Wellbeing and Health In-reach Nurse Coordinator Program - Operational Guidelines
All students attending a school with a wellbeing nurse, and their families, are eligible to access the WHIN Coordinator program.
Any child or young person attending a school with a wellbeing nurse can be referred into the program by their parent or carer. Students 14 years and older can refer themselves to the program. The referral can be made directly to the wellbeing nurse in person, by email, telephone or videoconference.
The school learning and support and wellbeing team and school staff can refer a student at the school of any age to the WHIN Coordinator program using the Referral and Consent form (Appendix 1). Parents/carers can ask the learning and support and wellbeing team to refer their child to the program. Students aged 14 years and over can also ask the learning and support team to refer them to the program. The school learning and support and wellbeing team is responsible for determining when a referral by this team to the WHIN Coordinator program is appropriate.
The wellbeing nurse assesses each referral and determines if the referral is accepted and informs the referrer of the referral outcome. The wellbeing nurse informs the parents/carers that the referral has been accepted. If a student is 14 years and older and is assessed by the wellbeing nurse to be Gillick competent, the student can request that their parents/carers are not told about the referral (refer to Consent section).
The wellbeing nurse can directly contact the parent/carer or can use an introduction letter that explains the WHIN Coordinator program and provides the wellbeing nurse’s contact details (Appendix 2). The wellbeing nurse schedules appointments with the student and when appropriate, their family.
The wellbeing nurse obtains written or verbal consent from the parent/carer using the Referral and Consent form (Appendix 1) before undertaking any formal assessments, referral to other services or providing support. Written consent is preferred. The consent given is documented in the electronic medical record (eMR) system.
The wellbeing nurse as an employee of NSW Health must comply with the NSW Health Consent to Medical and Healthcare Treatment Manual.
If a student 14 years or older requests that their parents/carers are not informed of the referral to the WHIN Coordinator program, and/or referral to another service by the wellbeing nurse, and they are assessed as having a sufficient level of understanding and maturity to enable them to make an informed decision, parental consent is not required. The wellbeing nurse uses clinical judgement to apply the criteria of Gillick competence and assess the student’s maturity and level of understanding of the proposed care.
The wellbeing nurse explores issues identified in the referral and conducts a health assessment to identify the health and social needs of students (and their families as appropriate). The wellbeing nurse aims to build a trusting relationship with students and their families and help them to overcome any barriers to accessing services. They can provide relevant information and service referral and linkage with health and wellbeing services.
Depending on the identified needs of the student and/ or their family the wellbeing nurse can:
If a student suffers a medical or mental health emergency when seeing the wellbeing nurse, the wellbeing nurse initiates and follows the school’s medical emergency response procedure.
The wellbeing nurse does not provide mental health diagnostic assessment or treatment.
The wellbeing nurse should apply the Mental Health Continuum to determine level of mental health needs and refer accordingly.
The wellbeing nurse develops and maintains referral pathways and connections so they can appropriately refer students for mental health services and supports. Their referral network includes:
The wellbeing nurse can use mental health and wellbeing triage tools such as the Ages and Stages Questionnaire, Strengths and Difficulties Questionnaire and Youth Health and Wellbeing Assessment Guideline to assist decision-making on the need for mental health services and supports.
Referrals, clinical information and care plans are documented in a child or young person’s eMR, in line with local health district processes.
The wellbeing nurse can document that the student is seeing the wellbeing nurse in the school’s centralised record keeping system. In accordance with NSW health privacy legislation (Health Records and Information Privacy Act 2002 and Privacy and Personal Information Protection Act 1998), this information must not contain specific details of identified issues or referrals made to the wellbeing nurse or referrals made by the wellbeing nurse to other services.
Once the student and/or parent/carer have been linked to any required or recommended service/s and no longer requires active support and coordination from the wellbeing nurse the student is discharged from the service.
The wellbeing nurse holds a meeting or phones the student and/or family prior to discharge from the WHIN Coordinator program to ensure their needs have been met before formally exiting them from the service.
The discharge is recorded in eMR and the school record system. The school learning and support and wellbeing team is informed that the student is no longer seeing the wellbeing nurse.
The wellbeing nurse must make students and parents/carers aware of their right to confidentiality and the exceptions to this right which includes:
Students and parents/carers must be informed that the child’s referral to a wellbeing nurse will be recorded in the school’s central records. Any details of the health assessment, health care or referrals made following the health assessment will not be recorded in the school’s records. This health information will be included in the student’s medical record held by the local health district.
