In the last NASNA column, Hayward (2024) explored the importance of incorporating the voices of children and young people into the design and delivery of school nursing programmes. These insights not only enhance the relevance and impact of our school nursing services but also underscore their critical role as advocates for young people's health and wellbeing. Building on that theme, this column shifts focus to the political advocacy required to ensure those voices are heard at the highest levels of policy-making.
On the 8th of October 2024, SAPHNA launched its inaugural survey, The Forgotten Frontline: Public Health School Nursing, in the House of Lords, marking a pivotal moment for school and public health Nursing. The survey launch, hosted by Baroness D'Souza, revealed critical challenges facing the profession. Among the findings: 71% of practitioners reported an increase in children on Child Protection Plans, 38% of school nurses spent more than half their time supporting these cases, and the average ratio of one school nurse in England to 4 000 pupils paints a stark picture of a workforce in crisis (SAPHNA, 2024a).
The event brought together influential voices, including Sharon White OBE (SAPHNA CEO), Paul Wright (managing director PH Affairs and vice president International Division Health Eco), Haris Sultan (chair of the NHS National Network of Youth Forums), Dame Donna Kinnair, and MP Lorraine Beavers, who collectively emphasised the vital role of school and public health nurses in early intervention. Members of SAPHNA's senior leadership team and expert advisory group were present, engaging in meaningful discussions about raising the profile of the profession and its critical impact on children, young people and their families.
A march to be heard
Following the launch at the House of Lords, attendees gathered outside, united by a shared mission: to advocate for ‘A School Nurse in Every School’. Armed with banners, placards, and an unshakable resolve, the group began their walk to 10 Downing Street.
The excitement was palpable, as attendees reflected on the significance of the event and the opportunity to raise awareness at the heart of the UK Government. The walk drew attention from members of the public, many of whom joined in to support the cause. ITV filmed the march, capturing the group's enthusiastic chants and calls for change.
The sight of a diverse group of school nurses, public health professionals and advocates marching through the streets of London symbolised the power of collective action. As the group approached Downing Street, the energy and determination among participants were unmistakable.
Personal reflections
Julie Critcher, deputy professional officer for SAPHNA, described the experience of delivering the petition and survey findings to Downing Street as deeply ‘humbling and inspiring.’ She was among six individuals chosen to attend Downing Street and present the survey, alongside Sharon White OBE and Paul Wright, as well as Sallyann Sutton (SAPHNA professional officer), Maggie Clarke (SAPHNA executive lead officer) and Dr Sarah Bekaert (senior lecturer – Oxford Brookes University).
For Julie, the moment was a powerful reminder of the importance of advocating for a profession she passionately believes in. ‘Walking to the door of 10 Downing Street was humbling,’ she shared, ‘and an incredible opportunity to represent the hardworking School Nurses who provide essential care and support for children and young people every day.’
The delegation was filmed by ITV as they delivered the petition and survey, further amplifying their message and ensuring it reached a national audience. The day was not only about raising the profile of School Nursing but also about uniting the profession in a collective call for meaningful change.
The importance of political advocacy
School nurses play a vital role in influencing policies that benefit children, young people and their families. The Nursing and Midwifery Council (2022) Standards of Proficiency for Specialist Community Public Health Nurses (SCPHN) emphasise the necessity of being at the frontline of public health, improving health outcomes through autonomous practice and policy influence. As advocates, they not only safeguard individual children but contribute to shaping policies that can positively affect entire populations. School Nurses must be politically informed and active.
However, SAPHNA highlights troubling gaps in school nursing services with some local authorities failing to commission school nurse services altogether (SAPHNA, 2024a; 2024b). This shortfall leaves many children and young people without access to essential services like early intervention, health promotion, and safeguarding support.
Barriers to political engagement
Despite the importance of advocacy, many nurses hesitate to engage politically. Common barriers include personal lack of political interest, competence and confidence, workplace constraints and persistent outdated stereotypes that discourage nurses from entering the public arena (Gleeson et al, 2015; Han and Kim, 2024).
Political participation extends beyond voting; it encompasses activities such as lobbying, campaigning, petitions and marches. These actions allow nurses to advocate for policies and resources that directly impact the populations they serve. For example, writing to MPs to support Early Day Motion (EDM) 62548 or raising awareness locally can amplify the voices of children and young people in need.
The role of nurse academics
The role of Nurse Academics is pivotal in overcoming these barriers. Research by Wilson et al (2022) shows that encouragement from nurse academics inspires confidence and equips nurses with the skills to influence healthcare policy effectively. Nurse academics must not only teach evidence-based practice but also champion political participation as a professional responsibility. By engaging in policy discussions, leading by example and inspiring students to act, nurse academics can foster a culture of advocacy within the profession. This leadership extends beyond the classroom, influencing governmental decisions and helping the next generation to drive systemic change.
A call to action
The evidence is clear: school nurses must be politically active to address the growing needs of children and young people. The findings from SAPHNA's survey, highlighting an overstretched workforce, are supported by the Care Quality Commission (CQC) in their recent annual report, which underscores the significant challenges faced by children, young people, and families in accessing timely services (CQC, 2024).
The stakes have never been higher. Forty per cent of 11-year-olds are now classified as obese or overweight (SAPHNA, 2024b), and between 2015 and 2024, there has been a staggering 140% increase in children with an Education and Health Care Plan or equivalent statement of special educational needs, with 55% of these children attending mainstream schools (National Audit Office, 2024). Alarmingly, 1 in 4 adolescents aged 14–16 report self-harming (SAPHNA, 2024b).
‘This is a pivotal moment for action. School nurses must champion their essential role by actively supporting the children, young people and families who rely on their care. Engaging in advocacy through writing to MPs, signing petitions, and raising awareness both locally and nationally ensures these critical issues remain in the spotlight.’
Without adequate school nursing services, children, young people and their families face missed opportunities for early intervention that can shape their long-term wellbeing. Addressing these gaps demands immediate advocacy, investment and collective effort to secure a better future for all.
This is a pivotal moment for action. School nurses must champion their essential role by actively supporting the children, young people and families who rely on their care. Engaging in advocacy through writing to MPs, signing petitions, and raising awareness both locally and nationally ensures these critical issues remain in the spotlight. By contributing to initiatives such as SAPHNA's campaigns, we can work towards a future where every school benefits from the expertise and support of a dedicated school nurse.
The events of 8th October 2024 serve as a reminder of the power of collective action. From the House of Lords to 10 Downing Street, the message was clear: A School Nurse in Every School. It is now essential to build on this momentum, turning awareness into sustained advocacy and meaningful change that secures the future of school nursing and strengthens public health for generations to come.