Monday, 15 March 2010

Correspondence: Confidential drop in service in school



The letter from the school nurse about bringing a confidential drop in clinic to our childrens' school, also invited parents to contact a representative of the local Primary Care Trust for further information .
So I did.
Here's how our correspondence has been going; I thought it best to keep the  names off, for now.

Dear Ms..............,

Having been notified of a proposal to provide a 'confidential health drop in service' at ................. Community College, I would like to ask for some clarification on a couple of questions raised.
1)For which age groups of young people  is  the proposed 'drop in'  designed?
2)I understand that the School Nurse operating within the drop in clinic, will be able to refer young people to other services. What services are these?
I would be grateful to hear back from you as soon as possible.
Yours sincerely,
Kate

Dear kate,
 Thank you for your enquiry, I would be happy to answer your questions and discuss this further.
  I would appreciate if you could either give me a ring or put your request in writing to the address below, indicating the reason for your query as you have not given any indication of whether you are asking as a parent, teacher or school governor.
 Kind Regards
  ...........................

Dear ...........,
Thank you for your reply, I'm sorry it has taken me a couple of days to respond.
To answer your question, I am a teacher by profession, was a governor for 10 years and remain a parent.
It would be very helpful to me if you could provide your response to my query via email, which is, after all, much more prompt than posting, and widely accepted as a legitimate means of communication.
With best wishes,
Kate 

Dear kate,
 I had hoped to have a conversation with you in preference to responding by email as this would have given greater opportunity for further discussion if required.
  We are proposing to develop, 'drop-in clinics' in response to national guidance from both health and education, with the driver being the requirement to promote the wellbeing of pupils at school.
  The drop-in would be accessible to young people attending the school and the school nurse would adhere to professional guidelines, national and local policies and procedures relating to confidentiality.
It is accepted best practice that the health professional would encourage the young person to talk to their parent or carer.
 It is difficult to answer your question about specific services that a school nurse may refer to, as this would depend on the issue, ranging from bullying and relationship problems to diet, body image and physical and emotional health and wellbeing issues.
 I hope this is helpful
 Best Wishes
........................ 

 Dear ............,
Thank you for your helpful answer.
I appreciate your difficulty in answering my earlier question about which services a school nurse might refer a pupil to. Since the range of issues you mention does not include include sexual health, STI's, emergency contraception or abortion referrals,  my understanding is that a school nurse operating in a school based confidential drop in service, would not refer pupils  to any of those services. Would that  be correct?
With best wishes
Kate 

Dear Kate,
The examples of issues that young people might bring to a confidential drop in was not comprehensive and yes, they might bring sexual health questions and concerns.
 These would be dealt with in the same professional manner, adhering to national and local policies and procedures.
 The advice and signposting that the school nurse would offer would depend on the assessment of the young person, this includes considerations relating to informed consent and safegaurding (i.e. issues of possible abuse).

A school nurse would not refer anyone for a termination of pregnancy as this is a doctors responsibility.

If you would like to discuss this further or any other aspect of the proposed drop in, please could you either give me your phone details so that I can ring you to arrange a meeting or contact me by phone (numbers below).  I think this would give you an oppportunity for a more in depth exploration of the proposal and I can share with you the documents/guidance supporting the establishment of the drop ins and the professional procedures that support the service.
Regards
...........

Dear ...........,
 Thanks again for your helpful reply.
You have stated that a school nurse would not refer anyone for a termination of pregnancy  (abortion) as this is a doctor's responsibility.
Of course, whilst not actually making a direct referral for an abortion, a  school nurse would be able to refer a pupil to a doctor who would make an abortion referral. That is so, isn't it?
Thank you for your offer of a meeting. Sadly, I must decline owing to various time pressures.
If you could email the various documents/guidance that you propose to share with me, I would be most grateful.
With best wishes,
Kate 
 

Still waiting for a reply to my last email above........

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