On the 23rd of July 2024, 150+ children, young people, professionals, and Members of Parliament from across the political parties, gathered on the lawn in Parliament Square. They came together to support the No Child Left Behind campaign organised by the National Education Union (NEU, 2024). The campaign is fighting to break down the barriers poverty puts up around equal access to education. Three hundred partners – charities, trade unions and professional bodies support this campaign and SAPHNA are proud to be one of these supporters and were delighted to be invited to the event and to be able to speak, giving a voice to the role of the school nurse in supporting the specific ask of the campaign, Free School Meals for all children. Twenty eight MPs attended on a busy sitting day, showing the cross-party commitment to the campaign. They were able to hear from the powerful coalition about why the campaign matters, spending time with the young people who attended at the picnic lunch.
Representing SAPHNA and as a frontline practitioner school nurse, I was able to share why this campaign is so important. School nurses are the only health professional with a reach extending to all school-aged children and young people, providing a public health service which is crucial to improving the health and wellbeing of children and young people and reducing inequalities. School nurses are aware of the worrying and growing evidence of poor health among children and young people, a growing crisis, and food poverty is one of the concerns central to this crisis. Seventy percent of school nurses report having seen an increase in support need for children where cost of living was an issue. During a week of action coordinated by the NEU's No Child Left Behind campaign, health professionals from either SAPHNA or the British Dental Association, were asked about the impact of hunger on children's health over the past year. Around two thirds (65%) of respondents reported that children's health had declined as a result of hunger and poor nutrition, while almost a third (28%) said children were experiencing an increase in the incidence or severity of health problems to a large extent. As specialist public health professionals school nurses understand the importance of nutrition as a critical part of health and development, better nutrition is related to improved infant and child health, stronger immune systems, lower risk of non-communicable diseases and longevity. Poverty amplifies the risk of, and risks from, malnutrition. People who are poor are more likely to be affected by different forms of malnutrition.
Malnutrition, in every form, presents significant threats to human health and in school nursing we see this every day, the focus is often on childhood obesity but what we are actually seeing is children who may flag as obese are actually malnourished due to lack of food options leading to lack of vital vitamins and minerals.
But the FSM campaign is about more than just nutrition – food in school matters for lots of reasons. Children and young people need fuel to learn and when this is not provided at home the impact can be seen in school. As a school nurse, I receive referrals asking for support for young people who are struggling to focus, presenting with challenging behaviour, presenting as being too tired to learn, struggling with friendships. Some of these referrals will suggest a diagnostic route may need to be explored but on further assessment, looking at the lived experience of the child and listening to the voice of the child, food poverty is the root cause of the concerns.
Referrals to school nurses for support for mental/emotional health have increased exponentially, demands on other services mean that school nurses are often holding these young people. The link between poverty and mental health is something that school nurses see each day in their direct work with children and young people. The Centre for Mental Health, the Children and Young People's Mental Health Coalition and Save the Children (2024) have published a joint report exploring the impact of poverty on the mental health of families in the UK, with first-hand insights from young people and parents experiencing poverty. The report discusses the dual crisis that young people are experiencing, of living in poverty – an estimated 4.3 million children in poverty which is an increase from 3.6 million in 2010/11 – and experiencing significant mental health issue s. In 2004, one in ten children had a mental health need. In 2023, about one in five 8–25-year-olds had a diagnosable mental health problem (NHS Digital, 2023).
’Poverty at any age can have a devastating mental health impact but can be especially pernicious for children and young people. It is “impossible to overestimate how important poverty is as a driver” for so many of the social challenges experienced by children and young people’.
As public health professionals school nurses are experts in looking at the context, thinking about the invisible backpack that many of our children and young people carry into school every day. To fill that gap of hunger with a nutritious hot meal every day in school would break that cycle.
To sit with friends every day, with no division, no stigma around entitlement, would encourage healthy eating habits, encourage the socialisation benefits of eating together and reduce some of the financial burden that parents and carers are experiencing.
In the area I work, in the Northwest, we do not have FSM, I asked some colleagues what they are seeing in their work, one colleague reported a massive rise of children eating beige only food such as chicken nuggets, chips and crackers or crisps. Food poverty makes this worse as parents may go for the easiest option knowing it will be eaten and not wasted and they cannot afford an alternative. One colleague was concerned that although schools are responsive to hungry children and will find food for them, not all children would admit to being hungry, or even know that they are if they have become used to limited food. Food poverty has become the norm for these children. I asked school nursing colleagues in London where FSM are provided what the impact has been. They were clear that FSM have made a positive impact, a lifeline for some families.
The call from the FSM campaign on the lawn in front of Parliament was loud and clear – no child should be denied the food they need to learn and thrive at schools. Investment in FSM for all will have a lifelong impact for children and young people but also for their families, communities, and society. SAPHNA will continue to support this campaign until the postcode lottery of FSM is removed and all children have access to a hot and nutritious meal in school every day.