Supporting learners with healthcare needs policy

We are committed to supporting learners with healthcare needs so that they have full access to education, including all offsite activities and physical education.

List of contents

1. Key principles

Swansea Council is committed to supporting learners with healthcare needs so that they have full access to education, including all offsite activities and physical education.

We work with parents / carers, learners and relevant professionals to ensure the needs of the learner with healthcare needs are properly understood and effectively supported. We do this through listening to the views and wishes of the learner and parent as well as the advice of education and health professionals.

Where possible we work together with schools to support the learner to build understanding and confidence so that they can increasingly self-manage their care needs depending on their ability to do so.

We make sure staff in education settings have access to appropriate training so that learners' healthcare needs are properly supported.

We understand that all learners with healthcare needs are entitled to a full education and Swansea Council has due regard to the United Nations Convention on the Rights of the Child (UNCRC). When making arrangements to meet a learner's health care needs we consider the impact on their education, attainment and wellbeing. Any arrangements also consider wider safeguarding duties whilst seeking to ensure all learners have access and enjoy the same opportunities.

Under the Equality Act 2010 we make reasonable adjustments to comply with the duties of the act so as not to discriminate against disabled learners.

2. LA's legal requirements

The LA must have regard to the guidance set out in Welsh Government guidance Supporting Learners with Healthcare Needs, document no: 215/2017 when carrying out its duties in promoting the welfare of children and young people, including meeting their health care needs (Section 175, Education Act 2002).

Under section 19(1) Education Act 1996 the LA must provide suitable education for learners of compulsory school age who may not receive it due to healthcare needs such as illness or otherwise.

The Social Services and Wellbeing Act 2014 places a duty on LAs to provide preventative services and make arrangements to promote cooperation between agencies and providers.

The Equality Act 2010 places a duty of the LA to make reasonable adjustments and prepare and implement an accessibility strategy which aims to:

Increase participation of disabled learners
Improve physical environments of schools to improve accessibility
Improve the delivery of information which is readily accessible.

Swansea was one of the first authorities to recognise the United Nationals Convention on the Rights of the Child and as part of its Equality Impact Assessments includes the impact on children's rights.

The LA has a duty to comply with the regulations of General Data Protection Regulation (GDPR) 2016 and Learner Travel (Wales) Measure 2008.

Furthermore the LA pays due regard to the Wellbeing of Future Generations (Wales) Act 2015 and in particular the five ways of working ensuring policy and practice balance short-term needs with longer term sustainable goals. We also try to assess the impact of policy objectives on the wellbeing goals of other agencies and Welsh government. We involve key stakeholders in the development of policy and collaborate with others to help meet our wellbeing objectives through a preventative approach.

3. Roles and responsibilities - outline the roles and responsibilities of the following:

Local authority

The local authority (LA) works with schools, the local health boards, parents / carers and carers and learners to ensure healthcare needs are identified and appropriate arrangement made to meet those needs.

The local authority will:

i. Work with schools to ensure learners with healthcare needs receive a suitable education.
ii. Make arrangements to provide suitable education where a learner of compulsory school age would not receive suitable education for any period because of their health.
iii. Make reasonable adjustments to ensure disabled children and young people are not substantially disadvantaged compared with their peers. This will include the development of an Accessibility Strategy.
iv. Promote cooperation between various bodies so as to improve the physical and mental wellbeing of learners including making arrangements to share information.
v. Make reasonable provision of counselling services for young people aged 11-18 and learners in primary schools.
vi. Provide support, advice and guidance, including how to meet the training needs of school staff, so that governing bodies can ensure the support specified within the individual healthcare plan.
vii. Provide home to school transport in accordance with the Learner Travel (Wales) Measure 2008 and Swansea Council's Home to School Transport Policy.

Director of Education

The Director of Education is responsible for ensuring the council has a Supporting Learners with Healthcare Needs Policy and all schools publish a School Healthcare Needs Policy. The Director should also seek to ensure all schools have:

An Accessibility Plan
Admissions Policy

The Director of Education is also responsible for ensuring the authority has an Accessibility Strategy under the Equality Act 2010 which sets out how the authority will improve 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'.

The Director of Education ensures key services including Education Welfare Officers, Inclusion Support Officer, Child Protection Coordinator, schools and governing bodies are aware of their responsibilities regarding learners with healthcare needs.

The responsibilities of schools and governing bodies are set out in the attached exemplar school healthcare needs policy.

