Help at school if your child has medical needs


Many children have medical conditions that significantly affect their school life. Some children miss a lot of school through illness. Others may require medication or personal care during school time, or emergency procedures need to be put in place for them.

The way to get extra help on any of these issues may not be clear, as there are different but overlapping routes for children with medical needs, disabled children and children with special educational needs. Some children may fit into more than one category.

My child has medical needs

Schools have particular responsibilities for pupils with medical conditions. On this page we'll explain what schools must do for this group and how to get help for your child with a medical condition.

My child is disabled

Many children with long-term conditions will count as disabled under the Equality Act. Our page on disability discrimination explains what schools must do to make sure these pupils are fully included and not disadvantaged.

My child has special educational needs

If your child's medical condition impacts directly on their learning, they may also have a special educational need. See our page on extra support in school.

Information for families in England

What duties do schools have for children with medical conditions?

Under section 100 of the Children and Families Act 2014, all state-funded schools must "make arrangements for supporting pupils at the school with medical conditions."

The law itself doesn't say any more than this, but details of these duties are spelled out in statutory guidance, which schools are expected to follow. The guidance is very clear about what schools should and shouldn't do. The guidance contains information on school policies and individual healthcare plans and also highlights unacceptable practices.

Independent schools do not have to follow this guidance and will have their own policies and procedures.

Policies

All state-funded schools must have a published policy on pupils with medical needs. This should be reviewed regularly and be easily available to parents and staff. Normally the medical needs policy would be published on the school's website.

The policy should include details of:

  • A named member of staff with overall responsibility for implementing the policy. This may be the headteacher or the SENCO.
  • Arrangements for ensuring all staff are aware of children's medical conditions.
  • Responsibility for staff training.
  • Cover arrangements and briefing of supply teachers.
  • Procedures for when the school is notified that a child has a medical need.
  • Procedures for managing medicines in schools.
  • Developing and monitoring of individual healthcare plans.
  • Arrangements for risk assessments for school trips.

Individual healthcare plans (IHCPs)

Individual healthcare plans are specifically for children with medical needs. They set out the child's medical condition, any support needed and any emergency procedures.

Although the name is similar, IHCPs are not the same as Education Health and Care EHC plans for children with special educational needs. Not all children with a medical condition will need an IHCP, but they should be considered when the child's condition needs different staff or agencies to work together or if the child may require emergency treatment.

There is no standard national format for an IHCP, so schools can draw up their own. There is a suggested template on gov.uk and several condition-specific organisations also have their own templates. You can find links to these through the Health Conditions in School Alliance.


What should be in the plan?

Government guidance suggests that the following should be included (we have given some examples about how that might work in practice):

  • Details of the child's condition; any medication or other treatment needed; any equipment needed; dietary needs; environmental adaptations.

A child with sickle cell needs to be kept warm. She is allowed to stay inside with a friend when the weather is cold and wet instead of going outside to play.

A teenager with chronic fatigue syndrome is allowed to take a reduced number of GCSEs and is given rest breaks for the actual exams.

  • The level of support needed - for example can the child manage their own medication? This will depend on age but also on any other additional needs the child may have. The plan should also record parents' permission for staff to administer medication if this is required.

A 15 year old with type 1 diabetes is able to administer his own insulin injections. There is a quiet area where he can do this. A seven year old with the same condition and additional learning difficulties cannot do this. Two teaching assistants from the school have agreed to share responsibility, and parents have given written permission

  • Who will provide the support, how will they be trained, cover arrangements, arrangements for judging competence of staff.

A young child with epilepsy is about to start school. The IHCP is drawn up before she starts. A session of awareness training is organised for all staff. In addition, three named members of staff are given training in administering emergency medication

  • Confidentiality and information sharing - who needs to know what about the child's condition.
  • Arrangements for school trips, including any risk assessments.
  • Emergency arrangements - what counts as an emergency, who should be called and at what stage.

A secondary school has a number of pupils with life-threatening allergies. They all have an anaphylaxis plan covering emergency interventions. This sets out clearly when an ambulance should be called if a child does not respond quickly to emergency medication.


Who writes the plan?

This is not an individual person's responsibility, but should be a partnership between school, parents and relevant healthcare professionals. Consultants will often give written recommendations. The school nurse may also be involved. For some conditions, such as epilepsy or diabetes, there may be specialist nurses who can come into school to give advice and to train staff.

Unacceptable practices

Many parents report that they are being asked to come into school to attend to their child or are facing action over the poor attendance of a sick child. The guidance lists a number of practices that are considered unacceptable, for example:

  • Asking parents to come in to give medication or attend to toileting.
  • Ignoring the views of children, parents and medical professionals.
  • Sending children home unnecessarily.
  • Penalising pupils who are absent for medical reasons.
  • Assuming that all children with the same condition require the same treatment.
  • Preventing access to medication.
  • Stopping children from eating or taking toilet breaks where this is necessary.
  • Putting barriers in the way of children taking part in all aspects of school life including trips.

