young people to have an appropriate continence assessment and that the issuing of continence containment products should be the exception rather that the rule (NHS England 2018). 

How did you initiate the work? 

A review of the delivery of continence and enuresis support was reviewed drawing on national guidance and good practice. A pathway which promoted continence including appropriate assessment and prescribing of continence containment products was developed.

What have the challenges to implementing the service/intervention been? And what has enabled the implementation of the service/intervention?

A pathway was implemented which included a robust initial assessment incorporating a toilet training readiness tool to identify children and young people who are showing signs that they could be toilet trained. Families are encouraged to attend either a toilet training for school aged children workshop, a toilet training for children with additional needs workshop or a bedwetting workshop (dependent upon need). If children are assessed and issued with continence products, then reassessment is planned every 12 months (ERIC and the Paediatric Continence Forum (2017).

It was important to ensure that staff were up to date with the assessment and management of continence and supported to deliver the pathway. A competency framework and training packages have been put in place to support this process.

The biggest challenge in implementing this intervention has been changing practice that has been left unchallenged for several years. This has taken courageous leadership to set a standard for the assessment and promotion of continence and the issuing of containment products which is consistent across the organisation.  The lead School Nurse for continence has met with the community nursing teams to discuss why the need for change is essential. It has been important to work with parents to gain their trust and improve their understanding of the pathway and reassure them that we are working with them to achieve the best care for their children. Further work is required in this area.

Has the initiative or project made a difference to patients/service users and or staff? 

Children and young people referred into our service with bladder and bowel problems now have a pathway of support.  New referrals receive a continence assessment and when appropriate attend a toilet training workshop. The pathway has been in place for over 6 months and long term this approach can effectively supports children and young people to achieve continence, promote their independence, raise self-esteem and reduce the risk of social exclusion (Perez, 2014, Whale, 2016). The organisation will benefit, in the long term by ensuring that resources are used in the most cost-effective way whilst delivering high quality, safe care.

What are the long-term aims for the work?

The focus of our work has been on promoting toilet training and appropriate, evidence based prescribing of continence containment products based on needs of the child. A wider paediatric continence pathway is still in development. Although progress is starting to be made, adequate referral pathways to specialist services, as necessary, is still required and School Nursing are part of a task and finish group to scope and develop this pathway. 

References

Alpaslan, A.H., Kocak, U., Avci, K. and Guzel, H.I. (2016) Association between elimination disorders and abusive maternal attitudes. Journal of Forensic and Legal Medicine. 40(2016), pp.22-27

Department of Health (DH) (2004) National Service Framework for Children, Young People and Maternity Services: Disabled Children and Young People and those with Complex Health Needs. London: Crown Copyright

NHS England (2018) Excellence in Continence Care. Leeds: NHS England

Nursing and Midwifery Council (NMC) (2015) The Code: Professional Standards of Practice and Behaviour for Nurses and Midwives. London: NMC

Paediatric Continence Forum. (2017) An Examination of Paediatric Continence Services Across the UK. London: Paediatric Continence Forum

Perez, J. (2014) Early intervention for childhood continence problems. Community Practitioner. 87(7), pp. 44-46

Rinald, K. and Mirenda, P. (2012) Effectiveness of a modified rapid toilet training workshop for parent of children with developmental disabilities. Research in Developmental Disabilities. 33(2012), pp. 933-943

Rogers, J. (2010) One step at a time: how to toilet train children with learning difficulties. Nursing Times [online]. 106(47), [Accessed on 2nd April 2018]. Available at: https//:www.nursingtimes.net

Stenson, A. and Danaher, T. (2005) Continence issues for people with learning disabilities. Learning Disability Practice. 8(9), pp.10-14

Whale, K. (2016) Effects of continence problems on children. Nursing Times. 112(36/37), pp. 8-10.

