FOI 2025/1308

The school nursing team

Where there are identified health needs requiring support for specific care interventions / training, this is supported by the CCNT and/or hospital-based specialist nursing services (health need specific).

Where there are identified health needs requiring support for specific care interventions / training, this is supported by the CCNT and/or hospital-based specialist nursing services (health need specific).

NCA are commissioned to deliver a service in Millwood, Elmsbank and the hub through special school nursing team. Special school nurses deliver medications inclusive of controlled drugs, train staff and complete competency checks, respond to emergencies and would in those situations repass NG tubes, gastrostomies and Tracheostomies, give emergency medication.

They also cover safeguarding across all levels.

•            on line theory training

•            competencies are signed off by School Nursing staff after observations.

The children’s integrated community health service in HMR Community Pharmacist provides medicines administration training.

The children’s integrated community health service offers ad hoc tracheostomy training in schools that need it.

Continence support is provided by CCNT and School Nursing depending on setting and complexity of needs – with an annual assessment and educational drop-in sessions.

The adult bladder and bowel practitioner provides support for bowel issues (cholostomy/ileostomy)

RMCH provide support for self-catheterisation

All the above services will support schools with developing the individual child’s care plan.

The clinical nursing services (Specialist School Nursing and CCNT) do not carry out interventions, instead training is provided and relevant competency assessment for duties delegated are completed. In some circumstances tertiary / specialist practitioners may provide training and competency assessment for example intermittent catheterisation

Note: Assess and train the special school tube feeding staff to provide medication

Stoma nurse from TGICFT looks after the children with these requirements

Do not have the clinical skills to do catheterisation but parents are trained to manage buy RMCH and have links with them for guidance

Private day nursery and respite settings – provide training for needs as required ie gastrostomy and tracheostomy

CCN deliver training in:

Medication administration

Gastrostomy feeds/enteral feeding

Suctioning and use of nebulised solutions

Change of tracheostomy tube

Administration of buccal midazolam (for epilepsy seizures)

Safe management of seizures.

We have completed a whole borough analysis of children’s medical needs in all schools and commissioned a training provider deliver training and competency assessments to school staff in respect of the children they work with who need support with procedures that can be delegated

We are currently reviewing our Special Needs nursing model with the aim of incorporating a mainstream training offer into our model of care moving forward

The other special schools are largely established to take children with Mental Health, Learning Disability Autism and behaviours that challenge on roll. As with mainstream a package of care can be arranged on the basis of clinical need under the scope of the Continuing Care framework, SEND code of Practice ( if there is also an educational need ) or through an individual care  package

For any change in provision required, training delivered is specific for individual need and may be funded via CCNT / L.A or Acute providers. CCNT would provide training for a health need if the child has met Continuing Care criteria eligibility and even then, would only be via a PHB to carers not school staff.

From an operational perspective, for any new diagnoses or clinical needs, training is undertaken directly through relevant hospital setting i.e Royal Manchester Children’s hospital, to ensure any new techniques / strategies have the correct training, advice and delivery. If there are concerns regarding specific interventions or increase in risk, this would follow NCA / Pennine care reporting procedures and be highlighted as a risk directly with the ICB. Other concerns in terms of increasing demand may be highlighted directly through locality and relevant Board processes.

Training is updated and adapted according to need to ensure reduction of risk in delivering procedures within an RP setting. Any training delivered is specific for individual need and may be funded via CCNT / L.A or Acute providers. CCNT would provide training for a health need if the child has met Continuing Care criteria eligibility. This would only be via a PHB to carers not school staff.

We are using the findings to inform a review of our special school service model which is ongoing

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