North West London is taking steps to standardise and improve special school nursing across its eight boroughs.

The North West London Joint Health Overview and Scrutiny Committee received an update on the progress of a core offer for community services, including special school nursing, at a meeting on 18 November 2025, according to the Supplementary Agenda - Special School Nursing Updated Report 18112025 JHOSC.

The initiative aims to reduce inconsistencies and enhance service quality for children with special educational needs (SEN) and disabilities in special schools across the region. The plan involves standardising service specifications, implementing a shared care/delegation model, and engaging key stakeholders, including school staff, healthcare assistants, and local authorities.

The report pack outlines a review process, and notes that a service specification outlines a shared care/delegation model in line with national guidance in the Children and Families Act 2014, with delegation of tasks to healthcare assistants and school staff. The core offer for community services is seen as a key element in improving outcomes and reducing variation across the North West London Integrated Care System (ICS). Community providers have committed to developing a consistent core offer for any place to drive service consistency across North West London. Providers will also consider how their services are part of and enable Integrated Neighbourhood Teams.

The service specification outlines a shared care/delegation model in line with national guidance in the Children and Families Act 2014, with delegation of tasks to healthcare assistants and school staff. This model aims to empower school staff to take on certain healthcare responsibilities, freeing up specialist nurses to focus on more complex cases.

Key milestones in the implementation of the core offer for special school nursing include:

  • Demand and capacity mapping to assess the needs of special schools across the region.
  • Agreement on outcome measures and key performance indicators (KPIs) to track the success of the initiative. The updated report for the 18 November 2025 meeting states that a first draft has been formulated, to be finalised once the specification is signed off.
  • Engagement with key stakeholders, including school staff, partner agencies, patients, carers, and the public, to gather feedback and address concerns.
  • Review of special school nursing workforce capacity and skill mix to determine resource requirements.
  • Agreement on competency and training approaches for school staff to ensure they are equipped to handle delegated healthcare tasks.
  • Finalisation of the service delivery model and timeline to achieve the core offer.

While the initiative is expected to benefit all boroughs, Ealing may see the most significant changes, with a larger proportion of work potentially moving to school staff. However, some schools may resist the proposed changes, highlighting the importance of clear communication, training, and support. The NWL JOSC Supplemental agenda - 9 September 2025 identifies the risk that Some schools may resist the proposed change. The mitigation is Creating delegation risk assessment and clear documentation for training and competency sign-off to increase confidence in the new model.

To ensure the successful implementation of the core offer, a special schools engagement work plan has been developed, focusing on:

  • Engaging designated clinical officers for SEND to incorporate their expertise into service design and skill mix requirements.
  • Involving Directors of Children's Services and local authorities to provide local insights into borough needs and variations.
  • Engaging special schools, parent and carer forums, and young people's forums to gather lived experiences and address concerns.
  • Informing all partners and stakeholders, including the Joint Health Overview and Scrutiny Committee, through surveys, interviews, and workshops.

The NWL ICB aims to have the service delivery model and timeline finalised by December 2025, with implementation and mobilisation plans agreed with partners. The success of the initiative will depend on effective collaboration between healthcare providers, local authorities, schools, and the community to ensure that children with special educational needs receive the consistent, high-quality care they deserve.