Ysgol Gynradd
Maes-y-coed
Primary School
Awn ymlaen gyda’n gilydd
Healthcare Needs Policy
Signed
Chair of Governors Valerie Mor’o Brien Date June 2017
Head teacher EH
Jarrold
Date of issue: June 2017
Review date: June 2018
School’s full address and post code:
School’s full address and post code:
Maesycoed Primary
Lanwern Road
Pontypridd
CF371EQ
Schools phone number 01443 486835
School’s email address: admin.maesycoedprimary@rctcbc.gov.uk
Website address for this policy: www.maesycoed.blogspot.co.uk
Name of person responsible for maintaining this policy: EH Jarrold
1. Key principles
1.1 Each child including learners with health care needs
is an individual developing in their own individual way; therefore it is our
aim to encourage the children to see for themselves their own talents, to
foster self-confidence, and to develop a sense of personal adequacy, so that
each child can cope with the environment, at a level appropriate to that child.
Hopefully each child will be well balanced, happy and able to develop sensible
attitudes to learning, so that they are able to find enjoyment in all aspects
of schoolwork, and gain satisfaction from their own achievements.
We also aim to develop certain social skills, tolerance,
respect, self-discipline, reliability and appreciation of others. Each child
should be respectful and careful with both their own and other people’s
belongings and begin to acquire moral values on which to base their own
behaviour.
A high regard for intellectual skills is important when
pursuing these aims, for without them little will be achieved. Every child
should be able to communicate clearly and accurately through written and spoken
language. They should be numerate, exploring mathematical concepts with
understanding and confidence. Using these skills they should be able to observe
and record accurately, and begin to understand their environment in a natural,
scientific, technological, historical, geographical and social way.
We aim to develop an appreciation of aesthetics in some
of its forms, both natural and artistic, thus enabling the children to develop
skills in communicating their thoughts and feelings through the arts.
With
regard to spiritual development we aim to give knowledge of Christian beliefs
and foster a respect for others and their beliefs.
We
will encourage every child to appreciate the language and culture of Wales and
to equally value all languages and cultures from around the world and to hold
in high regard the conservation of our environment and heritage.
1.2 Healthcare issues
affect each learner individually and support from the education setting may
have an impact on their quality of life and future chances. Therefore,
governing bodies and head teachers should ensure arrangements focus on meeting
the needs specific to the learner and consider how this impacts on their
education, attainment and well-being. Arrangements should give learners and parents’
confidence that provision is suitable and effective
2. School’s legal requirements
2. School’s legal requirements
2.1 Section 175 of the Education Act 2002
places a duty on local authorities and governing bodies to make arrangements to
ensure their functions are exercised with a view to safeguarding and promoting
the welfare of children in school or another place of learning. This includes
supporting children with healthcare needs.
2.2 In meeting the duties under section 175
of the Education Act 2002, local authorities and governing bodies must have regard to guidance issued by
the Welsh Ministers under this section.
2.3 Section 21(5) of the Education Act 2002
places a duty on governing bodies to promote the well-being of learners at the
school so far as related to the matters mentioned in section 25(2) of the Children
Act 2004, which includes physical and mental health and emotional well-being,
education, training and recreation, and social well-being.
2.4 The non-statutory advice contained within
this document is issued in exercise of the Welsh Ministers’ duty to promote the
education of the people of Wales and their power in relation to the promotion
or improvement of the economic, social and environmental well-being of Wales[1].
3. Roles and responsibilities
3.1. School
3.2
Governing bodies
Governing bodies should oversee the
development and implementation of arrangements, which should include:
·
complying with applicable statutory duties,
including those under the Equality Act 2010 (e.g. the duty to make reasonable
adjustments in respect of learners with healthcare needs if they are disabled,
as outlined above)
·
having a statutory duty to promote the
well-being of learners. Schools should give consideration to how they can meet these
needs, including providing learners access to information and material aimed at
promoting spiritual and moral
well-being and physical and mental health (Article 17 of
the UNCRC)
·
considering how they can support learners to
develop the skills, knowledge and emotional resilience required to uphold their
rights, and the rights of others
·
ensuring the roles and responsibilities of
all those involved in the arrangements to support the healthcare needs of
learners are clear and understood by all those involved, including any
appropriate delegation of responsibilities or tasks to a headteacher, member of
staff or professional as appropriate
·
working collaboratively with parents and
other professionals to develop healthcare arrangements to meet the best
interests of the learner
·
developing and implementing effective arrangements
to support learners with healthcare needs. This should include a policy on
healthcare needs and where appropriate, IHPs for particular learners
·
ensuring arrangements are in place for the development,
monitoring and review of the healthcare needs arrangements
·
ensuring the arrangements are in line with
other relevant policies and procedures, such as health and safety, first aid,
risk assessments, the Data Protection Act 1998, safeguarding measures and
emergency procedures
·
ensuring robust systems are in place for
dealing with healthcare emergencies and critical incidents, for both on- and
off-site activities, including access to emergency medication such as inhalers
or adrenaline pens
·
ensuring staff with responsibility for
supporting learners with healthcare needs are appropriately trained
·
ensuring appropriate insurance cover is in
place, any conditions are complied with and staff are clear on what this means
for them when supporting learners
·
having
an infection prevention policy that fully reflects the procedures
laid out in current guidance[2].
