The number of school nurses in England has fallen by more than 38% since 2010, according to analysis by The King's Fund.
Numbers dropped from a peak of 3,026 in January 2010 to 1,862 in June 2026, while the overall nursing workforce grew by 32% over the past 15 years.
Health visitor numbers have also fallen, by 45% from a peak of 10,309 in October 2015 to 5,666 in June 2026.
The think tank warns that children could miss out on early support for issues including mental health, obesity, oral health and conditions such as asthma and epilepsy.
It says school nurses are increasingly spending time on safeguarding, leaving less capacity for preventative work, and that more responsibility may fall on teachers.
Both services are funded through the public health grant to councils, which has been cut by 16% in real terms for children's services between 2016/17 and 2025/26.
The King's Fund also warns of a postcode lottery, with some local authorities reported to have decommissioned the services altogether.
Niamh Buckingham, Policy Adviser at The King’s Fund, said: 'Despite children spending five days a week in school, the support available to help them stay healthy and prevent more serious health and wellbeing issues is being stretched thinner and thinner.
‘Schools are supporting growing numbers of children with complex needs related to mental health, SEND and safeguarding, while the specialist workforce designed to provide early help and prevention has been steadily hollowed out.’