Names: Debbie Hughes, Alison Payne and Sarah MacKenzie

Job titles: School Nurse Specialist Practitioners

Specialty: School Nursing

Organisation: Walsall Healthcare NHS Trust 

What is the initiative and or project you are involved in? 

This initiative involved School Nurses co-producing a Relation and Sex Education (RSE) Toolkit and delivering training to school staff to support schools to delivery high quality RSE.

The School Nursing service and the Teenage Pregnancy Team worked with Brook to develop RSE Toolkit, consisting of a set of micro sessions, for the key stages in primary and secondary school. The toolkit is hosted on Walsall’s EasySRE website and is a free resource for health, education and social care professionals in Walsall. School nurses received training about how to use the resource and train to school staff to use the toolkit. In addition, the service offers co-delivery of RSE sessions in school to help school staff gain confidence in delivery.

What prompted you to do this work?

There is a high incidence of teenage pregnancy within our local area. High quality RSE in schools combined with accessible and effective services for young people has shown to reduce the teenage pregnancy rate significantly in this country over the last 18 years (Public Health England 2018). However, the evidence suggests that teachers often highlight confidence as a barrier to delivery and value the expertise of health professionals to support delivery. School nurses are ideally placed to provide this support. 

The School Nursing service increasingly received requests to provide RSE sessions to pupils however we had few up to date resources and lacked resources which covered current issues such as CSE, FGM, internet safety. The Toolkit was designed to increase teachers’ capacity and confidence to deliver the sessions themselves by offering a series of lesson plans and co-facilitated team-teaching session supported by school nursing staff.

How did you initiate the work?

Supporting delivery of RSE is a key performance indicator in the commissioning contract and therefore a core element of our delivery. The development of the toolkit to support this was undertaken with additional investment via the Teenage Pregnancy Strategy. 

The teacher training sessions were promoted to schools via a variety of methods, Twitter, flyers on the school links intranet and promoted by the named nurse during their termly school liaison and planning visits. 

The sessions were delivered in the autumn term which allowed staff to use the toolkit to plan SRE sessions which tend to be delivered in the summer term, especially within the primary schools. Schools were offered the option for a co-delivery team teaching with a member of the school nurse team. Our school nurses support delivery in secondary schools covering topics such as contraception, law and consent, relationships. Our nursery nurses deliver the sessions about puberty and growing up to pupils in primary schools. 

What have the challenges to implementing the service/intervention been? And what has enabled the implementation of the service/intervention?

Encouraging all schools to engage in the training has been a challenge. At this moment not all aspect of RSE are mandated. Some schools indicated that they struggle to release teachers for training sessions due to capacity and cost of cover teachers.  

Although the sessions evaluated well some schools still express a preference for the school nursing team to deliver the sessions. Capacity of the service to deliver in classrooms within the core offer of the service is a challenge however, this has provided an opportunity to develop a traded service option which allows schools to commission additional support.

Has the initiative or project made a difference to patients/service users and or staff? 

The teacher training sessions were evaluated qualitatively and received positive responses about the usefulness of the training and staff perceptions about how the training has benefitted them and how they intend to use the training in their settings. Staff able to identify how they will use the resource, feeling more confident about delivery and more knowledgeable. Comments from this year’s training include ‘Informative, useful and a great resource’ and ‘the session was delivered by competent staff who clearly had knowledge of the subject topic’. 

Locally the teenage pregnancy rates have fallen, It could be argued that the delivery of high quality RSE, as part of the wider Teenage Pregnancy Strategy has contributed to these improvements.

What are the long-term aims for the work?

More elements of RSE become mandated in 2020 and it anticipated that a greater number of schools will take up the training offer in order to meet the new requirements. As more schools take up the offer of training and use the resource increase we will move a step further to ensuring that more pupils receive RSE from knowledgeable and confident teachers who use high quality resources.

We are developing a workshop for parents to support them to talk to their children about RSE, this will be based on the resource and help parents to continue the conversations with their children after schools have delivered the curriculum.