3.3 Headteacher/teacher in charge;
The headteacher should ensure arrangements to
meet the healthcare needs of their learners are sufficiently developed and
effectively implemented. This can include:
·
working with the governing body to ensure
compliance with applicable statutory duties when supporting learners with
healthcare needs, including duties under the Equality Act 2010
·
ensuring the arrangements in place to meet a
learner’s healthcare needs are fully understood by all parties involved and
acted upon, and such actions maintained. In larger education settings it may be
more practical to delegate the day-to-day management of a learner’s healthcare
needs to another member of staff. The headteacher should directly supervise
this arrangement as part of the regular reporting and supervision arrangements
·
ensuring the support put in place focuses on
and meets the individual learner’s needs, also known as person-centred planning[3]
·
extending awareness of healthcare needs
across the education setting in line with the learner’s right to privacy. This
may include support, catering and supply staff, governors, parents and other
learners
·
appointing a named member of staff who is
responsible for learners with healthcare needs, liaising with parents,
learners, the home tuition service, the local authority, the key worker and
others involved in the learner’s care
·
ensuring a sufficient number of trained staff
are available to implement the arrangements set out in all IHPs, including
contingency plans for emergency situations and staff absence
·
having the overall responsibility for the
development of IHPs
·
ensuring that learners have an appropriate
and dignified environment to carry out their healthcare needs, e.g. private
toilet areas for catheterisation
·
checking with the local authority whether
particular activities for supporting learners with healthcare needs are
appropriately covered by insurance and making staff aware of any limits to the
activities that are covered
·
ensuring all learners with healthcare needs
are appropriately linked with the education setting’s health advice service
·
ensuring when a learner participates in a
work experience placement or similar, that appropriate healthcare support has been
agreed and put in place
·
providing annual reports to the governing
body on the effectiveness of the arrangements in place to meet the healthcare
needs of learners
·
ensuring all learners with healthcare needs
are not excluded from activities they would normally be entitled to take part
in without a clear evidence-based reason
·
notifying the local authority when a learner
is likely to be away from the education setting for a significant period, e.g.
three weeks (whether in one go or over the course of the academic year) due to
their healthcare needs. Ultimately, what qualifies a period of absence as
‘significant’ in this context depends upon the circumstances and whether the
setting can provide suitable education for the learner. Shorter periods of
absence may be significant depending upon the circumstances
·
being mindful of the Social Services and
Well-being (Wales) Act 2014. Education settings should be fully aware of this
approach and ensure assistance to learners is provided using a holistic
approach.
3.4 teachers, support staff and all other members of staff (e.g. catering staff or reception staff);
Any staff member within the education setting
may be asked to provide support to learners with healthcare needs, including
assisting or supervising the administration of medicines. This role is entirely
voluntary. Staff members must receive sufficient and suitable training and
achieve the necessary level of competence before they take on the
responsibility. No staff member can be required to administer or supervise
medication unless it forms part of their contract, terms and conditions or a
mutually agreed job plan.
In addition to the training provided to staff
that have volunteered or are contracted to support learners with healthcare
needs, the education setting should ensure staff:
·
fully understand the education setting’s
healthcare needs policies and arrangements
·
are aware of which learners have more serious
or chronic healthcare needs, and, where appropriate, are familiar with these
learners’ IHPs. This includes knowing how to communicate with parents and what
the triggers for contacting them are, such as when the learner is unwell,
refuses to take medication or refuses certain activities because of their
healthcare needs
·
are aware of the signs, symptoms and triggers
of common life-threatening medical conditions and know what to do in an
emergency. This includes knowing who the first aiders are and seeking their
assistance if a medical emergency takes place
·
fully understand the education setting’s
emergency procedures and be prepared to act in an emergency
·
ask and listen to the views of learners and
their parents, which should be taken into consideration when putting support in
place
·
ensure learners (or their friends) know who
to tell if they feel ill, need support or changes to support
·
listen to concerns of learners if they feel
ill at any point and consider the need for medical assistance (especially in
the case of reported breathing difficulties)
·
make sure learners with healthcare needs are
not excluded from activities they wish to take part in without a clear evidence-based
reason, including any external trips/visits. This includes ensuring learners
have access to their medication and that an appropriately trained member of
staff is present to assist where required
·
are aware of bullying issues and emotional
well-being regarding learners with healthcare needs, and are prepared to
intervene in line with the education setting’s policy
·
are aware that healthcare needs can impact on
a learner’s ability to learn and provide extra help when needed
·
support learners who have been absent and
assist them with catching up on missed work ‒ this may involve working with
parents and specialist services
·
keep parents informed of how the healthcare
need is affecting the learner in the education setting. This may include
reporting any deterioration, concerns or changes to learner or staff routines.
3.5 Parents/carers
/ Learners
It is vital that learners and parents are actively involved in the planning of support and management of healthcare needs. Meeting the individual’s needs should be at the centre of decision making and processes. The UNCRC states learners should have access to appropriate information essential for their health and development and have opportunities to participate in decisions affecting their health.
3.5.1 Parents and learners should:
·
receive updates regarding healthcare
issues/changes that occur within the education setting
·
be involved in the creation, development and
review of an IHP (if any). The parent and learner may be best placed to provide
information about how their healthcare needs affect them. They should be fully
involved in discussions about how the learner’s healthcare needs will be met in
the education setting, and contribute to the development of, and compliance
with, their IHP
·
provide the education setting with sufficient
and up-to-date information about healthcare needs, including any guidance
regarding the administration of medicines and/or treatment from healthcare
professionals. Where appropriate, learners should be encouraged and enabled to
manage their own healthcare needs
·
inform the education setting of any changes
such as type of medication, dosage or method of administration
·
provide relevant in-date medicines, correctly
labelled, with written dosage and administration instructions
·
ensure a nominated adult is contactable at
all times and all necessary forms are completed and signed
·
inform the education setting if their child
has/had an infectious disease or condition while in attendance.
