A vital facet that adds value to schools is the partnership between the departments of education and health at national level. At the heart of making this partnership effective in order to achieve its potential is the need for synchronisation of the roles of school nurses and teachers to mitigate sustainability risks. In order to investigate the harmonisation of these roles, an explorative qualitative study was conducted with school nurses and teachers in three district municipalities in two provinces of South Africa. The aim was to determine the perceptions of these two groups of their respective roles and the possibility of harmonising these roles. The administrative task, which included obtaining the consent of parents for their children's immunisation provided an opportunity for sharing responsibilities. However, the roles of school nurses--health screening and immunisation--and the roles of teachers--screening for barriers to learning--could not be harmonised due to a lack of understanding of health promotion and a tendency to work in silos because of a lack of trust and openness. This was compounded by the school managers' inability to provide guidance and leadership.