More than a third of school nurses are dissatisfied with council children’s services' responses on at least half of referrals, according to a new report by the Children’s Commissioner for England.

Nurses claimed the high thresholds operated by council departments meant making successful referrals about children was more difficult – and as a result they were picking up protection work and support for rejected cases.

A fifth of school nurses felt the child protection caseload was limiting capacity for other roles with an average one case conference a week, taking up around 4.5 hours of their time – and stopped front-line work, including identifying abuse in the first place.

The Lightning Review of almost 800 primary and secondary school nurses also showed that their ability to highlight children at risk of neglect or abuse was reduced by time pressures created by bureaucracy.

The report also found school nurses have less direct contact with children and spend twice as much time on paperwork. It revealed their ability to support and promote children’s health and wellbeing, mental health and sexual education was also being compromised.

Anne Longfield, children’s commissioner for England, said: 'They are one of the professionals at the front-line identifying abuse or neglect, as well as supporting children with a host of other issues – whether that’s mental health, age-appropriate relationships and sex education or healthy eating. Being available for children for face to face time is irreplaceable.

'It is clear from this research that school nurses face significant barriers in working directly with children and young people, with paperwork getting in the way. The support they offer needs to be better promoted and new ways to enhance their engagement with children explored.'

Responding to the report, chairman of the Local Government Association’s community wellbeing board, Cllr Izzi Seccombe, said: 'Councils want to see school nurses being able to work directly with children, rather than spending too much time on paperwork, and many local authorities are looking at new models by redesigning what school nurses can do.

'It is important to note though, that paperwork is generally not generated by commissioners, but as a requirement of the safeguarding process.'