4. Creating an accessible environment

Many learners will have a short term healthcare need at some point which may affect their participation in educational activities. Other learners may have significant or long term healthcare needs affecting their cognitive or physical abilities, their behaviour or emotional state. The LA has a duty to ensure that schools and PRUs promote inclusivity and accessibility in the fullest sense to all learners with healthcare needs. We are committed to creating an inclusive and accessible environment for all learners. Our plans for improving the accessibility of our schools are laid out in the Local Authority's Accessibility Strategy and Accessibility Plan - Guidance for Schools. Every school should develop a school accessibility plan, following the LA guidance to outline how they are creating an accessible environment for all learners.

The LA supports schools to ensure they are making reasonable adjustments to ensure all learners are able to access all aspects of school life by providing appropriate auxiliary aids, services and trained staff.

a) All offsite activities

The LA encourages schools to actively support all learners with healthcare needs to participate in all offsite activities including trips and residential activities and make reasonable adjustments to trips and residential visits to ensure full participation from all learners.

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 learner¹. Schools must share appropriate information with offsite providers as needed with the permission of parents and carers and seeking the learner's views as well.

b) Social interactions

The LA encourages schools to take a proactive approach to ensuring learners with healthcare needs are included in structured and unstructured social activities, such as during breaks, breakfast club, productions, after-hours clubs and residential visits. Staff must be made aware of potential barriers to inclusion and make reasonable adjustments to ensure inclusion.

The LA encourages schools to have a strong ethos which promotes inclusion and the rights of the child and use restorative approaches to tackle the potential problems of bullying and social exclusion.

c) Exercise and physical activity

The LA understand the importance of all learners taking part in physical activities and encourages schools to make appropriate adjustments to sports and other activities to make them accessible to all learners, including after-hours clubs and team sports.

Schools must ensure that staff are aware of the healthcare needs of learners when planning physical activities and seek the views of the learner, their parents / carers and health professionals when planning. Where possible schools must ensure all physical activity is accessible to all learners.

d) Food management

The LA encourages schools to take careful consideration to the dietary needs of learners with healthcare needs and ensure kitchen staff are able to provide lists of ingredients and display any potential allergens for the meals they supply. Schools must understand that learners with healthcare needs may need to eat and drink in class and have snacks available.

It is paramount that the dietary and food intake requirements of individual learners will be set out in their individual healthcare plan and communicated to all staff.

e) Risk assessments

The LA encourages that all activities in schools are appropriately risk assessed and formally recorded by appropriate staff members. Specific risk assessments will be undertaken with all pupils with specific healthcare needs in full consultation with the parent / carer and appropriate healthcare professional and include the views of the learner where possible.

5. Sharing information

Our local authority policy is available online and as a hard copy on request. Links to the policy are available through the Swansea School's newsletter and is available on the Swansea Council website. It is also shared within the ALN network group via Hwb.

When sharing information with others we comply with the EU's General Data Protection Regulations 2018.

Parents / carers are asked to sign a consent form which clearly details the bodies, individuals and methods through which their learner's medical information will be shared. The learner will also be involved in decisions about sharing medical information. The school keeps a record of what information is being shared and with whom.

6. Procedures and record keeping for the management of learners' healthcare needs

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.

Contact details for emergency services.
Parental agreement for educational setting to administer medicine.
Head of educational setting agreement to administer medicine.
Record of medicine stored for and administered to an individual learner.
Record of medicines administered to all learners by date.
Request for learner to administer own medicine.
Staff training record - administration of medicines.
Medication incident report.

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'. Electronic versions can be found on the Welsh Government website.

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.

Schools should ensure that the public are not able to access the data, and if this is not possible, this should be made clear to parents at the time of gaining consent with risks clearly set out. Parents need to provide consent for schools to display photographs and information about their medical needs on display boards.

Teachers, supply teachers and support staff (this may include catering staff and relevant contractors) 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:

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 rights to privacy must be taken into account.
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.

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 they 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, eg. 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.

All administration of medication must be recorded on the appropriate forms as outlined in the Welsh Government guidance issued March 2017. 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.

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 General Data Protection Regulations 2018.

7. Storage, access and the administration of medication and devices

a) Supply of medication or devices

Settings should not store surplus medication. Parents should be asked to provide appropriate supplies of medication. These should be in their original container, labelled with the name of the learner, medicine name, dosage and frequency, and expiry date. Settings should only accept prescribed medicines and devices that:

i. are in date
ii. have contents correctly and clearly labelled
iii. are labelled with the learner's name
iv. are accompanied with written instructions for administration, dosage and storage
v. are in their original container / packaging as dispensed by the pharmacist (with the exception of insulin which is generally available via an insulin pen or a pump).