Evaluation highlighted that teachers felt that the resource did not consider the needs of children and young people with special education needs (SEN), The school nursing service was approached by a trainee educational psychologist who had also identified the need for an additional resource for SENDi. School nurses are now part of a multi-agency and disciplinary working group who are scoping and developing a resource.

References

Public Health England (2018) Teenage Pregnancy Prevention Framework. London. PHE

Local Teenage pregnancy outcomes 

Name: Jean Rollings

Job title: School Nurse Specialist Practitioner

Specialty: School Nursing 

Organisation: Walsall Healthcare NHS Trust

What is the initiative and or project you are involved in? 

Children and young people are best supported by adults who are emotionally resilient. This includes professionals as well as parents/carers. Importantly, the wellbeing and resilience of health professionals has been linked to the delivery of safe, high quality care and an improved patient experience. Given these links it made sense to intervene and develop the positive coping skills of staff in our service.

What prompted you to do this work

The school nursing service recognises the how good emotional health of children and young people is intrinsic to their ability to learn, achieve and enjoy life and this is improved if children are cared for by resilient carers. The service has a robust pathway which includes workshops and FRIENDS groups across the age range of 4-19 years. These groups help children and young people to develop skills to improve their confidence, self-esteem and resilience. More recently the service introduced the adult programme ‘strong not tough’ to support parents and carers to develop resilience to in turn improve their support to their children. 

The aim of delivering the programme to staff in the School Nursing service was twofold, to increase their knowledge and skills to support the delivery of the children’s FRIENDS programme and improve their own resilience (FRIENDS).

How did you initiate the work? 

Staff were divided into four groups and each group was invited to attend five sessions lasting for two and a half hours on a fortnightly basis. Attendance was on voluntary basis however staff fully engaged.

What have the challenges to implementing the service/intervention been? And what has enabled the implementation of the service/intervention?

The barriers to our work were initially thought to be one of limited time commitment that the staff would potentially encounter due to caseload responsibilities and demanding work schedules. However, the sessions were programmed into everyone’s diary and regarded as protected time, this allowed worry free attendance.

The programme was originally designed for delivery to parents and required some slight modification to meet the needs of staff thus offering it as a training package alongside providing an intervention for their own wellbeing. 

The Nursery Nurses and Lead School Nurse are trained as trainers and group facilitators and the staff groups were led by the nursery nurse lead and Lead School Nurse. It was a concern that staff might feel uncomfortable with the familiarity of facilitators from within the service however this was not played out in practice.

Has the initiative or project made a difference to patients/service users and or staff? 

By far the most important aspect of this work has been the enthusiastic response from a great many of the team who attended our programme. Both professionally and personally this has been such a rewarding feature.

Brief examples of some of the comments from participants included:

• “Who says you can’t teach an old dog new tricks?”
• “I’m going to try to make positive thoughts a feature in my life from now onwards.”
• “It was so good to get to know my colleagues.”
• “I will use the strategies of challenging negative thoughts at home with my children.”

The sessions were evaluated using feedback forms. The top three learning aspects were ‘taking valuable time for me (mindfulness)’, ‘awareness of body signals/ how to cope with anxieties’, and ‘knowing that resilience can be learnt and become a normal feature of daily life’. Participants expressed that they enjoyed the sessions and felt able to share thoughts in a safe place. Improvements that were suggested that could be introduced were confined to location and room size.

What are the long-term aims for the work?

The adult resilience programme continues to be offered in the community setting to parents and carers and teenagers 16+ and receives very positive feedback from service users.

We have been approached by the speech and language therapy department to deliver the adult resilience programme to their workforce; this is currently in the planning stages and we have delivered the programme to Early Help workers in one of our localities.

Names: Laraine Marston and Amanda Street 

Job titles: School Nurse Specialist Practitioner (SCHPN)

Specialty: School Nursing Service

Organisation: Walsall Healthcare NHS Trust

Introduction

The aim of the project was to develop a transition package for children who were preparing to transition to secondary school, increasing the visibility of the service, improving children’s knowledge about the role of the school nurse and improving their confidence and ability to access our service.

