School Nursing Service (Medway)

We can help address health barriers to regular school attendance. 

How we can help 

• Advice on managing minor health issues to support attendance. 

• Working with the school and family to address barriers. 

• Working with other health professionals to help develop an appropriate care plan for school. 

• Emergency medication management guidance for school colleagues. 

• Signposting to relevant health services. 

When another service is more suitable 

• Complex medical conditions that need specialist care. 

• Diagnosing a condition or authorising investigations or tests. 

The school remains responsible for the care plan. It is an agreement between home and school. 

We support families with nutrition, meal routines and active lifestyles. 

How we can help 

• General healthy eating advice, including balanced diets, portion sizes and meal routines 

• Support with fussy or selective eating where needs are not complex 

• Encouraging daily physical activity 

• Advice on healthy weight and lifestyle choices 

• Signposting to local healthy lifestyle and weight management programmes 

• Health promotion for individuals, classes or the whole school 

• Interactive workshops for parents, carers or school colleagues. 

When another service is more suitable 

• Children who are underweight or may be malnourished, who should be referred to their GP and a dietitian 

• Suspected eating disorders, which should be referred to a GP or the NELFT All Age Eating Disorder Service 

• Medical dietary needs, such as diabetes or coeliac disease, which need specialist support 

• Complex feeding issues, including a severely restricted diet linked to sensory or emotional needs, such as avoidant restrictive food intake disorder, which need support from a dietitian. 

Other reasons we may not accept a referral 

• Unexplained weight loss during the past three months, which should be referred to a GP. 

• Visible physical symptoms, such as paleness or a change in weight, which should be referred to a GP. 

We support positive friendships, personal boundaries and online safety. 

How we can help 

• Education about friendships, empathy and communication. 

• Age appropriate advice about boundaries and consent. 

• Online safety and healthy digital interactions.

• Sexual health. 

• School based support, including one-to-one targeted help. 

When another service is more suitable 

• Abuse or exploitation, where safeguarding procedures must be followed until appropriate specialist support is complete. 

• Complex relationship counselling, which needs a specialist service. 

Other reasons we may not accept a referral 

• Concerns about coercive control or unhealthy behaviours, which need a specialist service. 

We support families with behaviour management strategies and signposting. 

How we can help 

• Behaviour that affects health, such as refusing food or disrupted sleep. 

• General advice about positive parenting approaches and routines. 

• Behaviour management guidance where needs are not complex.

• Signposting to parenting programmes and community resources. 

• School based health and wellbeing activities. 

When another service is more suitable 

• Severe behavioural concerns or possible neurodevelopmental conditions, such as attention deficit hyperactivity disorder or autism, which need specialist support. 

• Complex family circumstances that need intensive help from Early Help or social care. 

Other reasons we may not accept a referral 

• Persistent challenging behaviour despite routine strategies. 

• Related concerns, such as parental mental health, neglect or family pressures, which should be considered using the Medway Threshold document. 

We provide information about puberty, menstrual health and personal hygiene. 

How we can help 

• Education about puberty and what to expect. 

• Personal hygiene routines, including washing, deodorant and dental care. 

• Menstrual health and managing periods. 

• Confidence and body image during puberty. 

• School based health promotion sessions about puberty and hygiene. 

When another service is more suitable 

• Complex endocrine or hormonal concerns, which need a GP or specialist. 

• Possible early or delayed puberty, which should be referred to a GP. 

• Menstrual health concerns, such as severe pain or heavy bleeding, which should be referred to a GP. 

We help families build healthy routines and environments for better sleep. 

How we can help 

• General advice about consistent bedtimes and calming routines. 

• Guidance on boundaries, including screen time limits and bedtime expectations. 

• Predictable evening and morning routines. 

• Advice about a quiet, dark and comfortable sleep environment, including temperature. 

• Sleep and wellbeing activities for individuals, classes or the whole school. 

• Interactive workshops for parents and carers. 

When another service is more suitable 

• Possible sleep disorders, such as sleep apnoea or narcolepsy, which should be referred to a GP. 

• Persistent insomnia or complex sleep needs, which need a GP or specialist sleep clinic. 

• Sleep difficulties linked to an underlying mental health condition, which need specialist mental health support. 

• Medical conditions affecting sleep, such as attention deficit hyperactivity disorder or epilepsy, which need a GP or specialist. 

Other reasons we may not accept a referral 

• A significant effect on school attendance or daily life. 

• Sleep problems lasting more than three months despite changes to routines. 

• A child or young person who has been prescribed sleep medication. 

We provide advice on healthy bladder and bowel habits and routines. 

How we can help 

• Healthy bladder and bowel habits. 

• Toilet training and establishing routines. 

• Hydration and diet for bowel health. 

• Signposting to continence services for more complex needs. 

• Interactive workshops for parents and carers. 

• Continence Champions sessions for professionals. 

When another service is more suitable 

• Complex continence needs or underlying medical conditions, which need a GP or specialist. 

• Possible urinary tract infections or severe constipation, which should be referred to a GP. 

• Prescribing medicines for continence needs, such as anticholinergics or macrogols. 

• Daytime wetting after a child was previously dry during the day, or daytime wetting without bedwetting, which should be referred to a GP or the level two children’s bladder and bowel service. 

Other reasons we may not accept a referral 

• Pain, or blood in urine or stools, which should be referred to a GP. 

We explain the risks, support attempts to stop and signpost to stop smoking and vaping services. 

How we can help 

• Education about vaping risks and nicotine dependence. 

• Advice about effects on breathing and oral health. 

• Basic strategies and signposting for young people who want to stop. 

• Support with peer pressure. 

• School-based sessions about vaping. 

• Signposting to local stop smoking and vaping services. 

When another service is more suitable 

• Complex dependence, which needs a GP or specialist stop smoking service. 

• Vaping linked to mental health or safeguarding concerns, where safeguarding procedures must be followed. 

• Medical complications, such as breathing difficulties, which need a GP or emergency care. 

After submission, a school nurse will review the referral and usually tell the parent or carer and referrer the outcome by email. 

• Parental consent must be obtained before referring, unless the child or young person is assessed as Gillick competent 

• Include attendance information, height and weight, routines or symptoms where relevant 

• Include details of the concern, relevant background and strategies already tried 

Before submitting a referral: 

Choose the form that best matches the person making the referral: 

• referral form for parents and carers 

• referral form for a young person 

• referral form for health professionals.