School nurses unhappy with social work responses to child protection concerns

School nurses reported that children's social care was inaccessible, and felt that children at risk were being turned away from services

More than a third of all school nurses are unsatisfied with the outcomes of at least half of the referrals they make to social workers, a report has found.

A review on school nurses, carried out by the Children’s Commissioner for England, found 41% of 382 school nurses “were unsatisfied with the outcomes of at least half of the referrals they make” while more than 5% were “not happy with the outcomes of any of the referrals they made”.

School nurses also felt child protection thresholds were “too high” and that concerns are not acted upon by children’s services. Almost a quarter of 309 school nurses have “difficulties contacting social services and particularly social workers, which takes up a lot of their time”.


The authors said school nurses also felt frustrated with the inaccessibility of children’s services with 23% reporting  children’s services and social work were very hard to contact and engage with.

“Trying to establish this contact, in many cases took up a lot of the school nurses’ time,” the authors stated.

Issues with communication and information sharing across different safeguarding and child protection agencies were also reported.

The survey was completed by 772 school nurses in total. Among those who answered questions on child protection, it was felt that thresholds were too high and that a number of children and young people at risk and/or in need of support were being turned away.

“As a result, schools and school nurses often hold significant child protection concerns, without the power to intervene,” the report said.



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9 Responses to School nurses unhappy with social work responses to child protection concerns

  1. Tom J September 12, 2016 at 11:43 am #

    Lets keep it real for a moment as I am concerned that this article implies that it is just a case of mean local authorities refusing to help children and families who need it.

    ‘There are currently 3.7 million children living in poverty in the UK. That’s over a quarter of all children. 1.7 million of these children are living in severe poverty’

    The research strongly suggests that all 1.7 million will be experiencing significant harm.

    However with huge local authority budget cuts there is no way we can support all the children and families who need often intensive support.

    The expectation is that school nurses will pick up the cases that the local authority will not and offer ‘universal support’/CAF and the like. However there is no reserve of workers twiddling their thumbs waiting for highly dysfunctional time intensive families to support.


    • Sarah September 13, 2016 at 8:15 pm #

      I have to agree with you. Some people think social care have a magic wand and get frustrated social workers cannot eliminate risk. We have to manage risk and be realistic just like Education and Halth professionals.

      I think some of the issues are around expectations. In reality social workers do not have much more power than school nurses in managing risk, especially if agreement isn’t reached through multi-agency decision for Child Protection involvement.

      As you point out, if social care had cases open in every instance where there was increased risk – including due to poverty, caseloads would be 300+ per social worker. It just isn’t achievable. Support from universal plus services can actually offer more effective support in such instances.

      As a frontline social worker, I had a school nurse tell me 2 months into a Child Protections plan, prior to even an initial review, that I should have “removed” a 14 year old child. This is not realistic – who can expect families to transform completely in a matter of weeks?? Not to mention Human Rights, leafs frameworks such as PLO processes etc – and a child’s wishes to stay at home.

      I hav explained I cannot legally “remove children”, especially so very early into a CP plan. However her view was that as home life was not perfect within 2 months, social care should remove this child. As we had not, we had failed. The school nurse proceeded to state all the concerns that had brought about the CP plan in the first place (that we had thereby acted on to call a Child Protection Conference) and felt social care were “doing nothing”. This is far from an isolated incident in terms of crazy expectations.

      Partner agencies need to understand social care work within a framework. That you cannot expect a family with entrenched issues (for decades) to make changes overnight. Services need to work together to support – part of this needs to be that expectations from Health and Education need to be realistic.

  2. tcm September 12, 2016 at 11:59 am #

    Having worked with school nurses for many years I understand there frustration and communication between children services and School Nurses needs to improve. I also understand that school nurses are often the named nurse in a significant number of schools at any one time which must add to the there frustration. More so when threshold decision making is not explained to them by children services .

    • Dave September 12, 2016 at 10:32 pm #

      If threshold decisions are not being explained then I suggest better safeguarding training with social care so they do understand the thresholds better

      Many councils offer good linked up joint working services, Doncaster for one has a good model with specific trained safeguarding nurses, health visitors who understavd the complexity and will go out with front line workers and actually see these families at home

  3. Hels September 13, 2016 at 12:10 am #

    But nothing seems to be if a concern during school holidays, the school nurses only have an issue during term time! Strange that like

    • Ian September 13, 2016 at 3:08 pm #

      Let nurses nurse, teachers teach and social.workers do their jobs!
      There is way too much buck passing.
      Wait a minute, we could be living in a blame culture. Oops, we already do…….

    • Ian September 13, 2016 at 5:34 pm #


  4. Lucy lou September 14, 2016 at 10:38 am #

    Shift the focus back to the cuts the government has made and be critical of them and supportive of social workers instead. School nurses need to spend time in a CP team to understand the pressures we are under.

  5. Right to Reply September 14, 2016 at 1:28 pm #

    My experience of working with health professionals, including School Nurses is a mixed bag. There are ones you know ‘get safeguarding’ very well and co-incidentally work very well with all other professionals and others who profess to understand it and don’t. I have worked in services where multi-agency training has been offered and these have good turnouts. However, there have been health professionals present on this training who then go out and think everything is then safeguarding. If there is training offered it needs to be more thorough for other professionals such as health ones, so that they have a chance to understand what an appropriate referral is. Where this has happened it has changed the whole referral process.
    I have also had ‘debates’ with School Nurses who don’t get this properly and insist something is safeguarding, including telling me to make a parent do something, which we wouldn’t and within that particular context had no right doing and unconnected with a safeguarding issues.
    When something isn’t done by a Social Worker that a health colleague feels should have been, this often results in a complaint by them, usually nearly always not upheld, to try and make the Social Worker do what it is they think we do.
    I like working with a lot of my health colleagues and have made good relationships over the years and hear their frustrations. I have also listened to other professionals, not just Health ones who state ‘you should be doing, etc.’ when this is either not a social work role or is within our powers. Everyone seems to be trained in Social Work. I would never talk to other sector colleagues the way in which Social Workers are often spoken to as I try to have more respect for their background, training and experience in their field. Again, the bad press at times doesn’t help provide a more positive view about Social Work in general.
    I also think that there is still a culture in some areas of the country where once something is reported to Social Care, other professionals no longer have to be responsible for accountable for what happens next.