Almost a third of classroom support staff say a shortage of school nurses has led them to consider alternative work, Tes can reveal.
And while 32 per cent of respondents said this in a survey of Unison support staff members, more than six in 10 said a shortage of school nurses, or access to them, had created additional workload and pressure.
This shortage is leaving classroom staff to help with catheters and colostomy bags, carry out physical therapy and deal with soiling incidents, according to the poll of over 2,500 support staff.
School leaders said the problem required an “urgent resolution”, warning that funding constraints in schools meant that the pressure on support staff was only getting worse.
The findings from the survey, run by Unison on behalf of Tes, come after research published earlier this week suggested that thousands more school nurses were needed.
In the Unison survey, more than a quarter (27 per cent) of support staff respondents said that they were providing physical therapy.
Nearly two-thirds (65 per cent) said they were supporting with toileting or dealing with soiling incidents.
And 7 per cent said they were providing assistance with both catheters and colostomy bags.
School support staff under pressure
While some support staff had agreed to take on the additional duties and were paid extra to do so (5 per cent), almost half (49 per cent) said they were not paid extra to do so.
And almost one-third (31 per cent) said that they felt forced into taking on the clinical duties but were not paid to do so.
One support staff member told Unison that while they were “underpaid anyway”, they are now expected to be “responsible for children with life-threatening medical needs”.
The staff member added that: “Many of us now feel out of our depth.”
There were also concerns around barriers to training, with 53 per cent citing a lack of time and almost one-third (31 per cent) claiming a lack of funding was an issue.
The problem was being felt particularly acutely in special schools due to the high numbers of support staff required, according to heads speaking to Tes.
Simon Knight, joint headteacher at Frank Wise special school, in Oxfordshire, said that school nurses were ”often critical to the safe and effective operation of special schools” but that provision was “far too variable”.
This variation - a result of localised commissioning arrangements and different interpretations of what special schools require - created ”inconsistencies of support and expectation upon school staff and leaders”, he said.
Mr Knight added: “This needs urgent resolution, but I worry that insufficient clinical staff capacity, inconsistent commissioning arrangements and budgetary pressures will mean that the situation faced by schools and families will get worse before it has any chance of getting better.”
One headteacher of a special school in West Yorkshire, who wished to remain anonymous, said that the situation “was already a car crash” before Covid, but had since worsened.
Health services had turned away from providing services themselves, instead training school staff to carry out those tasks, the head added.
Joe Steward, deputy head of John F Kennedy Special School’s Beckton autism provision site in London, part of the Learning in Harmony Trust, said that over the past two to three years, physical access to an on-site nurse had been totally withdrawn.
Before Covid, Mr Steward said that the school - which is spread over four different sites - had an allocated school nurse for two days a week.
The withdrawal of access for his school was caused by a lack of funding in the health sector, and had led to difficulties with the recruitment and retention of staff, he said.
Support staff in his school are education professionals, not healthcare professionals, and they “feel that burden and that pressure”, Mr Steward added.
He said the situation was particularly difficult in special schools due to support staff making up the “vast majority of the workforce”.
When the school is forced to put extra responsibilities on certain members of staff without increased pay, it makes it “increasingly difficult to retain good quality members of staff”, Mr Steward stated.
Two thirds (67 per cent) of respondents to the Unison survey said they did not feel they were being paid adequately for the responsibility of providing clinical care, while almost six in 10 (59 per cent) were concerned about “something going wrong”.
46 per cent said they did not have enough trained staff to carry out medical duties.
Warren Carratt, chief executive officer of Nexus MAT, told Tes that his schools had only been able to function over the past 10 years due to the “willingness of support staff to fill the breach”.
He said it was “yet another example of passporting high-risk issues to schools” as they “pick up the slack for other services”.
Commenting on the survey, Unison head of education Mike Short said: “Teaching assistants are neither trained nor paid to do the jobs of NHS specialists such as school nurses.
“Chronic low wages are already driving support staff into better paid and less stressful careers. More will leave if they’re pressured into administering medication and carrying out other healthcare tasks.
“All children should enjoy school to the full, including those with health issues. But expecting teaching assistants to fill workforce gaps is neither fair on them nor the pupils.”
A Department of Health and Social Care spokesperson said: “Support in school is vital, and we are committed to increasing the number of mental health teams to almost 400 by the end of April 2023, providing support to 3 million children and young people.
“School nurses are public health specialists and skilled in delivering care to children and young people. It is the responsibility of local authority commissioners, working with their service provider, to determine school nurse numbers based upon local needs.
“We are also investing £2.3 billion a year into mental health services, meaning an additional 345,000 children and young people will be able to access NHS-funded mental health support by 2024.”
