School Health Services

I’ve been meaning to write about the contribution that school nurses can make to drug prevention and this report from WHO Europe from 2009 that I came across today has prompted me to at least point out some of the things we know.

Across Europe it appears that most school health services have some responsibility for substance misuse prevention.

school nurses

Cross referencing this with the PSHE mapping exercise carried out by researchers from Sheffield Hallam University a few years ago suggests that quite a lot of the drug and alcohol prevention activities that school nurses in England undertake are outside the classroom.  That review found that 17% of schools (both primary and secondary) used school nurses to deliver at least some of their drug education.

Health England when they looked at preventative spending in the NHS were able to show that of the £5 billion being spent on prevention and public health services in 2006/07 £159 million (3%) went to school health services.  They were able to split this down between primary (£44m) and secondary (£115m) prevention, and noted that £17 million could be attributed to the national Health Schools Programme.

Since then the government have issued a new vision for school health services, Getting it right for children, young people and families, which says:

School nurses will be part of teams providing ongoing additional services for vulnerable children, young people and families requiring longer term support for a range of special needs such as disadvantaged children, young people and families or those with a disability, those with mental health or substance mis-use problems and risk taking behaviours. School nursing services also form part of the high intensity multi-agency services for children, young people and families where there are child protection or safeguarding concerns.

There is a useful brief overview of this vision produced by the Department of Health and the LGA aimed at councillors, which can be downloaded here.

Also worth examining is the NICE guidance on school based interventions for alcohol, which makes the following recommendations (identifying school nurses as one of the groups who should take action):

  • alcohol education should be an integral part of the school curriculum and should be tailored for different age groups and different learning needs
  • a ‘whole school’ approach should be adopted, covering everything from policy development and the school environment to staff training and parents and pupils should be involved in developing and supporting this
  • where appropriate, children and young people who are thought to be drinking harmful amounts should be offered one-to-one advice or should be referred to an external service
  • schools should work with a range of local partners to support alcohol education in schools, ensure school interventions are integrated with community activities and to find ways to consult with families about initiatives to reduce alcohol use.

Finally below is a presentation that the Drug Education Forum had at one of the seminars we ran. It describes a multi-agency approach to improving health and wellbeing for young people in Bury, which included school health services.

NICE guidance on alcohol

NICE in a briefing for local authorities about what they can do about alcohol harms say the following about young people’s drinking:

A survey of nearly 10,000 young drinkers aged 15–16 years in north west England reported that 28% had experienced violence when drunk, 13% had regretted alcohol-related sex and 45% had forgotten things after drinking. (See Teenage drinking, alcohol availability and pricing: a cross-sectional study of risk and protective factors for alcohol-related harms in school children.)

Half a million children in England between the ages of 11 and 15 will have been drunk in the past 4 weeks (CMO guidance on the consumption of alcohol by children and young people).

Thirteen thousand children and young people aged under 18 are admitted to hospital each year as a result of drinking alcohol (Statistics on alcohol: England 2012).

Their advice for public health on educational interventions is:

  • Maintain and develop local partnerships to support alcohol education in schools.
  • Provide community-based programmes that educate parents and children together about alcohol and the harm it can cause (programmes for parents-only are effective, but less so than when children are also involved). These should start early, before the child reaches 13, because it is important to establish a strong message in the early years of a child’s life.
  • Ensure programmes complement the personal, social, health and economic (PSHE) education provided in schools and other education settings.