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All secondary schools should have at least one full-time school nurse, England’s chief nursing officer has recommended in a report.

Primary care trusts, children’s trusts and local authorities should aim for a minimum of one full-time school nurse for each secondary school and its cluster of primary schools, says Sarah Mullally in her review of nursing for vulnerable children and young people.

She adds that nurses working with school-aged children need specific skills, particularly in child and adolescent mental health, and that all nurses should be trained in child protection.

The review, which looks at how nurses, midwives and health visitors can act on the government’s proposals for the reform of children’s services, states that care is "often fragmented" between health, social care, and education. It highlights a "mismatch" between the needs of vulnerable children and the skills of nurses, midwives, and health visitors.

Thirteen areas are identified as needing to change. More integration is recommended as well as a move away from services based around professional titles.

But the review warns that there is no single way to bring services together and that integrating in one direction could leave gaps in others.

Integrated children’s teams should include the whole spectrum of workers from assistant practitioners to specialists, with the role of nurses clearly spelt out, the review states.

- The Chief Nursing Officer’s Review of Nursing, Midwifery and Health Visiting for Vulnerable Children and Young People from www.dh.gov.uk/