3.6. Local authority
Local
authorities should ensure education provision is available to learners, and:
·
must make reasonable adjustments to ensure
disabled children and young people are not at a substantial disadvantage
compared with their peers. This duty is anticipatory. For example, learners
should not be disadvantaged when leaving primary school and beginning secondary
school. In practical terms this means adjustments must be planned and
implemented in advance to prevent any disadvantage. Discussions around the
responsibility for provision should not impact on the delivery of service, as
delays could be detrimental to the education and
well-being of the learner
·
must make arrangements to promote cooperation
between various bodies or persons, with a view to improving, among other
things, the well-being of children in relation to their physical and mental
health, their education, training and recreation[4]. When making these arrangements, local authorities
should ensure appropriate agreements are in place for data sharing. This could
be through working within the Wales Accord on Sharing Personal Information
(WASPI) Information Sharing Protocols or Data Disclosure Agreements. Local
authorities and health boards have WASPI coordinators who can support service
providers to develop appropriate agreements
·
must make reasonable provision of counselling
services for young people aged 11‒18 and learners in Year 6 of primary school[5]. Within schools, this provision should complement the
different approaches already in place to support the health, emotional and
social needs of learners
·
should work with education settings to ensure
learners with healthcare needs receive a suitable education. Where a learner of
compulsory school age would not receive a suitable education for any period
because of their health, the local authority has a duty to make arrangements to
provide suitable education[6]. If a
learner is over that compulsory school age but under 18, the local authority
may make such arrangements
·
should provide support, advice and guidance,
including how to meet the training needs of education setting staff, so that
governing bodies can ensure the support specified within the individual
healthcare plan (IHP) (see ‘Section 3: Individual healthcare plans (IHPs)’ on
page 23) can be delivered effectively.
3.7 NHS Wales school health nursing service, health and other
professionals, third sector organisations and other specialist services (pages 10-11)
Healthcare and practical
support can be found from a number of organisations. Education settings have
access to a health advice service. The scope and type of support the service
can offer may include:
·
offering advice on the development of IHPs
·
assisting in the identification of the
training required for the education setting to successfully implement IHPs
·
supporting staff to implement a learner’s IHP
through advice and liaison with other healthcare, social care and third sector
professionals.
Health advice and support can also be
provided by specialist health professionals such as GPs, paediatricians, speech
and language therapists, occupational therapists, physiotherapists, dieticians
and diabetes specialist nurses. In addition, third sector voluntary
bodies can provide advice and practical support. Proactively engaging with
specialist services can provide practical help when writing and implementing
IHPs. They can also provide training and awareness-raising resources, including
video links.
4. Creating an accessible
environment - outline how your school is inclusive and
accessible in the fullest sense to your learners with healthcare needs,
including:
Local authorities and governing bodies should
ensure their education settings are inclusive and accessible in the fullest
sense to learners with healthcare needs. This includes the following.
4.1 Physical
access to education setting buildings
A duty is placed on
local authorities to produce a written accessibility strategy for all schools
they are responsible for under the Equality Act 2010[7]. Any such strategy is expected to address:
‘improving the physical
environments of schools for the purpose of increasing the extent to which
disabled learners are able to take advantage of education and benefits,
facilities or services provided or offered by the schools’ (Schedule 10,
Equality Act 2010[8]).
This strategy must
relate to a prescribed period, be consulted upon, available for inspection and
kept under review. Similarly, individual schools must carry out accessibility
planning and are under a duty to prepare an accessibility plan following the
same principles as the strategies prepared by the local authorities.
4.2
Reasonable adjustments ‒ auxiliary aids or services
The Equality Act 2010
places a duty on learning establishments to make ‘reasonable adjustments’ for
learners who are disabled as defined by the Act. In regard to these learners,
auxiliary aids or services (with the appropriate number of trained staff) must
be provided.
4.3 Day trips and residential visits
4.3.1
Governing bodies should ensure the education
setting actively supports all learners with healthcare needs to participate in
trips and visits. Governing bodies must be aware of their legal requirements to
make reasonable adjustments to trips and residential visits ensuring full
participation from all learners.
4.3.2 Staff should be aware of how a learner’s
healthcare needs may impact on participation, and seek to accommodate any
reasonable adjustments which would increase the level of participation by the
learner[9]. Staff should consider how to accommodate
the sharing of personal information with third parties if necessary for
off-site activities (in compliance with the Data Protection Act 1998 and in
respecting the learner’s right to privacy). This may include information about
the healthcare needs of learners, what to do in an emergency and any additional
support, medication or equipment needed.
4.4 Social
interactions
4.4.1. Governing bodies
should ensure the involvement of learners with healthcare needs is adequately
considered in structured and unstructured social activities, such as during
breaks, breakfast club, productions, after-hours clubs and residential visits.
4.4.2 The education
setting should make all staff aware of the social barriers learners with
healthcare needs may experience and how this can lead to bullying and social
exclusion. A proactive approach is needed to remove any barriers.
4.5 Exercise
and physical activity
4.5.1 The education
setting should fully understand the importance of all learners taking part in physical
activities and staff should make appropriate adjustments to sports and other
activities to make them accessible to all learners, including after‑hours clubs
and team sports.
