DECADES ago school nurses were associated mainly with helping to eradicate head lice.

Today, their invaluable role extends far further than that.

“Everything has changed,” says Kathy O’Connell, specialist practitioner with Bradford District Care NHS Foundation Trust, whose team visits primary and secondary schools. “We don’t do head checks any more, we give out advice and address a wide variety of issues.”

These range from healthy eating, hand washing and dental health to mental health problems, self-harming and drug and alcohol abuse.

At this time of year many young children starting school have transferred from the health visitor to school nurse. Health visitors review every child’s health records, highlighting any concerns, before their care is transferred to the school nurses.

School nurses are trained in all aspects of child development and public health from age five to 19. Each primary school has a registered nurse and nursery nurse allocated to that school. All upper schools have a qualified school nurse who regularly attends.

Having a nurse for every school ensures that the school has a direct link to health services, which supports children in getting the best out of their education. It ensures that youngsters have the best start in school as their health needs are met and children and families are supported.

Says Kathy: “We may give out lunch box advice, and encourage children to eat fresh fruit and vegetables.”

Difficulties at home may be picked up, or bullying problems. “Sometimes parents will ring and say that their son or daughter is having a problem or that a family member has died and they are not coping well,” says Kathy. Sexual health support is also given.

“Part of our role is safeguarding - we attend many safeguarding meetings to protect children from harm,” adds Kathy. “Sometimes we come across cases of neglect, where parents are in need of extra support but do not know where to go.”

School nursing teams work closely with health centres and health visitors, creating strong links with health professionals including GPs, speech and language therapists and dental specialists.

The provision of school nursing in the UK arose out of the Boer War. A large proportion of army volunteers had been found to be medically unfit for service, so in 1903 a committee was formed to study the causes. It reported back a year later, saying that there was no general health problem, but treatable conditions had been left untreated and had worsened to the extent that they became debilitating. The committee produced a raft of recommendations including one of having medical inspections in schools.

Children starting in reception take home a pack containing a welcome letter explaining the school nursing service, the support that is on offer and contact details. They also receive a health needs questionnaire for the parent or carer to complete, giving them the opportunity to let the school nurses know of any issues which may need addressing.

Many schools across the district invite the school nursing service to their new parents’ events where they will do a presentation about the service and give parents the opportunity to meet the school or nursery nurse and ask any questions.

The service also runs drop in sessions where children or young people can pop in and ask questions in confidence. Schools also have direct contact to the service by telephone if they are needed for advice.

More staff are allocated to deprived areas, which generate more problems, although, Kathy points out, the same issues arise in leafy suburbs.

Dawn Lee, Operational Service Manager for School Nursing in Bradford said: “Having a nurse for every school across the district brings a number of benefits, it ensures that the school has a direct link with health colleagues and are able to get help with health issues when needed. It also means that young people know who their school nurse is and are able to access the school nursing service during school time.

“Our school nurses are available to offer support and advice to children and young people and also their parents or carers. They work closely with the wider school team and use these positive working relationships to ensure that all children and young person are healthy and safe.”

Public Health England alerts schools across the country to outbreaks such as measles, meningitis, or norovirus. School nursing teams then support staff in monitoring the situation.

As the flu season approaches school immunisation teams work closely with school nurses, delivering vaccinations in primary schools across the district.