School nurses' workloads: how should they be prioritised?

The school nurse role has developed considerably over the past two decades in order to meet the changing health needs of the school-age population. Changes demand continuous adaptability to prioritise workload pressures, one example of which is the new vaccination programme against human papillomavirus. This paper examines the wider context in which school health care is delivered and proposes a systematic, evidence-based approach that school nurse managers could take toward prioritising tasks. It suggests that decisions regarding competing priorities could be underpinned by three aspects---available evidence, young people's perspectives and clinical effectiveness. Applying this approach to each intervention will help to clarify their relative priority. However, this evidence-informed strategy creates a further dilemma if government-directed interventions are assessed to be of reduced priority, jeopardising the achievement of national targets. One example of this is the National Child Measurement Programme. Employing a systematic approach to prioritising interventions would facilitate planning and commissioning of school nursing services more appropriately than being required to respond to various initiatives.