4.5.2 Staff should be
made fully aware of learners’ healthcare needs and potential triggers. They
should know how to respond appropriately and promptly if made aware that a
learner feels unwell. They should always seek guidance when considering how
participation in sporting or other activities may affect learners with healthcare
needs.
4.5.3 Separate ‘special
provisions’ for particular activities should be avoided, with an emphasis
instead on activities made accessible for all. Where this might not be
possible, advice from healthcare or physical education professionals and the learner
should be sought.
4.5.4 Staff should also
understand that it may be appropriate for some learners with healthcare needs
to have medication or food with them during physical activity; such learners
should be encouraged to take the medication or food when needed.
4.6 Food
management
4.6.1. Where food is provided by or through the education setting,
consideration must be given to dietary needs of learners, e.g. those who have
diabetes, coeliac disease, allergies and intolerances.
4.6.2. Where a need occurs, education settings should in advance provide menus
to parents and learners, with complete lists of ingredients and nutritional
information. Gluten and other intolerances or allergens must be clearly marked.
Providing information will help facilitate parent and catering teams’
collaborative working. This is especially important when carbohydrate counting
is required. Consideration should be given to availability of snacks. Sugar and
gluten-free alternatives should always be made available. As some conditions
require high calorific intake, there should always be access to glucose-rich
food and drinks.
4.6.3. Food provided for trips must reflect the dietary and treatment needs
of the learners taking part. Food provided for snacks in classroom settings should
also take the dietary and treatment needs of these learners into account. While
healthy school and ‘no sweets’ policies are recognised as important, learners
with healthcare needs may need to be exempted from these policies. Learners
needing to eat or drink as part of their condition should not be excluded from
the classroom or put in isolation.
4.7 Risk assessments
4.7.1 Staff should be clear when a risk assessment is required and be aware of
the risk assessment systems in place. They should start from the premise of
inclusion and have built into them a process of seeking adjustments or
alternative activities rather than separate provision.
4.7.2 In addition, there are duties under the Equality Act 2010 to prepare
and implement accessibility strategies and plans. These strategies and plans deal with matters
related to increasing participation by disabled learners. They are described in
more detail in ‘Annex 1: Outline of legal framework’ on page 28.
5.1. Sharing information (pages 13-14) - outline
how your school will communicate information effectively and confidentially,
including with:
5.1.1 Governing bodies should
ensure healthcare needs arrangements, both wider education settings’ policies
and IHPs, are supported by clear communication with staff, parents and other
key stakeholders to ensure full implementation. It is essential that all
information is kept up to date. All information-sharing techniques such as staff
noticeboards and school intranets must be agreed by the learner and parent in
advance of being used, to protect confidentiality.
5.2 Teachers,
supply teachers and support staff (this may include catering staff and relevant
contractors)
5.2.1 Staff should have access to the
relevant information, particularly if there is a possibility of an emergency
situation arising. How this is done will depend on the type and size of the
setting and could include:
5.2.2 where suitable,
and following appropriate consent, a noticeboard in a staff room used to
display information on high-risk health needs, first aiders and certificates,
emergency procedures, etc. It should be noted that not all staff use their
staff room, that the size of some educational settings could make this form of
information-sharing impractical, and that at all times the learner’s right to
privacy must be taken into account
5.2.3 The education setting’s secure intranet area
and staff meetings being utilised to help ensure staff are aware of the
healthcare needs of learners they have or may have contact with.
5.3 Parents
and learners
5.3.1 Parents and learners should be active partners, and to
achieve this the education setting should make parents fully aware of the care
their children receive. Parents and learners should also be made aware of their
own rights and responsibilities. To help achieve this the education setting
should:
·
make healthcare needs policies easily
available and accessible, online and in hard copy
·
provide the learner/parents with a copy of
their information sharing policy. This should state the type of bodies and
individuals with whom the learner’s medical information may be shared
·
ask parents to sign a consent form which clearly
details the bodies, individuals and methods through which their learner’s
medical information will be shared. Sharing medical information can be a
sensitive issue and the learner should be involved in any decisions. Education
settings should keep a list of what information has been shared with whom and
why, for the learner/parent to view on request
·
consider including a weblink to the
healthcare needs policies in relevant communications sent to parents, and
within the learner’s IHP
·
include student councils, ‘healthy schools’
and other learner groups in the development of the setting’s healthcare needs
arrangements, where appropriate
·
consider how friendship groups and peers may
be able to assist learners, e.g. they could be taught the triggers or signs of
issues for a learner, know what to do in an emergency and who to ask for help.
The education setting should discuss with the learner and parents first and
decide if information can be shared.
6 .1 Procedures and record keeping for the management of learners’
healthcare needs
6.1. The education setting
should create procedures which state the roles/responsibilities of all parties
involved in the identification, management and administration of healthcare
needs. The following documentation should be collected and maintained, where
appropriate.
1.
Contact
details for emergency services
2.
Parental
agreement for educational setting to administer medicine
3.
Head
of educational setting agreement to administer medicine
4.
Record
of medicine stored for and administered to an individual learner
5.
Record
of medicines administered to all learners by date
6.
Request
for learner to administer own medicine
7.
Staff
training record ‒ administration of medicines
8.
