School Nursing (SN)

Who to refer

NB this is not a referral to raise a child protection concern- If you have a child protection concern; please follow NHS Tayside’s child protection protocol. School nurse can be informed after the initial procedural steps have been taken, in accordance with policy. 

The 10 key areas on the referral form serve as a guide across all services to help identify initial concerns. The school nursing service receives referrals not only from health professionals but also from education, social work, parents, carers and young people themselves.

Below are examples of what may be referred under each pathway:

• Emotional Health and Wellbeing

Anxiety

Low mood

Emotional regulation difficulties

Self harm or thoughts of self harm

• Substance Use

Use of alcohol, cannabis or other substances

Vaping or smoking

Risk taking behaviours linked to substance use

Concerns raised by parent about possible substance use.

• Child Protection

School nurses are invited to attend all school age initial child protection planning meetings (CPPM) and Inter-agency Referral Discussions (IRD), contributing to multiagency decision making.

      Provide health information requested for CPPM and IRD

Concerns around neglect, physical or emotional abuse

Supporting child’s plan post CPPM and IRD

NB: Referrals to the school nursing service are received from social work when a child protection order is being considered or has been made. In such cases, school nurses are part of the multiagency team and contribute to the Childs plan. They play a key role in supporting children and young people on the child protection register.

• Domestic Abuse

Child or young person living in a home where domestic abuse is present

Impact on mental health, sleep or behaviour

Exposure to controlling behaviours or coercive control

• Care Experienced Children and Young People

Health need assessment of care experienced children in foster, at home or in kinship care. 

Monitor physical and emotional wellbeing and provide support as necessary.

Support education transitions and care planning

• Homelessness

Young person living in temporary accommodation

Family at risk of eviction

Lack of access to basic needs (e.g. hygiene, good, sleep)

• Youth Justice

Concerns about peer influence and antisocial behaviour or where there are charges pending

• Young Carers

Child taking on significant caring responsibilities at home.

Impact of caring role on school attendance, health or wellbeing

Young person not linked into young carer support services

Sign of fatigue, stress or withdrawal linked to caring role

• Sexual Health

Questions about contraception and healthy relationships

Concerns about STIs, pregnancy

Low self esteem related to body image or sexual identity

• Transitions

Child moving from nursery to P1 with additional health or emotional needs

P7 to S1 transition  concerns, particularly for care experienced or vulnerable pupils

Support required for school leaver, particularly for care experienced or vulnerable pupils

Co-ordinate with education for ongoing support planning.

GPs and other professionals often have existing links to specialist services that offer targeted support for example:

• The Corner/ NHST sexual health clinic: Specialist sexual health services
• Dundee’s Woman’s Aid: For women, young people and children who have experienced domestic abuse.
• WRASAC (Women’s Rape and Sexual Abuse Centre): Specialist services for children and young people affected by sexual abuse

While school nurses work closely with GPs and specialist agencies, it is important that GPs and other professionals help identify and refer children and young people and families to the appropriate specialist services as early as possible. This partnership ensures timely access to the right support, promoting the best outcomes for those in need.