Students and parents/carers must also be informed that if they disclose any information that relates to the safety, welfare or wellbeing of a child or young person, the wellbeing nurse as a mandatory reporter will need to respond. This may involve sharing the information disclosed with other agencies.
Consent is not necessary for exchange of information under Chapter 16A of the Children and Young Persons (Care and Protection) Act 1998 provided that the information exchanged relates to the safety, welfare and/or wellbeing of a child and fulfils the objects and principles of the legislation. Chapter 16A recognises that the protection of confidentiality or of an individual’s privacy must be balanced against another form of the public interest, which is ensuring the safety, welfare and/or wellbeing of vulnerable children and young people.
The wellbeing nurse can use Chapter 16A of Children and Young Persons (Care and Protection) Act 1998 to share a student’s information with the school’s learning and support and wellbeing team, when appropriate to ensure their safety, welfare and/or wellbeing.
The wellbeing nurse encourages students to talk with their parents/carer about their health concerns and/or provide permission for the wellbeing nurse to do so on their behalf.
At the first appointment, young people and parents/carers should be provided with NSW Health confidentiality resources We keep it zipped and Privacy Leaflet for Patients brochures. These resource outline:
The wellbeing nurse is responsible for checking that the student and/or parent/carer reads and understands the information contained in the resources they provide.
If a child or young person discloses abuse and/or neglect to the wellbeing nurse, the wellbeing nurse must record the time and date of the conversation and, as far as possible, the exact words used. It is important to be clear that it is the wellbeing nurse’s role as a health worker to support a child or young person’s health, safety and wellbeing. The wellbeing nurse must be careful not to ask leading questions, but to gather enough information to determine whether the child or young person is at suspected ROSH by using the NSW Mandatory Reporter Guide.
If an outcome of suspected ROSH is reached, the wellbeing nurse makes a report to the Child Protection Helpline for an investigative response. Once a report is made, the wellbeing nurse’s role returns to working with children to support their psychological and physical health, address the impact of the abuse and maintain a strong supportive relationship.
The wellbeing nurse should reassure the child or young person that they have the right to disclose abuse and/or neglect so that steps can be taken to help them and keep them safe.
As NSW Health employees, wellbeing nurses have a responsibility to promote the health, safety, welfare and wellbeing of children and young people. As a mandatory reporter, the wellbeing nurse must identify and appropriately respond to child wellbeing and child protection concerns.
In accordance with the Child Wellbeing and Child Protection Policies and Procedures for NSW Health (PD2013_007), the wellbeing nurse must:
The wellbeing nurse must advise school principals when they identify any child wellbeing or child protection concern or when they identify a ROSH using the information exchange provisions of Chapter 16A of the Children and Young Persons (Care and Protection) Act 1998. The wellbeing nurse works collaboratively with school staff as appropriate to plan any actions to address child safety, welfare or wellbeing concerns.
When a suspected ROSH report is indicated and both the wellbeing nurse and the school principal are aware of the same information, they both must ensure a report is made. The wellbeing nurse and school principal must agree:
The wellbeing nurse and school principal should only make separate reports if they have different or additional information to report or when views on the need to report differ.
The wellbeing nurse and school principal can contact their respective CWU to confirm whether a ROSH has been made about a student, or to receive assistance in planning a response after a ROSH report has been made.
The NSW Health CWU supports NSW Health staff and the NSW Department of Education CWU supports NSW Department of Education staff. The CWUs help them to fulfil their child protection and wellbeing responsibilities. This includes assistance in deciding when concerns need to be reported to the Child Protection Helpline. The NSW Health CWU can make a report on behalf the wellbeing nurse based on who has the most relevant, direct information and is best placed to have the reporting conversation with the Child Protection Helpline.
When a child protection concern is identified, the wellbeing nurse can:
If the wellbeing nurse has concerns about child related allegations, charges or convictions , the NSW Health Policy Directive, Managing Child Related Allegations, Charges and Convictions Against NSW Health Staff (PD2020_044), must be followed. This includes advice on what to do if it is known that the alleged perpetrator works in a non-NSW Health organisation.
If there are concerns about a Department of Education staff member (paid or unpaid), they must immediately inform the school principal.