Medication
incident report
6.2 New records should be completed when there
are changes to medication or dosage. The learning setting should ensure that
the old forms are clearly marked as being no longer relevant and stored in line
with their information retention policy. These forms/templates can be found in
‘Annex 2: Form templates’ on page 32. Electronic versions can be found on the
Welsh Government website.
6.2.1 All
administration of medication must be recorded on the appropriate forms. If a
learner refuses their medication, staff should record this and follow the
defined procedures where parents will be informed of this non-compliance as
soon as possible.
6.2.2 The best examples of record keeping include
systems where the learner’s healthcare needs records have been computerised to
allow quick and easy access by the appropriate staff. Data systems can also
allow for easy access to the required information for staff that may be placed
into classrooms where they are not familiar with the healthcare needs of the
learners.
The operation of such systems must comply
with the Data Protection Act 1998.
Please see the form templates
which can be accessed at Annex 2 at the following link: http://learning.gov.wales/resources/browse-all/supporting-learners-with-healthcare-needs/?lang=en)
7.1 Storage, access and
the administration of medication and devices
7.1 .1 Storage, access
and disposal
While all medicines should be stored safely,
the type and use of the medication will determine how this takes place. It is
important for learners to know where their medication is stored and how to
access it.
7.1.2 Refrigeration
Some medicines need to be refrigerated. The
refrigerator temperature will need to be regularly monitored to ensure it is in
line with storage requirements. Medicines can be kept in a refrigerator
containing food, but should be in an airtight container and clearly labelled. A
lockable medical refrigerator should be considered if there is a need to store
large quantities of medicine.
7.1.3 Emergency
medication
Emergency medication must be readily
available to learners who require it at all times during the day or at off-site
activities. Medicines and devices such as asthma inhalers, blood glucose
testing meters and adrenaline auto-injectors (pens) should be readily available
to learners and not locked away. This is particularly important to consider
when outside of the education setting’s premises, e.g. on trips. If the
emergency medication is a controlled drug it should be kept as securely as
possible so as to minimise the risk of unauthorised access while also allowing
quick access if this might be necessary in an emergency. For example, keys
should not be held personally by a member of staff. A learner who has been prescribed a controlled drug may
legally have it in their possession, if they are competent to do so, and they
must not pass it to another learner or other unauthorised person. Monitoring
may be necessary. Where staff administer emergency medication to a learner,
this should be recorded.
7.1.4 Non-emergency
medication
All non-emergency medication should be kept
in a secure place with appropriate temperature or light controls. If it is a
controlled drug, additional security measures and controls are advisable.
7.1.5
Disposal of medicines
When no longer required, medicines should be returned to
parents to arrange safe disposal. Sharp boxes must always be used for the
disposal of needles and other sharp instruments, and disposed of appropriately.
7.2 Administration of
medicines
·
Where the learner is under 16, assistance or
administration of prescribed or non-prescribed
medicines requires written parental consent, unless Gillick competence is
recorded. The administration of all medication should be recorded.
·
Where medication is prescribed to be taken in
frequencies which allow the daily course of medicine to be administered at home,
parents should seek to do so, e.g. before and after school and in the evening.
There will be instances where this is not appropriate.
·
Learners under 16 should never be given
aspirin or its derivatives unless prescribed to them.
·
Unless there is an agreed plan for the
learner to self-medicate (16 years and above or Gillick competent), all
medication should be administered by a member of staff. In other cases, it may
need to be supervised in accordance with the IHP.
·
Medication should only be administered by
suitably trained staff. The movement and location of these trained staff should
always be in conjuncture with the learners they support.
·
Staff should check the maximum dosage and the
amount and time of any prior dosage administered.
·
Certain medical procedures may require
administration by an adult of the same gender as the learner, and may need to
be witnessed by a second adult. The learner’s thoughts and feelings regarding
the number and gender of those assisting must be considered when providing
intimate care. There is no requirement in law for there to be more than one
person assisting[10]. This should be agreed and reflected in the IHP and risk
assessment.
·
The education setting should have an intimate
care policy[11]. It should be followed, unless alternative arrangements
have been agreed, and recorded in the learner’s IHP.
·
If a learner refuses their medication, staff
should record this and follow their defined procedures informing parents as
soon as possible. If a learner misuses any medication, their parents should be
informed as soon as possible. The education setting should ask parents to seek
healthcare advice as appropriate. If parents cannot be contacted immediately, staff
need to consider seeking immediate healthcare advice.
·
Staff involved in the administration of
medication should be familiar with how learners consent to treatment. Further
information on this from the Welsh Government can be found in the Patient Consent to Examination and Treatment
‒ Revised Guidance (NHS, 2008)[12].
·
All staff supporting off-site visits should
be made aware of learners who have healthcare needs. They should receive the
required information to ensure staff are able to facilitate an equal experience
for the learner. This information may include health and safety issues, what to
do in an emergency and any other additional necessary support that the learner
requires, including medication and equipment.
8. Emergency procedures
8.1 Governing bodies should ensure a policy is
in place for handling emergency situations. Staff should know who is
responsible for the policy, nominated first aiders and how to deal with common
healthcare needs. In situations requiring emergency assistance, 999 should be
called immediately. The location of learners’ healthcare records and emergency contact
details should be known to staff.
8.2 Where a learner has an IHP, this should
clearly define what constitutes an emergency and explain what to do. Staff
should be made aware of emergency symptoms and procedures.
