MEDICAL NEEDS IN SCHOOLS

When children and young people are not fine in school, health, education and other professionals need to work in partnership with families to support them.

Based on the experiences of parents of children with additional educational and medical needs, we are aware that NHS medical professionals and school staff are struggling with decreasing budgets and limited resources. As a result, parents are reporting difficulties in accessing the support they feel their children need. This impacts on school attendance, and school attendance pressures can also impact on their health. It is likely that despite being described as “fine in school”, these children and young people are really struggling. 

It is difficult for teachers, let alone doctors and social workers to keep up with changes within education, and the support available within school. Many would assume that children with additional needs have access to the support they need. This is simply not the case in many educational settings, so how can you help to improve the situation?

Education and social care are adding to the workloads of the medical profession - Doctors do not need to produce repeated sick notes for children who are too ill to attend school. Children with viruses and other illness which would otherwise be dealt with at home, should not be attending doctors' surgeries to clarify illness for the sake of attendance codes. SEND and mental health   are specialist areas and children may need specialist Educational or Clinical Psychology based advice and support.     

Education professionals must accept medical diagnoses and follow medical advice. A child may need an EHCP in place to be able to access the necessary support. 

All professionals need to be aware of the implications of long waiting lists and health problems on children’s school attendance. There is an obvious impact of health conditions upon children’s learning and ability to do well at school. However, the health impact of inadequately understood and unsupported SEND is often underestimated. Please also remember that co-morbidities can affect diagnoses and treatment and may require referral to specialists who understand these.     

School nurses and even community Paediatricians may not have the expertise required for these complex cases so please consider the most applicable referrals to make.

All too often when children are not coping with school, even if they are waiting for treatment, or adequate intervention and support, they are referred to attendance officers, and safeguarding social workers may also become involved. Missing school is listed as a cause for concern of child abuse, but in the case of the majority of school refusers their difficulties are more likely to be due to mental health or SEND needs not being met within the school environment. Social workers may have limited knowledge or experience of education and health policies and practices. Whilst safeguarding must be taken very seriously, child protection proceedings should only apply for children at risk of significant harm. This causes unnecessary strain on children and families who are already struggling, and requesting help. We would recommend a multidisciplinary approach to support children and families including the involvement of voluntary agencies with specialist experience. Assessment and diagnoses are taking too long for SEND and medical conditions. 

We urge schools to accept and acknowledge other qualified professionals diagnoses and consider their impact on attendance. 

Long waiting times for diagnosis and treatment, changing criteria for diagnoses, a lack of expertise with co-morbidities, and relatively uncommon conditions, all contribute to the difficulties faced by children and their families - having significant impact on attendance.     

Could the time being used to provide medical evidence where repeated medical reports are not necessary, and the time and resources being used to investigate families be re-diverted and used to diagnose and treat our children sooner - to focus on supporting them within school or via other forms of educational provision? 

Resources and time need to be prioritised to follow recommendations for interventions and environments children need to stay well. If health and education services are not adequately funded, then working together efficiently is more vital than ever. The sooner children and young people receive the support and treatment they need, the sooner they can increase their attendance and return to education.