The LA does not recommend the supply of non-prescribed medicines such as liquid paracetamol, and settings should not administer aspirin or its derivatives unless it is prescribed. Parents can request that a non-prescribed medicine other than aspirin is stored by the school but only if the medicine:

i. is in date
ii. has its contents correctly and clearly labelled
iii. is labelled with the learner's name
iv. is accompanied with written instructions for administration, dosage and storage - this can be from the parent
v. is in its original container / packaging.

b) Storage, access and disposal

All medicines should be stored safely dependent on the type and use of the medication, which may include refrigeration. It is important for staff and learners to know where their medication is stored and how to access it.

i. Emergency medication

Settings should ensure emergency medication such as inhalers and auto-injector pens are readily available and not locked away. If a learner is competent to do so, they may have their medicine with them but must not pass it to an unauthorised person. A request for the learner to carry / administer their own medicine can be submitted by the parent / carer and will be discussed with relevant staff. If staff have concerns then the parent / carer should discuss these with healthcare professionals. Any request is subject to review if further concerns / risks are highlighted. The provision of emergency medication and its security are also part of the planning of offsite activities including trips and residential activities.

Schools are encouraged to hold an emergency salbutamol inhaler for situations where a learner is unable to locate their own inhaler. Guidance on the use of emergency salbutamol inhalers can be found at: Guidance on the use of emergency salbutamol inhalers in schools. Emergency inhalers are purchased from our local community pharmacy.

ii. 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 will be applied as guided by specialist health staff.

iii. Disposal of medicines

When no longer required, medicines should be returned to parents to arrange safe disposal. Sharp boxes should be used for the disposal of needles and other sharp instruments, and arrangements made to be disposed of appropriately.

c) Administration of medicines

i. Where the learner is under 16, assistance or administration of prescribed or non-prescribed medicines requires written parental consent. The administration of all medication should be recorded.
ii. 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, such as before and after school and in the evening. There will be instances where this is not appropriate though.
iii. Learners under 16 will never be given aspirin or its derivatives unless prescribed to them.
iv. Unless there is an agreed plan for the learner to self-medicate (16 years and above), all medication should be administered by a member of staff in accordance with the IHP.
v. Medication should only be administered by suitably trained staff. The movement and location of these trained staff should always be in conjunction with the learners they support.
vi. Staff should check the maximum dosage and the amount and time of any prior dosage administered.
vii. 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 should be considered when providing intimate care. There is no requirement in law for there to be more than one person assisting². This should be agreed and reflected in the IHP and risk assessment.
viii. The school should have an intimate care policy³ which should be followed, unless alternative arrangements have been agreed, and recorded in the learner's IHP.
ix. 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.
x. 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 as equal an experience for the learner as is practicable and reasonable. 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

The authority recommends that all education settings should have procedures in place for handling emergency situations. Staff should know:

i. who is responsible for the policy and procedures
ii. nominated first aiders and how to deal with common healthcare needs. In situations requiring emergency assistance, 999 should be called immediately.
iii. the location of learners' healthcare records and emergency contact details.

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.

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.

9. Training

The governing body and headteachers are responsible for ensuring there is a sufficient number of staff identified to meet the healthcare needs of all children and young people in education settings across Swansea. Staff who volunteer or who are contacted to support those with healthcare needs in education settings should be provided with appropriate training.

When assisting learners with their healthcare needs, it is 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.

However, where IHPs reflect complex needs requiring staff to have specific information and training the LA works with health or other agencies to secure appropriate training. Appendix 1 provides a list of health staff who can be contacted to provide training in key areas such as diabetes, asthma, allergies and epilepsy. The LA will monitor how training is recorded and kept up to date in the education settings it maintains and will gather this information in a survey basis.

It is recognised that 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. We therefore have a programme of training to raise awareness and understanding of common conditions to ensure recognition of symptoms and understand where and when to seek appropriate assistance.

The LA also provides training on the development of IHPs.

Schools induction procedures should make sure new and temporary staff are aware of what preventative and emergency measures are in place so they can recognise the need for intervention and react quickly.

If the trained staff who are usually responsible for administering medication are not available, the IHP will set out alternative arrangements.