8.3 Other learners in the education setting
should also know what to do in general terms in an emergency, such as to inform
a member of staff immediately. If a learner needs to be taken to hospital, a
staff member should stay with the learner until a parent arrives. This includes
accompanying them in an ambulance to hospital. The member of staff should have
details of any known healthcare needs and medication.
See Emergency situations
policy
9. Training
9.1 Governing bodies must ensure staff who
volunteer or who are contracted to support those with healthcare needs are
provided with appropriate training. Governing bodies should also ensure their
policies clearly set out how a sufficient number of these staff will be
identified and supported.
9.2 When assisting learners with their
healthcare needs, it should be recognised that for many interventions no
specialist training is required and the role of staff is to facilitate the
learner to meet their own healthcare needs.
9.3 IHPs may reflect complex needs requiring
staff to have specific information and training. This training may also be in
the use of aids such as hearing aids (staff could be shown how to change
batteries) and various adaptive technologies. If these have been instigated by
health professionals, they can be asked to provide advice suitable for
education settings as well as learners and families.
9.4 Training provided should be sufficient to
ensure staff are competent, have confidence in their ability to support
learners and fulfil IHP requirements. Crucially this training should involve
input from the learner and parents, who often play a major role in providing information
on how needs can be met. However, parents should not be solely relied upon to
provide training about the healthcare needs of their child.
9.5 If a learner has complex needs, input may be
needed from healthcare services and the local authority who will be able to
advise and signpost to further training and support.
9.6 All staff, irrespective of whether they have
volunteered to assist or support learners with healthcare needs, may come into
contact with learners who have healthcare needs. It is therefore advisable that
all staff have a basic understanding of common conditions to ensure recognition
of symptoms and understand where to seek appropriate assistance.
9.7 Policies should include a procedure on how
to raise awareness of common conditions, a healthcare needs policy and staff
roles in carrying out arrangements. New and temporary staff should especially
be made aware of what preventative and emergency measures are in place so staff
can recognise the need for intervention and react quickly.
9.8 If the trained staff who are usually
responsible for administering medication are not available, the IHP should set
out alternative arrangements. This also needs to be addressed in risk
assessment and planning of off-site activities.
10. Qualifications and assessments
10.1 Efficient and effective
liaison is imperative when learners with healthcare needs are approaching
assessments, including those undertaking examinations in hospital or at home.
The coursework element may help learners to keep up with their peers. The home
and hospital teachers may be able to arrange for concentration on this element
to minimise the loss of learning while they are unable to attend. Liaison
between the education setting and the hospital teacher or home teacher is most
important, especially where the learner is moving from education setting or
home to the hospital on a regular basis.
10.2 Awarding bodies may make special arrangements for learners with
permanent or
long-term
disabilities and learning difficulties, or temporary disabilities and
illnesses, who are taking public examinations such as GCSEs or A levels.
Applications for special arrangements should be submitted by schools to the
awarding bodies as early as possible. Full guidance on the range of special
arrangements available and the procedures for making applications is given in
the Joint Council for Qualifications’ circulars Adjustments for candidates with
disabilities and learning difficulties (2016)[13]
and A guide to the special consideration process
(2016)[14],
which are both accessible from the Joint Council for Qualifications’ website[15].
10.3 Adjustments, adaptations or additional time
for learners taking the National Reading and Numeracy Tests should be based on
normal classroom practice for particular needs. Teachers are expected to use
their professional judgement to support learners. Guidance is provided in the
current National Reading and Numeracy
Tests ‒ Test administration handbook[16].
11. Education other than at school (EOTAS)
This section describes the support available
to learners of compulsory school age who, due to their healthcare needs, may
not for any period attend a mainstream education setting. The support they
receive during an episode of illness could be in hospital, a PRU or at home.
Local authorities have a duty (sections 19(1) and 19(4) of the Education Act
1996) to make arrangements for the provision of suitable education for all
children and young people of compulsory school age.
11.1 A learner who is unable to attend their education
setting because of their healthcare needs should have their educational needs
identified, and receive educational support quickly so they continue to be
provided with suitable education. This means education suitable to the age,
ability, aptitude of the learner and any special educational needs (SEN) they may
have. The nature of the provision should be responsive, reflecting the needs of
what may be a changing health status.
11.2 The local authority is unlikely to provide education at
home for learners who are ill for very short periods of time, as their
education setting should be able to provide appropriate support. However, they
should take into account the way in which the absence is likely to affect the
learner on their return to education. In the case of a short absence (likely to
last for less than 15 school days) the learner’s school should provide work to
be completed at home, if the learner’s condition permits, and support the
learner to catch up on their return. The local authority should be ready to
make arrangements for learners in cases where it is clear that the learner is
likely to be absent from school for a significant period, e.g. more than 15
school days, whether consecutive or cumulative over the course of an academic
year. However, the local authority might still need to make arrangements if a
shorter absence is anticipated, depending upon the circumstances.
11.3 Where absences are anticipated or known in advance,
close liaison between the school and local authority should enable the EOTAS
service to be provided from the start of absence.
11.4 The local authority should take into account any period
of education provided in hospital when considering whether it needs to provide EOTAS
for a learner and what to provide. If the learner has been in hospital and has
received tuition there, their curricular progress and experiences may be
different to that of their peers in school. Even so, as much continuity as
possible should be ensured. The local authority should provide as many lessons
as the learner’s condition allows, and as is beneficial, taking into account
what is suitable for the learner. It may be necessary to give particular
consideration to a learner who is on a course leading to qualifications.
