In January, founder and chief executive of the School and Public Health Nurses Association (SAPHNA), Sharon White, announced her retirement after 45 years of working with children, young people and their families and almost two decades leading the charity.
Marking the end of her career, Ms White has spoken to Nursing Times about how she fell into the specialty she has come to love, the successes of her “small but mighty” charity and why she is hopeful that this government might be the one to finally invest in school nursing.
“We have improved the lives of a lot of children, we’ve influenced policy, but we haven’t built the workforce”
Sharon White
Ms White’s nursing career “started by accident” and was initially intended to be a “temporary stop gap” until she could figure out what she wanted to pursue long term.
Little did she know, she would go on to become the mind behind the UK’s leading organisation for school and public health nurses.
After commencing her nurse training in Middlesbrough in 1979, Ms White was placed at a rural cottage hospital in North Ormesby, which she said gave her “the best grounding ever”.
“We had really basic equipment and resources, which I think stood me in good stead for autonomy [and] decision making,” she explained, likening the experience to the environment in which she would come to work later as a school nurse.
Ms White did a short stint as a theatre nurse after qualifying, before moving to Scotland to do her midwifery training.
Once again, she gravitated towards another cottage hospital “in the middle of nowhere in a field that had no facilities”.
Ms White said: “I had the best midwifery experience. We had to be inventive, creative, spontaneous, reactive [and] proactive.”
Between 1985 and 1990, Ms White was working as a sister for paediatric infectious diseases in Leeds.
It was her intention at this point to become a health visitor. However, as she had three children to look after and no local childcare, she decided instead to get a part-time job share as a school nurse.
Soon after, Ms White was looking to undertake a qualification to establish herself as a school nurse.
She went on to be among the first cohort to undertake a specialist public health nursing degree at the former Leeds Metropolitan University.
She noted that it was similar to the specialist community public health nursing (SCHPN) qualification that school nurses are expected to undertake today.
“I was one of the guinea pigs, and a number of us have done really well who did that degree,” Ms White added.
After qualifying, Ms White “gravitated to more senior positions” and eventually became director of children’s services across Leeds.
However, she admitted that the corporate world was “not fulfilling” for her.
“I found myself in a position of significant influence and seniority but didn’t like it,” she said.
It was in the early 2000s that Ms White had a turning point in her career and the idea of SAPHNA came into fruition.
At the time, Ms White was chair of the Community Practitioners’ and Health Visitors’ Association (CPHVA), a trade union and professional body for community healthcare staff in the UK, which is part of the bigger union Unite.
However, Ms White resigned from her role “on principles and values” when the indoor smoking ban policy was coming into force, because she perceived a conflict of interest in Unite representing both public health nurses and tobacco workers.
She said: “I felt very compromised that I was pontificating to be representing children [and] young people’s health and wellbeing, when actually the structure I was in couldn’t support that.”
“Don’t ever underestimate the difference you can make, even in the tiniest way”
Sharon White
What followed was an unexpected “coup” by other CPHVA members and then, two weeks later, Ms White received an offer from a large publishing company to set up a new professional body dedicated to school nurses: SAPHNA.
Ms White described the birth of the organisation as “one hell of a baptism” after funding was suddenly withdrawn only a few months after SAPHNA was founded.
She said: “What do school nurses do? You think, ‘I’ll swim’. So, we swam even harder.”
What was once a project with major financial backing became a labour of love by volunteers determined to keep SAPHNA afloat.
“The beginning was a highlight,” Ms White said, adding: “It really restored my faith in humanity and in school nursing.”
SAPHNA, now 19 years old, continued to flourish and is now a nationally recognised professional organisation for school and public health nurses.
Ms White said: “I call us a very small but mighty charity. If you Google ‘school nursing’, SAPHNA comes out on top, and yet we are tiny.”
The group has more than 2,000 members and is mostly volunteer led with a couple of whole-time equivalent staff.
Since its inception, the organisation has “made lots of differences to policy”, explained Ms White.
“You’ll see school nurses named in multiple policies that we never, ever would have been named in,” she added.
Key moments include lobbying for changes to be made to the sex education curriculum, calling for the smoking ban in enclosed public places and school nurses leading the vaccination roll out for human papillomavirus (HPV).
More recently, the organisation has been lobbying for further changes to optimise the health and wellbeing of children and young people.
These have included universal free school meals for children in schools, expanding the Healthy Start scheme and banning disposable vapes.
In addition, the organisation launched a toolkit in parliament in 2022 that aimed to empower school nurses to discuss eating disorders with children and young people.
However, where SAPHNA has succeeded in recognition, it has not “succeeded in the resource” to match, Ms White argued.
“We have improved the lives of a lot of children, we’ve influenced policy, but we haven’t built the workforce,” she said.
Latest NHS England workforce figures show school nurse numbers have dropped by 34% between 2009 and 2024.
In November 2009, there were 2,962 school nurses working in the NHS in England, compared to just 1,958 in November 2024.
Recently, SAPHNA has been calling on the government to reverse the cuts to the school nursing workforce, through its ‘school nurse in every school’ campaign.
SAPHNA handing in its petition at 10 Downing Street
The campaign has even made its way to parliament, with the charity last year handing a petition into 10 Downing Street.
Offering some flexibility in her demands, Ms White said she envisaged a band 6 or 7 school nurse “who makes the leadership decisions” across a cluster of schools and is supported by staff nurses, nursery nurses and other trained staff.
Ms White noted that, in some Scandinavian countries, school nursing services were mandated in law and funded by the government.
“Our children [at] Scandinavian schools have much better outcomes than our children here, so there’s something in it,” she said.
Getting the UK to copy the same financial model as its Scandinavian counterparts would require “billions” in investment, Ms White admitted.
But she argued that the return for the money spent on public health would be significant in terms of health outcomes for children.
She said: “Actually it makes fiscal, if not moral, sense to do this. I think it is aspirational, but we should aspire.”
There has been some headway recently in getting further funding for school nursing services in England.
In February this year, the government announced that it would uplift the public health grant by 5.4% for 2025-26 – equal to a £200m boost.
Ministers said local councils could use this additional money for essential public health nursing services, including family nurses, health visitors and school nurses.
On this, Ms White said: “I think the important bit is it’s the first uplift that has named school nursing in it for decades. Others might say it’ll be worth nothing. I think it’s invaluable.”
Reflecting on the last four decades, Ms White said becoming a school nurse was “the best career choice” she ever made.
She added: “The opportunity to be invited to work in a family and make a difference, even with the smallest things, gives you such a buzz.
“I would say, don’t ever underestimate the difference you can make, even in the tiniest way.”
In 2015, Ms White received an Order of the British Empire (OBE) in the Queen’s New Year Honours list for services to public health nursing for school-aged children – an accolade that she argued was dedicated not just to her but “to the profession”.
For now, Ms White’s focus is on her health, as she steps down from SAPHNA following a period of extended sick leave.
SAPHNA confirmed to Nursing Times that it was looking to appoint a new chief executive in the near future.
Asked about how she felt leaving the charity, Ms White said “bereaved” but “excited”.
She added: “We have grown significantly in the past two years, even though it’s still tiny.
“[It’s about] being visible, being outspoken, being challenging, which I think we do really well.
“The projections are good, and I am hopeful for SAPHNA.”