Background

Children move from primary school to secondary school at a time when they are experiencing significant biological and social change. It is an important life transition point that can affect children’s attainment and wellbeing in the long term (Rice et al, 2011). School Nurses have an importance role in supporting children through transition. However, far too few children know who their school nurse is and so a challenge is to deliver a ‘visible, accessible and confidential’ service (British Youth Council, 2012).

How did you initiate the work? 

We used the British Youth Council (2012) School Nurse Champion programme, designed for secondary aged pupils as a base for our intervention. Using our prior knowledge and experience of delivering the programme, we adapted the materials to ensure that they were engaging for a younger age group. In addition, the Makewaves ‘Know Your School Nurse’ badge syllabus was used to design activities for the package. 

Initially, the plan was to work with Year 6 pupils who were due to make the transition to secondary school. However, they were preparing for SATS and unable to commit to further work. After discussion with the pilot school, the focus was changed to year 5 pupils which would allow us to continue to work with the children throughout year 6. 

What have the challenges to implementing the service/intervention been? And what has enabled the implementation of the service/intervention?

We had some false starts on this programme whilst trying to engage pilot schools. Part of challenge was clearly articulating what we were trying to achieve and how this might benefit the children and the schools. We now have a more coherent script and the benefit of being able to evidence the success of this programme and this will support engagement of future cohorts.

Engagement and commitment of the schools’ senior leadership team has been key to successful delivery of this programme. It has helped us identify a group of children to work with, gained support from a teaching assistant and supported the links to other health initiatives that the school was engaged with.

Has the initiative or project made a difference to patients/service users and or staff? 

School Nurses and nursery nurses, supported by a teaching assistant ran weekly sessions covering the ‘Know Your School Nurse’ badge syllabus and the components of the School Nurse champions programme. The children were supported to design questionnaires and run focus groups with their peers, present the results and collate the information into a report.

The survey results were interesting. A higher number of children in Year 5/6 reported to have seen a school nurse and knew what a school nurse did. We focus our delivery of our ‘relationship and sex education’ programme and this may explain our visibility to this cohort. Even so, the results showed a need to continue to improve our visibility.

The children reflected their learning from the programme and told us: 

• I now understand how to help others
• I would like to teach others about what school nurse do
• We are now not going to have sugary snacks for lunch or dinner
• I’d like to help deliver PSHE classes
• I’d like to do assemblies 
• To invite the school nurse in to school to help people with their problems
• We really liked doing the survey’s and finding out what other children think.

Based on their keenness to take this work further, they asked their peers what they’d to learn more about.

What are the long-term aims for the work?

Taking an approach to link existing evidence-based interventions and programmes together with trialling new ones has worked well. Adapting existing materials to meet the needs of the younger age group took less time than building a programme from scratch which was a more effective use of our staff resource. 

The work has exceeded our expectations and we are now feeling more confident work with the children to start to co-produce work. 

The future looks bright. We plan to roll this out as part of our core offer to other primary schools, led by the named School Nurse for the school. A big challenge moving forward will be how we keep momentum and keep those School Nurse Champions motivated and engaged. We are exploring options of sharing practice days to keep the champions in touch with our service, each other and other schools to build a network. This will be a key element to sustainability.

References 

British Youth Council (2011) Know your School Nurse

British Youth Council (2016) School Nurse Champions

Rice, F; Frederickson, N and Seymour, J (2011), ‘Assessing pupil concerns about transition to secondary school’ British Journal of Education Psychology, 81(2) pp.244-263 doi.org/10.1348/000709910X519333

Names: Laraine Marston, Amanda Street and Cate Edmondson

Job titles: School Nurse – Specialist Practitioners and Senior Nursery Nurse

Specialty: School Nursing Service – Young Carers

Organisation: Walsall Healthcare NHS Trust 

What is the initiative and or project you are involved in? 