11.5 The local authority should have a written policy
regarding EOTAS for learners with healthcare needs. Policies should include
arrangements for the service and the way it is staffed, the timing of the
provision, and a named person who parents, hospital teachers and others should
contact. The policy should make links with related services in the local
authority such as those for SEN and other local authority support services,
educational psychologists, the Education Welfare Service (EWS) and PRUs.
11.6 Monitoring and evaluation of EOTAS should form a key
element in the local authority’s strategies. It should seek to ensure new
developments are taken on board, levels of education are of a sufficient
standard and provision represents good value for money.
11.6 Cooperation between education, health and administrative
staff in hospital is essential. The aim should be to achieve the greatest
possible benefit for the child or young person's education and health, which
should include the creation of an atmosphere conducive to effective learning.
11.7 Close liaison between home/hospital teachers and
mainstream teachers underpins the provision of an effective educational
programme for the learners. However, parents can also act as a valuable link.
Learners with complex healthcare needs may be
discharged from hospital with a written care plan. Where this happens, the
written care plan should be integrated into any IHP
12. School transport
12.1 There are statutory duties on local authorities, head teachers
and governing bodies in relation to learners travelling to the place where they
receive their education or training[17]. For example, depending upon the circumstances, local
authorities may need to arrange home-to-school transport for a learner, or
provide appropriately trained escorts for such journeys to facilitate the
attendance of a learner. Information and guidance on this is set out in the Learner
Travel: Statutory Provision and Operational Guidance (2014) document[18].
13. Reviewing policies, arrangements and procedures
13.1 Governing bodies should
ensure all policies, arrangements and procedures are reviewed regularly by the
education setting. IHPs may require frequent reviews depending on the
healthcare need – this should involve all key stakeholders including, where
appropriate, the learner, parents, education and health professionals and other
relevant bodies.
14.1 Governing bodies of maintained
education settings should ensure an appropriate level of insurance is in place to
cover the setting’s activities in supporting learners with healthcare needs.
The level of insurance should appropriately reflect the level of risk.
Additional cover may need to be arranged for some activities, e.g. off-site
activities for learners with particular needs.
15. Complaints procedure
15.1 See complaints procedure policy
15.2 If the learner or
parent is not satisfied with the education setting’s health care arrangements they
are entitled to make a complaint. The governing body must publicise their
formal complaints procedure[19], including how complaints can be escalated from teacher
to Headteacher, then to the governing body, and then to the local authority. The
complaints procedure should also be summarised in their policy for supporting
learners with healthcare needs.
If the complaint
is Equality Act 2010-/disability-related, then consideration of a challenge to the
Special Education Needs Tribunal for Wales (SENTW) can be made.
16. Individual healthcare plans (IHPs)
16.1 IHPs set out
what support is required by a learner. They do not need to be long or
complicated. Governing bodies should ensure their healthcare needs policy
includes information on who has overall responsibility for the development of
the IHPs. IHPs are essential where healthcare needs are complex, fluctuating, long
term or where there is a high risk that an emergency intervention will be
needed. However, not all learners with healthcare needs require an IHP and
there should be a process in place to decide what interventions are most
appropriate. The following diagram outlines the process for identifying whether
an IHP is needed.
In most cases, especially concerning short-term
illnesses such as those requiring a course of antibiotics, a detailed IHP may
not be necessary. In such circumstances it may be sufficient to record the name
of medication, dosage, time administered and any possible side effects. These
procedures should be confirmed in writing between the learner (where
appropriate), the parents and the education setting.
However, when a learner has continual or
episodic healthcare needs, then an IHP may be required. If these needs are
complex and the learner is changing settings, then preparation should start
early to help ensure the IHP is in place at the start of the new term.
16.2
Roles and responsibilities in the creation and management of
IHPs
16.2.1 IHPs do not need to be complex but they should explain
how the learner’s needs can be met. An IHP should be easily accessible to all
who need to refer to it, while maintaining the required levels of privacy. Each
plan should capture key information and actions required to support the learner
effectively. The development of detailed IHPs may involve:
·
the learner
·
the parents
·
input or information from previous education
setting
·
appropriate healthcare professionals
·
social care professionals
·
the Headteacher and/or delegated responsible
individual for healthcare needs across the setting
·
teachers and support staff, including
catering staff
·
any individuals with relevant roles such as a
first aid coordinator, a well-being officer, and special educational needs coordinator
(SENCo).
While the plan should be tailored to each individual learner, it may include:
·
details of the healthcare need and a
description of symptoms
·
specific requirements such as dietary requirements,
pre-activity precautions (e.g. before physical education classes)
·
medication requirements, e.g. dosage, side
effects, storage requirements, arrangements for administration
·
an impact statement (jointly produced by a
healthcare professional and a teacher) on how the learner’s healthcare condition
and/or treatment affects their learning and what actions are required to
mitigate these effects
·
actions required
·
emergency protocols and contact details
·
the role the education setting can play, e.g.
a list of things to be aware of
·
review dates and review triggers
·
roles of particular staff, e.g. a contact
point for parents, staff responsible for administering/supervising medication,
and arrangements for cover in their absence
·
consent/privacy/sensitive information-sharing
issues
·
staff training needs, such as with regard to healthcare
administration, aids and adaptive technologies
·
record keeping ‒ how it will be done, and
what information is communicated to others
·
home-to-school transport ‒ this is the
responsibility of the local authority, who may find it helpful to be aware of
the learner’s IHP and what it contains, especially in respect of emergency
situations.
