Schools Need Nurses

Schools and society are not creating happy, healthy 18-year-olds, ready to meet the challenges of the modern world.

Some of the health statistics on our youth make grim reading. 31% of 11-year-olds are overweight or obese, 25% of adolescent girls self-harm, and nearly a quarter of five-year-olds have tooth decay, with an average of three to four teeth affected. During the pandemic, the percentage of children in the UK with mental health problems increased from 12% to 17%. When I trained as a doctor 40 years ago, Type 2 diabetes was a disease of the elderly; now we see it in teenagers.

This does not just impact on children’s poor health, but also on their educational achievement. In East London, where I work as a GP, the children with health issues are almost always the same children who underachieve at school. In response to this, our Bromley by Bow Health Centre has over a hundred different projects under its roof, addressing the wider determinants of health: family finance, the environment, education, employment, creativity and the healthcare I learnt at medical school. For over two years, we have also had a food bank (that counts nurses among its users), one of many in London’s East End now supporting one out of every 50 families. But most of these projects are aimed at adults and particularly the elderly.

If we are to improve the poor health of our children, we need social prescribing health projects in every school, where children spend 190 days a year. In our part of London, the GPs run the school nursing service as part of their social enterprise, but the resource is only enough for one whole-time equivalent nurse for every six schools.

We need a nurse or equivalent in every school and on every governing board – someone who has the wider skillset to manage all the social, physical and psychological determinants of health. They need to be on the governing board to articulate the main ambition of parents (that their children are happy and healthy) and of schools (that their pupils fulfil their maximum educational potential).

One secondary school in Tower Hamlets, which has a GP from our partnership as Chair of Governors, also has a ground-breaking social prescribing project. In Oxford, the local authority is supporting a school nurse in every secondary school. The amazing charity Place2Be supports mental health projects in many schools around the country, as does the Healthy Schools Project. The offer, though, is variable across the country. What is needed are the resources, the nurses or equivalent, and a desire to invest in our future generation. ‘Nurses’, as I have defined above, could be recruited from mums and dads interested in a mainly term-time job.

We all need to support equitable funding between generations. My son says our generation have good pensions, mortgages, housing and have been greatly responsible for global warming, and we were protected during the pandemic, all at the cost of the younger generation. He is right. It is time for the older generation to invest in this world’s future generations.

Sir Sam Everington has been a GP in Tower Hamlets (East London) since 1989 at the Bromley by Bow Centre. He is a 2022 recipient of the RSA’s Albert Medal, awarded in recognition of his innovative work to improve the way local healthcare services support patients.

This article first appeared in the RSA Journal Issue 1 2023.