For years, school nurses have said the same thing: there are not enough of us, and the gap is getting wider. Now there is official data to prove it.
The Department of Health and Social Care has published its first ever Children’s public health nursing: workforce and activity report, giving a national picture of the health visiting and school nursing workforce across England. The findings make difficult reading, but they also give the sector something it has long lacked: a clear, shared evidence base.
What the numbers show
The report estimates there were 4,405 whole-time equivalent staff working in school nursing services during 2025. Of those, just 1,434 were school nurses holding the Specialist Community Public Health Nursing (SCPHN) qualification, meaning only a third of the workforce is SCPHN qualified.
That figure is a steep drop from the 1,980 SCPHN school nurses recorded by SAPHNA in 2024: a fall of 27% in a single year.
Spread across the population, the picture is starker still. Nationally, there are an estimated 0.11 whole-time equivalent school nurses for every 1,000 young people aged five to 19. On average, that works out at 0.4 of a school nurse per secondary school.
A postcode lottery
The national averages hide enormous variation. Depending on the local authority, the number of school nurses per 1,000 young people ranges from 0.01 to 0.41. Some areas have around two school nurses per secondary school; others have a fraction of one.
That variation shows up in the services children receive. According to SAPHNA, only 74% of services deliver drop-ins in secondary schools, 64% offer school entry questionnaires and 62% provide support to children with specific health needs. Whether a child gets that support can depend entirely on where they live.
Health visiting faces the same pressure. The Institute of Health Visiting reports that health visitor numbers have fallen by 41% since 2015, with average caseloads of 454 children per health visitor. As its chief executive, Alison Morton, put it: “The question now is: where is the plan to fix it?”
Why this matters for the Healthy Child Programme
The Healthy Child Programme sets out that a SCPHN nurse should lead and oversee delivery for children and young people. SAPHNA values the contribution of skill mix teams, but has warned that with numbers this low, it is hard to see how most areas can meet that standard without significant investment.
For school nursing leads, that means making difficult choices every week about where limited specialist time goes.
Protecting nursing time for nursing
Workforce investment is the long-term answer, and SAPHNA and the iHV are right to call for a fully funded national strategy. But teams cannot wait for that to arrive. In the meantime, every hour a school nurse spends chasing paper consent forms, re-keying screening results or compiling returns by hand is an hour not spent with a child who needs them.
This is where the right digital tools make a real difference. Not software that simply moves a clunky paper process onto a screen, but systems designed to take administrative work away from nurses altogether.
SchoolScreener was built with school nursing teams to do exactly that. It helps teams to:
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collect questionnaires and consent digitally through a parent portal, so information arrives complete and ready to review
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record screening results once, with outcomes and letters generated instantly
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identify children who need follow-up quickly, so specialist time is focused where it is needed most
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produce accurate reporting without manual spreadsheet work
When there is less than half a school nurse per secondary school, efficiency is not a nice to have. It is how teams keep essential services running.
A first step, not the final word
The DHSC has committed to publishing these statistics every year. That is genuinely welcome: consistent data will help commissioners, providers and professional bodies track progress and hold decision makers to account.
The next step is action. Until then, school nursing teams deserve tools that give them back time, so the specialists we do have can spend it where it counts: with children and young people.
Want to see how SchoolScreener could save your team time?