School Nurses have a key role in supporting young carers to look after their health and wellbeing. The service has a School Nurse who is a Young Carers Champion (DfE, 2011) and already supports children and young people at the local young carer’s youth group. Engagement work had been undertaken to understand what support these children and young people wanted, where they wanted it delivered and how they wanted to access support. This initiative was developed as a result of the engagement work and involved School Nurses working with young carers to support their emotional health and wellbeing through the delivery of an evidence based resilience programme at their youth club.

What prompted you to do this work? 

A young carer is someone under 18 who helps look after someone in their family, or a friend, who is ill, disabled or misuses drugs or alcohol. They take on considerable responsibilities of caring and supporting in the home which might lead to then having higher levels of school absence, missing out on extra curriculum activities and time to socialise with peers. Whilst the caring responsibilities can be rewarding it is recognised that young carers can experience additional stresses that can impact negatively on their emotional wellbeing (Young Minds, 2019/Carers Trust, 2019). 

The service delivers interventions to improve the emotional health and wellbeing of children and young people. The evidenced based FRIENDS programme teaches children and young people the skills to help improve their confidence, self-esteem and manage mild anxieties. There are programmes for all age groups, Fun FRIENDS 4-7, FRIENDS for Life 7-13 and Teen FRIENDS 13 - 19. However, it was recognised the timing and venues of the interventions offered might be potential barriers to accessing young carers accessing services, as these conflict with their care responsibilities. 

How did you initiate the work? 

The themes emerging from the initial engagement were that the children and young people valued their time with peers, to interact and have fun. The FRIENDS programmes seemed to meet these requirements, it is a group intervention which encourages peer interaction and uses a fun approach to learning. It was agreed to pilot two groups, one for young primary age children and a second for teenagers. The delivery of the FRIENDS programme is a commissioned part of our core delivery and supporting vulnerable groups runs as a theme throughout the high impact areas (PHE, 2018) and therefore no additional budget or business case was required. 

What have the challenges to implementing the service/intervention been? And what has enabled the implementation of the service/intervention?

The challenges were that young carers only meet with their peers at the youth club fortnightly. So, there was a need to balance the young carers preference to having fun social time with peers with delivering an intervention to support their wellbeing without significantly limiting their social time. Taking time to engage with the group and understand what they wanted from services was key to identifying and providing the appropriate support that the young carers were happy to engage in.

Has the initiative or project made a difference to patients/service users and or staff? 

The groups ran fortnightly and consisted of 6 children attending the primary age group and 6 young people attending the teenage group. 

The feedback from the children and young people and the support staff was very positive. A qualitative evaluation sheet was used and yielded comments such as they now felt more confident in themselves and that they would implement the strategies taught when dealing with situations out of their comfort zone. However, there was a key difference between the age groups. The teenagers were less engaged and expressed views that they preferred to spend more social time with their peers who they viewed as an important support network as opposed to participating in the programme. They expressed a wish for a ‘drop in’ style of support

What are the long-term aims for the work?

The next steps are to continue running primary FRIENDS because this age group were the ones who found it most beneficial and to explore training young carers to co-deliver groups themselves in the young carer’s settings. 

There is a need to develop a better understanding of the role School Nurse might lay in supporting teenage young carers. The plan is to consider delivering a modified version of the School Nurse Champion programme which is provide young people with skills to consult with peers and contribute towards developments in the service leading to an ASDAN award (British Youth Council, 2016). 

References

Young Minds, 2019
Carers Trust, 2019
British Youth Council, 2016.

Name: Sallyann Sutton

Job title: Professional Lead for School Nursing Services

Speciality: School Nursing/Public Health

Organisation: Walsall Healthcare NHS Trust

What is your current role?

Professional Lead for School Nursing Services including delivery of Health Transitions, HCP for Special Schools, NCMP and enuresis/continence support.

What was your route to this role?