16.2.2 .The aim of the plan is to capture the steps which need
to be taken to help a learner manage their condition and overcome any potential
barriers to participating fully in education. Those devising the plan should
agree who will take the lead, but responsibility for ensuring it is finalised
and implemented rests with the education setting. Many third sector
organisations have produced condition-specific template IHPs that could be
used.
16.2.3 Governing bodies should ensure the plans are reviewed at
least annually or more frequently should there be new evidence that the needs
of the learner have changed. They should be developed with the best interests
of the learner in mind and ensure the education setting, with specialist
services (if required), assess the risks to the learner’s education, health and
social well-being.
Where a learner has an SEN the IHP should be
linked or attached to any individual education plan, Statement of SEN, or learning
and skills plan.
16.3 Coordinating
information with healthcare professionals, the learner and parents
The way in which a learner’s healthcare needs
are shared with social and healthcare professionals depends on their
requirements and the type of education setting. The IHP should explain how information
is shared and who will do this. This individual can be a first point of contact
for parents and staff and would liaise with external agencies.
16.4
Confidentiality
It is important that relevant staff
(including temporary staff) are aware of the healthcare needs of their learners,
including changes to IHPs. IHPs will likely contain sensitive or confidential
information. The sharing and storing of information must comply with the Data
Protection Act 1998 and not breach the privacy rights of or duty of confidence
owed to the individuals.
16.5 The learner’s role in managing
their own healthcare needs
Learners who are competent to do so should be
encouraged to take responsibility for managing their own medicines and
procedures. This should be reflected within the learner’s IHP.
Where possible, learners should be allowed to
carry their own medication and relevant devices, or be able to quickly access
their medication. Some learners may require an appropriate level of supervision.
If a learner refuses to take their medicine
or carry out a necessary procedure, staff should not force them to do so, but
follow the setting’s defined arrangements, agreed in the IHP. Parents should be
informed as soon as possible so that an alternative arrangement can be
considered and health advice should be sought where appropriate.
16.6 Record keeping
16.61 All administration of medication must be recorded on the
appropriate forms. If a learner refuses their medication, staff should record
this and follow the defined procedures where parents will be informed of this
non-compliance as soon as possible.
16.6.2 The best
examples of record keeping include systems where the learner’s healthcare needs
records have been computerised to allow quick and easy access by the
appropriate staff. Data systems can also allow for easy access to the required
information for staff that may be placed into classrooms where they are not
familiar with the healthcare needs of the learners.
The operation of such systems must comply
with the Data Protection Act 1998
17. Unacceptable practice
it is not acceptable practice to:
it is not acceptable practice to:
·
prevent learners from attending an education
setting due to their healthcare needs, unless their attending the setting would
be likely to cause harm to the learner or others
·
prevent learners from easily accessing their
inhalers or other medication, and prevent them from taking their medication
when and where necessary
·
assume every learner with the same condition
requires the same treatment
·
ignore the views of the learner or their
parents, or ignore healthcare evidence or opinion (although these views may be
queried with additional opinions sought promptly)
·
send learners with healthcare needs home
frequently or prevent them from staying for normal activities, including lunch,
unless this is suitably specified in their IHP
·
send a learner who becomes ill or needs
assistance to a medical room or main office unaccompanied or with someone
unable to properly monitor them
·
penalise a learner for their attendance
record if the absence is related to their healthcare needs. ‘Authorised
absences’ including healthcare appointments, time to travel to hospital or
appointment, and recovery time from treatment or illness should not be used to
penalise a learner in any way. This includes, but is not limited to, participation
in activities, trips or awards which are incentivised around attendance
records
·
request adjustments or additional time for a
learner at a late stage. They should be applied for in good time. Consideration
should also be given to adjustments or additional time needed in mock
examinations or other tests
·
prevent learners from drinking, eating or
taking toilet or other breaks whenever needed in order to manage their
healthcare needs effectively
·
require parents, or otherwise make them feel
obliged, to attend the education setting, trip or other off-site activity to
administer medication or provide healthcare support to the learner, including for
toileting issues
·
expect or cause a parent to give up work or
other commitments because the education setting is failing to support a
learner’s healthcare needs
·
ask a learner to leave the classroom or
activity if they need to administer
non-personal medication or consume food in line with
their health needs
·
prevent or create unnecessary barriers to a
learner’s participation in any aspect of their education, including trips, e.g.
by requiring a parent to accompany the learner.
17.1 Please see the
‘Unacceptable Practice’ section in the Welsh Government’s ‘Supporting Learners
with Healthcare Needs’ statutory guidance: http://learning.gov.wales/resources/browse-all/supporting-learners-with-healthcare-needs/?lang=en
[9] The duty to make reasonable
adjustments under the Equality Act may apply depending on the circumstances.
[11] Intimate care can be defined as any care which
involves washing or carrying out a procedure to intimate personal areas which
most people usually carry out themselves but some learners are unable to do
because of their young age, physical difficulties or other special needs.
Examples include care associated with continence and menstrual management as
well as day-to-day tasks such as help with washing, toileting or dressing. It
also includes supervision of learners involved in intimate self-care.
[12] Please
note this circular will be revised in spring 2017. The current version can be
accessed at www.wales.nhs.uk/sites3/page.cfm?orgid=465&pid=11930
[16] learning.gov.wales/resources/browse-all/national-reading-and-numeracy-tests-administration-handbook/?lang=en
[17] The Learner Travel (Wales) Measure
2008.
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