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Reports on a detailed study of a school nursing service which has revealed the untapped value of the service and a generally poor understanding of what, precisely, school nurses do, and the nature of their skills and experience. Focuses on one aspect of this study: the changing nature of the school nursing role in health education and health promotion. Finds that school nurses have adjusted their practice to meet the changing nature of children’s health needs. They now increasingly work to health education and health promotion agendas and are acting in a health advisory role. Calls into question the need for universal health screening, particularly for older children, as the core activity of school nursing. Concludes that the service should in future be designated as being for “children of school age”, and that the range of sites where school nursing is delivered should be extended.

The purpose of this paper is to examine the effects of an integration programme on service users from users’ own perspective.

Multi-method approach was used. Both quantitative and qualitative data collection and analysis were employed to uncover and examine service users’ views of the impact of the integration programme.

An improvement in the physical functioning of one in three occupational equipment users; a rise in the level of satisfaction of 85 per cent of occupational health and 82 per cent of physiotherapy users; older people with complex problems and high-level needs were able to be helped to live at home; and waiting times for both assessment and for services within two weeks and four weeks were below the national achievement and ministerial targets. The impact of the integration programme on users was complex. Positive outcomes were achieved for some user groups and individuals but not for others. A lack of change outcomes in social care, and service users’ low level of satisfaction with social care services appears to be associated with the impact of agency work and the predominant aim in social work of achieving maintenance and prevention outcomes.

This paper contributes to knowledge on what and how the total integration in Cambridgeshire has benefited users.