I started Registered General Nurse training at the Sister Dora School of Nursing in 1986 and qualified in 1990. I worked as a staff nurse on the medical and then surgical ward at Walsall Manor Hospital until 1992. 

In 1992 I left acute nursing and moved in a role as a School Nurse. This was pre Specialist Practice qualifications. I worked on a probationary year as an ‘E’ grade nurse for 12 months completing an internal development to gain promotion to an ‘F’ grade School Nurse. The School Nurse certification courses commenced, followed by the opportunity to complete a diploma prior to the degree level Special Practice course being introduced. I started in a School Nurse Team Leader role before commencing my SCPHN degree in 2003, graduating in 2004. 12 months later I gained a place to study an MSc in Child and Family Mental Health at the University of Birmingham. During this time, I worked closely with the Child and Family Psychology Team which afforded me practice experience alongside my academic studies.

The introduction of Choosing Health agenda bought new opportunities and I stepped into the role of Young People’s Health Advisor for Emotional Health and Wellbeing, working alongside School Nursing Services and the Primary Mental Health in CAMHS.  In 2008, the DfE Targeted Mental Health in Schools commenced, and I secured a seconded role as the Regional TaMHS Project Management working for NHS West Midlands. I gained my Post Graduate Award in Public Mental Health and Wellbeing from the University of Warwickshire in 2011.

On my return, a further service re-organisation provided an opportunity to apply for the Professional Lead role which I commenced in 2012 and remain in now. Keen to develop my leadership skills I gained a place on the NHS Leadership Academy Elisabeth Garret Anderson programme which lead to an MSc in Healthcare Leadership and the NHS Senior Healthcare Leadership Award which I completed in 2017. I am also proud to have received the title of Queen’s Nurse in recognition of my services in community nursing. 

What prompted you to do this role?

I knew early on in my career that I wanted a role in the community. I’d enjoyed community placements during my nurse training. In my life outside of work I was very involved in Girl Guiding and enjoyed working with girls to help their personal and social development. Moving into a role which had a focus on promoting health and wellbeing seemed an obvious career move. School Nursing was very different in 1992, still very much a medical model and medically lead however there were soon opportunities to change this approach and I became very involved locally in leading change.

Service development and leadership really interested me, and I was quite good at it!  The progression through various leadership roles has been exciting. I had two areas of interest during my career; sexual health and mental health. I worked at a young people sexual health clinic on a Saturday alongside my School Nurse role. However, mental health was my real direction of travel and I have combined leadership and clinical roles in this area of work.

What education/courses/modules have you undertaken to equip you for the role?

Besides the qualifications listed above I have also completed ENB 903 Family Planning, safeguarding supervisor's course (NSPCC), ENB 903, Teaching and Assessing in Clinical Practice, Trainer the Trainer course for Skills Training for Risk Management (STORM), FRIENDS Resilience Programmes, Solihull Approach Parenting interventions and facilitator training for Triple P Parenting level 2-4, Mental Health First Aid for Adults and Young People. I am a Level 5 ILM Coach and a NLP Practitioner. 

How do you see yourself developing your skills?

I have a wide range of skills in public health, mental health, leadership and coaching. With my strong interest in leadership and development I am embracing opportunities to use and develop my skills further afield. I am currently part of Expert Reference Group contributing to developing the Mental Health in Schools Handbook, part of the Children’s Green Paper for Mental Health developments and also a topic expert working with NICE on the review of the Alcohol Education in School Guidance. I have recently become a committee member for SAPHNA which has opened opportunities to be part of a round table event with the Shadow Health Secretary to explore Children’s Public Health matters and I am working with a national charity on a mental health and wellbeing project. 

What is your long-term career plan? 

I have never had a plan, I have been fortunate to receive funding and the opportunities to develop, this has been alongside a lot of personal commitment to study. I’d like to continue to work in leadership and development with a focus on mental health and wellbeing. Now is a good time to have such a focus with the investment and commitment to improve mental health provision for children and young people. 

