Collapse in school nurses risks creating a generation of sick children with a lifelong dependence on the NHS, report warns

The collapse in school nurses and health visitors risks creating a generation of sick children with a lifelong dependence on the NHS, a report warns.The healthcare workers play a 'crucial' role supporting babies, new parents and school children by offering lifestyle advice and spotting mental and physical health issues early, when they are easier to treat.But new analysis by The King's Fund think tank reveals the workforce has been 'hollowed out' in recent years, with remaining staff 'stretched thinner and thinner'.It means children's health is too often left to escalate to crisis levels, with many battling obesity, rotten teeth and mental distress, according to its new report, 'What does the health and care system look like for children in England?'.Researchers highlight that the school nurse workforce has shrunk by 38 per cent, from a peak of 3,026 full-time equivalent roles in January 2010 to 1,862 in June 2026.Meanwhile, the number of health visitors has plummeted by 45 per cent, from a peak of 10,309 in October 2015 to 5,666 in June 2026.Health visitors support families from pregnancy until children start school, monitoring child development, supporting infant feeding and promoting parental wellbeing.School nurses are specialist community public health nurses who promote the health and wellbeing of school-aged children, including those with additional needs such as asthma or epilepsy. New analysis reveals the school nurses and health visitor workforce has been 'hollowed out' in recent years, with remaining staff 'stretched thinner and thinner'They help to identify problems early, manage long-term conditions, safeguard vulnerable children and connect families with wider services.But the report notes that many are spending an increasing share of their time responding to safeguarding and child protection concerns, leaving less capacity for the preventative work that 'sits at the heart of their role'.The King's Fund warns that without adequate support for children's health in school, an 'entire generation risks missing out on preventative or early care for issues ranging from mental health and obesity to oral health and long-term conditions such as asthma and epilepsy'.More responsibility may also fall on teachers, who are already under significant pressure and may not have the specialist training or capacity to provide medical care, it adds.Perversely, the fall in school nursing numbers comes as the government is trying to shift care out of hospitals and closer to the community and amid a 32 per cent increase in the overall nursing workforce over the past 15 years.Niamh Buckingham, policy adviser at The King's Fund, said: 'These findings expose a stark gap between the government's ambition to create the healthiest generation of children and the reality facing children, schools, families and the staff working tirelessly to support them.'Despite children spending five days a week in school, the support available to help them stay healthy and prevent more serious health and wellbeing issues is being stretched thinner and thinner.'Schools are supporting growing numbers of children with complex needs related to mental health, special educational needs and disabilities, and safeguarding, while the specialist workforce designed to provide early help and prevention has been steadily hollowed out.'Health visitors and school nurses are uniquely placed to support children and families because they reach almost every child.'But with fewer health visitors supporting families in the early years and school nurse numbers dwindling, opportunities to intervene and 'nip problems in the bud' early are being lost.'At the start of her tenure, the Secretary of State for Health and Social Care said she wanted to focus on children's health, and the government has rightly said it wants to shift the focus from sickness to prevention.'School nurses and health visitors will play an important part in turning those ambitions into reality.'But warm words alone are little remedy for years of workforce decline and squeezed budgets for the areas outside the NHS that deliver many of these services.'If government is serious about delivering on their promises, it must tilt the scales towards prevention and ensure these services are not squeezed out by the urgent demands that consume resource and attention elsewhere.'That is a tricky balance to strike, but it will be crucial to prevent more children reaching crisis point because earlier support wasn't available.'School nursing and health visiting services are funded by central government through the public health grant provided to local councils but funding for children's services from this 'preventative pot' has been cut in real terms by 16 per cent between 2016/17 and 2025/26.The King's Fund also warns of a postcode lottery in access to services, with reports that some local authorities have decommissioned these services altogether. A Department of Health and Social Care spokesperson said: 'Following a decade of underinvestment, this government is committed to strengthening health visiting and school nurse services so that every family has access to the support they need, and we are also rolling out mental health support teams across every education setting in England, so young people can get professional support in their own schools and colleges.'These investments are at the heart of our 10 Year Health Plan to shift care into the community, and ensure that everyone who needs healthcare support can get it where they need it, when they need it.'That is also why the Health Secretary announced last week that health services for babies would be rolled out across every family hub in England.'