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Children’s Commissioner – Big Ambition Report

SAPHNA welcomes the Children’s Commissioners Big Ambition Report: Ambitions, Findings and Solutions March 2024 The Big Ambition: Ambitions, Findings and Solutions | Children’s Commissioner for England ( The report is a call to action and makes recommendations to future Governments. The Children’s Commissioner listened to the voices of children and young people in the Big Ambition survey in September 2023. This report supports a joint call by the College of Medicine, SAPHNA and The Queen’s Nursing Institute for a school nurse in every school A school nurse in every school campaign | SAPHNA – School And Public Health Nurses Association.

The Children’s Commissioner first ambition is that every child grows up happy and healthy and where children need additional help it is provided as early as possible. One young man stated the need to “focus a lot more on preventative measures in relation to healthcare this will take strain off NHS and be much cheaper.” – Boy, 15. Dame Rachel de Souza recommends that every school-aged child, both those in and out of school, is assigned a school nurse. One young girl told the commissioner “A school nurse could come and ask if you want to talk about home life school life or if you just want to talk.” – Girl, 11. The Children’s Commissioner recommends “a school nurse in every school who can work with youth workers, paediatricians, public health leaders and other partners in a local Integrated Care System to identify and support children who are particularly at risk of poor health – including children with experiences of poverty, violence and abuse, difficult home lives, and exclusion from education”. In addition, she recommends an annual health review by a school nurse to ensure their health needs are identified at the earliest opportunity.

School Nurses are highly qualified and skilled public health nurses, qualified as registered nurses before completing additional post-graduate training in specialist community public health nursing (SCPHN). They are leaders of the Healthy Child Programme 5-19 which provides an evidence base public health approach to prevention, promotion and early intervention to improve children and young people’s health and wellbeing. The programme is universal in reach and personalised in response, every child and young people should have access to the universal elements of the programme and when additional support is required then more targeted and specialist provision should be available. However, the number of school nurses has significantly fallen by around 33% in the past decade and provision across the country is a postcode lottery. Many school nurses tell SAPHNA that their time is focused on child protection and child in need, leaving little time to provide the universal access required to identify problems early, intervene and reduce the risk of escalation. School Nurses are a pivotal links between schools, communities and parents/carers, they are the only health professional offering universal support. A school nurse assigned to every child, both those in and out of school will help to achieve the Children’s Commissioners ambitions including supporting:

  • The provision of high-quality Personal, Social, Health and Economic Education (PSHE) and Relationships and Sex Education (RSE),
  • A joined-up public health approach to promote healthy attitudes to food, diet and exercise,
  • Every child to have access to high-quality mental health and wellbeing support in their school and local community (as part of a whole school approach to good mental health).
  • Every disabled child or child with special educational needs, and neurodiverse child receives excellent, joined up healthcare, social care and education.

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