What advice would you give to someone thinking about moving to work in school nursing and public health?

Working in School Nursing has always been a challenge, the service has had a fair share of struggles. So, working in the field of public health takes commitment, passion and enthusiasm. You need to have a good sense of humor and have a passion for learning. 

What do you most enjoy about this area of care?

The children and young people. They are amazing! I have witnessed some real resilience in children and young people when they have experienced challenging times. I love engaging with young people, working with them to develop their ideas and guide how services for them are developed. 

Name: Suki Sencee

Job title: School Nurse Specialist Practitioner (SCHPN)

Speciality: School Nursing Service

Organisation: Walsall Healthcare NHS Trust Harden H.C

What is the initiative and or project you are involved in? 

The School Nursing Service has developed an intervention for parents and carers to support transition of their children into reception year.

As a school nurse focusing on the lead area for school transitions the priority was to focus on the school readiness approach for nursery age children to Reception age in supporting their transition. 

What prompted you to do this work? 

School Nurses supports children and young people aged 5-19 years through the delivery of Healthy Child Programme and take over care from Health Visitors when the child enters full time education. Successful transition from home or nursery to school is key to better long-term outcomes. Children need to be ready to go to school and this includes being able to separate from parents, are toilet trained, able to communicate and their health needs managed. School Nurses have a key role in supporting children to transition (xxxx). Working collaboratively with schools to address the needs of children is a key factor in improving outcomes of health and inequalities. It is important to take a public health perspective to meet the needs of the local population.

How did you initiate the work?

Two infant schools were engaged in a pilot project. The Lead School Nurse for Transition gathering data and information by working with pastoral and parent support staff. Information was obtained to identify the needs of nursery age children who were transitioning into reception Year through a questionnaire. Questionnaire were used to gather information which was then collated and used to develop the content of a workshop for parent’s nursery age children.

A coffee morning was designed as a welcoming and a positive way to engage with parents. The school wrote to each parent to invite them to the event. A short presentation was developed covering the health topics highlighted in the questionnaires. Time for consultations with individual parents was built into the coffee morning and a resource box of leaflet designed to help with signposting and self-help guidance. Questionnaires were developed to measure the effectiveness of the intervention and to gain the views of parents, school staff and the lead nurse. The Health Visiting service was invited to co-deliver the coffee morning which was aimed at supporting a seamless handover of care.

What have the challenges to implementing the service/intervention been? And what has enabled the implementation of the service/intervention?

Two members of staff from the school nursing service delivered the parent transition workshop, the named nurse for the school and a nursery nurse. A nursery nurse from the Health Visiting service also supported the workshop. 30 parents attended. The parents were encouraged to ask questions and following the presentation came forward to ask specific health related questions regarding child’s health. The time allowed towards the end of the coffee morning was useful as It was an opportunity for parents to come forwards without an audience and feeling comfortable in approaching the nurse at their own leisure. The coffee morning took approximately just over an hour.

Resource box was laid out for parents and school staff to browse and access information on health age-related topics for the parent. Some parents chose to take a leaflet without asking any questions. An evaluation was handed out to parents on arrival and collected prior to leaving. 

Has the initiative or project made a difference to patients/service users and or staff? 

Evaluations were collected and parents identified that they were interested topics about behavioural concerns, toileting and fussy eating. 

Parents indicated that they were not aware that the School Nursing service takes over the support for children from the Health Visiting service, at the age of 5.

School staff were very welcoming and perceived the support offered through the School Nurse was helpful and improved the accessibility of the service.

What are the long-term aims for the work?

To develop Transition workshops as part of our core offer to all schools, working within individual schools to ensure topics delivered are relevant to parents of children transitioning to the school. The workshops will be lead by the named School Nurse for the school with the aim of increasing visibility and accessibility of the service. To continue to co-deliver, where possible with the Health Visiting service to promote seamless transition.