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.
A child’s mental and physical health should be properly supported in school, so that the pupil can play a full and active role in school life, remain healthy and achieve their academic potential.
The Department for Education has issued Statutory Guidance on “Supporting pupils at school with medical conditions“. This applies to all state schools including academies aside from independent schools. The governing body of a maintained school, proprietor of an academy and management committee of a pupil referral unit must have regard to the Statutory Guidance in this document. This means that they must follow it unless there is a good reason not to.
An often overlooked and under used section of the Children And Families Act (2014) is the duty to support pupils with medical conditions (Section 100).
The law says
(1)The appropriate authority for a school.... must make arrangements for supporting pupils at the school with medical conditions
In the statutory guidance the Department for Education explains that this duty may include adopting a flexible school day permitting those who may be unwell to attend a little later or leaving a little earlier if their medical needs dictate. It might include arrangements to adopt a flexible approach to curricular delivery adapted to meet the needs of children who would otherwise miss out.
A Headteacher can agree to the use of Individual healthcare plans which should clarify what needs to be done, when and by whom, in order to support a child’s medical condition.
The following should be the kind of thing covered in health care plans for those with medical condition:. (It is not an exhaustive list).
A The medical condition , it's triggers signs symptoms and treatments.
B. The resulting needs including medication (dose side effects and storage).
C Facilities needed including access to food and drink and other matters to manage their condition including dietary requirements and environmental issues IE crowded corridors travel time between lessons etc must all be considered..
D Specific support for a pupils educational and social and emotional needs. IE how absences may be managed and what remedial support they might need to catch up on lessons missed.
E. Level of support needs including in emergencies.
F. Who will provide the actual support. Their training requirements to meet the needs and the expectations of their roles etc.
G. What to do in emergency.
The Health Conditions in School Alliance is made of over 30 organisations, including charities, healthcare professionals and trade unions who work collaboratively to make sure children with health conditions get the care they need in school.
The site offers guidance and tools to schools who are looking after children with health conditions. You can download a template medical conditions policy a sample individual healthcare plan and advice on what it should contain, guidance on the legal situation across the UK and a process for making sure children who require education in different settings get the support they need too.
Families where a child has a brain condition face challenges every day. Just to learn, play, make friends, enjoy and experience the world can feel difficult, even impossible. But we don’t believe there is any challenge that can’t be over come.
Our Vision is that every family that includes a child with a brain condition will have the chance to discover a better life together.
Our Mission is to listen to families that include children with brain conditions. We use what they tell us to inspire the best research and innovation. Then we help them put the knowledge into practice so they can discover a better life together.
We use ‘brain condition’ to describe any disorder or disability that affects the brain, including those caused by illness, genetics or traumatic injury. Brain conditions include (but are not limited to) autism, ADHD, Down’s syndrome, learning disabilities, cerebral palsy, epilepsy and developmental delay.
PANS and PANDAS are a set of conditions which result in inflammation of the brain, causing a variety of neuro-psychiatric conditions such as OCD, tics and eating disorders.
PANS PANDAS UK was formed in order to raise awareness and understanding of these conditions amongst the general public and medical professionals.
PANS PANDAS UK are working closely with a Network of Doctors in order to ensure better diagnosis and early effective treatment for those suffering with these little understood, but life changing conditions.
Up-to-date information on hundreds of medical conditions
This page provides information on the duties of schools to support children and young adults with medical needs. It explains the law on illness-related absences, administering medicine within school and individual healthcare plans.
The Dyspraxia Foundation is a country Wide charity, founded in 1987 as the Dyspraxia Trust by two mothers who met at Great Ormond Street Hospital for Sick Children.
The Dyspraxia Foundation is committed to making the teaching and medical professions more aware of dyspraxia; and to spread understanding of how those who have the condition can be helped.
We aim to support and encourage individuals with PoTS. We hope to educate family, friends and medical professionals within the United Kingdom to this widely unknown and misdiagnosed condition by means of sharing up to date medical research and resources. PoTS UK desires to offer hope that life can be enjoyed while living with this health condition.
Well at School is a resource helping schools support students with medical and mental health conditions so they can fully engage in education.
We work in partnership with health professionals, students and teachers to ensure our content is relevant and up to date.
Well at School is maintained and updated by Chelsea Community Hospital School