Medical needs policy

Wherever possible, we believe all young people, including those with health needs, should be supported to learn in their substantive school alongside their peers.  This should include access to a broad and balanced curriculum, suitable for their age ability and aptitude.

Education professionals share the responsibility for providing support for children and young people during periods of ill health, whether physical or mental.  This includes those working in schools and academies, school support teams and the LA. Each has a part to play in supporting children and young people to access their statutory right to education.

By law, governing bodies or trustees must have a policy to show how they will support and provide for pupils with medical needs. This should include the arrangements schools will have in place to support pupils with medical conditions and include:

• the process for early identification
• nature and range of support available
• reasonable adjustments to the learning and physical environment
• how pupils can access this support
• the role of individual health care plans
• a named staff member with responsibility for pupils with ill health

The law also requires maintained schools and academies to make arrangements to support pupils with medical conditions. Schools should use all available resources, including the pupil premium where available.  They should aim to keep a pupil in school through the development of a bespoke learning package.  This may include virtual learning and blended learning opportunities.

Healthcare plans can help to ensure that schools effectively support pupils with medical conditions, in terms of both physical and mental health.  They provide clarity about what needs to be done, when and by whom. 

They are often essential.  For example, in cases where:

• conditions fluctuate
• there is a high risk that emergency intervention will be needed

A plan is likely to be helpful in the majority of cases, especially where medical conditions are long-term and complex. The school, healthcare professional and parent or carer should agree, based on evidence, when a healthcare plan is required. If consensus cannot be reached, the headteacher is best placed to take a final view.  

Governing bodies should ensure that the school’s policy covers:

• the role of individual healthcare plans
• who is responsible for their development in supporting pupils at school with medical conditions

The governing body must ensure healthcare plans are reviewed annually, or sooner if there is evidence changing needs. Plans should be developed:

• with the child or young person’s best interests in mind
• to ensure that the school assesses and manages risks to the child’s education, health and social wellbeing, and minimises disruption

Further information regarding the use of healthcare plans can be found in supporting pupils at school with medical conditions.

Pupils with mental health needs

The DfE's mental health and behaviour in schools states that 'all schools are under a statutory duty to promote the welfare of their pupils, which includes: preventing impairment of children’s health or development'. It identifies that schools have a central role to play in:

• enabling pupils to be resilient
• actively promoting their mental health and wellbeing

Pupils with mental health needs may exhibit behaviours that present a barrier to their learning and engagement in school. Behaviours could appear as:

• negative and challenging, including refusal to engage with learning opportunities
• non-co-operation with school staff

Alternatively, a pupil may present as withdrawn, anxious and isolated. The school environment should be a significant protective, not a risk factor, for children and young people who experience difficulties with their mental health. Governors and school staff should consider this in their responses to such behaviours.

Some pupils experiencing a period of poor mental health may also self-harm. School staff should be aware of and robustly follow their safeguarding duties wherever this is the case. The Lincolnshire Children's Safeguarding Partnership model policy on banned items provides advice to schools on responding to incidents where a pupil is found in possession of banned items for the purpose of self-harm.

There is a range of mental health support available in Lincolnshire for schools to access as part of their support for pupils:

Here4You

Offers an advice and self-referral line for parents/carers of children and for young people (aged 13 or over), who are struggling with their emotional or mental health and are not currently being supported by Healthy Minds, MHST or CAMHS.  There is also an online self-referral form and access to information about online workshops, websites and tips from young people to young people.  

Healthy Minds

Provides emotional wellbeing support for children and young people up to 19 years old (or 25 years old for young people with SEND or are a care leaver). The support offered is based on cognitive behavioural therapy (CBT).

Mental Health Support Teams (MHST)

An expanding service designed to help meet the mental health needs of children and young people in selected education settings. Teams are made up of clinical lead practitioners and education mental health practitioners (EMHPs). They work collaboratively with selected education settings.

Child and Adolescent Mental Health Service (CAMHS)

This is designed to meet a wide range of moderate to severe mental health needs in children and young people. These will include moderate, acute and severe, complex or enduring mental health problems or disorders that are causing significant impairments in their lives. 

The CAMHS crisis and enhanced home treatment team (CCETT) provides crisis intervention for young people actively displaying:

• suicidal ideation or following suicide attempts
• severe symptoms of depression with suicidal ideation
• life threatening harm to self
• harm to others as a result of a mental health concern
• acute psychotic symptoms
• presentation of anorexia with severe physical symptoms

Where involved, the CCETT and CAMHS team would work together to support a child or young person and their family. 

Our role as the local authority

Arranging education for children who cannot attend school because of health needs provides statutory guidance on our duties to this cohort of pupils.

The statutory guidance states that there can be a range of circumstances where a child or young person has a health need. They will still receive a suitable education that meets their needs without our intervention, for example:

• where the pupil can still attend school with some support
• where the school has made arrangements to deliver suitable education outside of school for the pupil
• where arrangements have been made for the pupil to be educated in a hospital by an on-site hospital school

Our head of service for inclusion, Kate Capel, is our children’s service designated officer. This role is responsible for providing education for children or young people unable to attend school because of medical needs. Contact the head of service at PRT@lincolnshire.gov.uk.

To support schools and academies in discharging their duties, there are a wide range of resources which schools can access through Lincolnshire's Local Offer to further support pupils with health needs to access their education.