Particular medical conditions

It would not be realistic to expect all schools to have prior knowledge of all medical conditions. However, many schools, particularly large secondary schools, may already have experience of children with more common conditions such as:

  • Asthma.
  • Anaphylaxis.
  • Bowel and bladder conditions.
  • Diabetes.
  • Cancer.
  • Epilepsy.
  • ME/CFS.

Many organisations supporting specific conditions have their own resources to explain how the condition may affect a child in school and what support may be needed. You can find the support organisation for your child's condition by searching our medical information. There are resources for more common conditions on the Health Conditions in School Alliance website.

Getting the right help in place

It's important to notify the school as soon as your child is diagnosed with a medical condition. If your child is about to start or change school, try to work with the new school in advance so the right support can be put in place from the beginning.

Ask for the school's medical needs policy and ask for a meeting with the member of staff responsible for medical needs. Below are a few points you may want to raise at the initial meeting.

  • Information about your child's condition. What are the essential facts that the school needs to know? Parents very quickly become experts, but school staff may not have time to wade through lengthy specialist articles. If you have an information pack for your child's condition, highlight what is particular to your child.
  • Think about who needs to know about your child's condition and how much. This will involve balancing your child's privacy with ensuring sufficient people have the necessary awareness. What about your child's friends and classmates? Older children and teenagers are likely to have their own views.
  • Does your child need an individual healthcare plan? If so, discuss who needs to be involved in putting it together.
  • Do any risk assessments need to take place?
  • How does the school store medication? Is it easily accessible if needed? Are existing school staff already prepared to give medication? Is there a safe space your child can go if they are feeling unwell?
  • Do the staff need any training? Who would be able to give this?
  • Emergencies - what are the signs you would look for? Remember, school staff won't know your child as you do and may lack confidence in their ability to detect what is a true emergency. In what circumstances is it ok for your child to remain in school but have a rest break in a quiet place?
  • Absences - will your child need hospital admission or time off for appointments? Or will poor health impact on attendance? Check that the school will authorise absences and what arrangements are in place for your child to catch up on work.

Some common questions

My child has medical needs. Can she/he have Education Health and Care (EHC) plan?

Although EHC plans cover all three areas, including health, they are education driven. It is only possible to trigger the EHC assessment process if your child has an educational need. However it is worth bearing in mind that the definition of special educational need has two parts and includes:

  • Children who have significantly greater difficulty in learning than others of their age.
  • Children with a disability who can't access educational facilities normally available in mainstream school.

Some children with medical needs may fit the disability part of the definition. For more information see our pages on extra help in school and EHC needs assessments.


Can school staff refuse to give my child medication?

Giving medication is not part of schoolteachers' conditions of service, so an individual teacher can't be forced to give medication. Teachers can volunteer to do so if they wish. Support staff may have the requirement to give medicine written into their contract.

The school should ensure that there are sufficient trained staff available to give medication to children who cannot manage it themselves. Parents should not be asked to come into school to give medication.


The school won't let my child start because the staff haven't been trained.

The school's medical needs policy should be clear about how staff will be trained. School staff should not undertake any medical support without proper training. If your child is likely to remain out of school for a lengthy period, ask your local authority to provide alternative education. See the guidance on children who cannot attend school for health reasons.

Further information

Your local authority must publish information on services for relevant early years providers, schools and post-16 institutions to help them support children and young people with medical conditions. This should be on the local authority's 'local offer' site.

See guidance from the Department for Education on supporting pupils at school with medical conditions

Health conditions in school alliance has some condition-specific examples and links to member organisations, as well as sample IHCPs.

Royal College of Nursing's Meeting Health Needs in Educational and other Community Settings is a guide for nurses caring for children and young people.

Dignity and inclusion: making it work for children with complex health care needs includes good practice examples from both specialist and inclusive settings

Other UK nations

If you live in Scotland, Wales or Northern Ireland, see the links below for nation specific guidance

Scotland

The Scottish Government, Guidance on Healthcare Needs in Schools, published in December 2017. This is guidance for NHS Boards, education authorities and schools about supporting children and young people with healthcare needs in schools.

Wales

The Welsh Government statutory guidance, Supporting learners with healthcare needs, published in March 2017. The link also includes template forms and policies and quick guides for school staff, parents and young people.

Northern Ireland

Joint guidance by the Department of Education and the Department of Health, Social Services and Public Safety, Supporting pupils with medication needs published in February 2008. The focus of this guidance is very much on medication only.