10. Education other than at school (EOTAS)

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.

In the case of a short absence (likely to last for less than 15 school days) the 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. If the absence is likely to be longer than 15 school days the school should contact the LA Home Tuition Team so that they can arrange appropriate education otherwise than at school.

Where absences are anticipated or known in advance, close liaison between the school and LA should enable the EOTAS service to be provided from the start of absence.

Close liaison between home / hospital teachers and mainstream teachers underpins the provision of an effective educational programme for the learners. However, parents / carers 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.

11. School transport

School transport will be provided in line with the authority's Home to School Transport Policy under the Learner Travel: Statutory Provision and Operational Guidance (2014) document.

Some children and young people with healthcare needs will be provided with transport to and from their school or setting. Transport is provided by the local authority based on set criteria, for example, distance and / or special educational needs.

The local authority will not normally administer medication to children or young people using transport to and from a school or setting. In most cases, if a medical emergency were to take place on transport, the driver would stop the vehicle and call 999. However, in circumstances where there is an identified and significant risk to a child or young person's health, Passenger Assistants (PAs) will be employed and trained to manage emergency situations and where necessary, administer emergency medication.

It is important therefore, that school transport and in turn, PA's are kept fully informed of a child or young person's medical condition and how to manage this, even where the PA will not be expected to administer emergency medication. In particular, where emergency medication has been administered within the previous 12 hours, schools and settings should inform the PA of this.

As such, schools and settings are encouraged to share the individual healthcare plan (IHP) with school transport, with parent consent, who in turn, can share this with the PA.

When schools or settings discuss the training needs of staff, they should give thought to the training a PA may require. Schools and settings should not use data protection concerns as a reason not to share relevant information with school transport.

Ultimately, it is the parent or carer's responsibility to ensure that any medication required during the school day is provided to the school. However, where transport is provided, particularly to special schools which are often some distance from the home, parents may ask a Passenger Assistant to deliver the medication. School transport will aim to support parents in this but each case will need to be risk assessed.

Where it is agreed that medication will be transported by the Passenger Assistant, this will need to be added to the route schedule and the parent will be asked to sign a consent form. Passenger Assistants will transport medication in a clear, portable and preferably, locked container that will be delivered directly to the school or setting office.

Passenger Assistants will be expected to keep accurate records of any medicines administered or self-administered on transport and share this information with the school or setting, or the parent. Usually, where emergency medicines are administered, this will be in conjunction with an emergency protocol which will involve stopping the vehicle and calling the emergency services.

Children and young people who are able to carry their own medicine safely on transport should be encouraged to do so, to increase their independence. This applies to all medicines, including asthma inhalers, epi-pens and insulin.

All schools and settings are encouraged to consider transport implications within their Supporting Learners with Healthcare Needs policy.

12. Reviewing policies, arrangements and procedures

Governing bodies should ensure all policies, arrangements and procedures are reviewed regularly by the education setting.

All IHPs will require frequent review, 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. All IHPs should be kept by schools and sent to the local authority representative to be recorded.

13. Insurance arrangements

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, for example, off-site activities for learners with particular needs.

The LA provides appropriate insurance cover for all maintained school settings with regard to children and young people with healthcare needs and administration of medication as long as school follow appropriate guidelines and training requirements as set out above and in the attached appendices.

14. Complaints procedure

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 procedure⁴, 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.

^{4 Section 29 of the Education Act 2002 at http://www.legislation.gov.uk/2002/32/section/29}

15. Individual healthcare plans (IHPs)

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:

i. the learner
ii. the parents
iii. input or information from previous school setting
iv. appropriate healthcare professionals
v. social care professionals
vi. the headteacher and / or delegated responsible individual for healthcare needs across the setting
vii. teachers and support staff, including catering staff
viii. any individuals with relevant roles such as a first aid coordinator, a wellbeing officer, and special educational needs coordinator (SENCo).

While the plan should be tailored to each individual learner, it may include:

i. details of the healthcare need and a description of symptoms
ii. specific requirements such as dietary requirements, pre-activity precautions (for example before physical education classes)
iii. medication requirements, for example dosage, side effects, storage requirements, arrangements for administration
iv. 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.
v. actions required
vi. emergency protocols and contact details
vii. the role of the education setting can play, for example a list of things to be aware of
viii. review dates and review triggers
ix. roles of particular staff, for example a contact point for parents, staff responsible for administering / supervising medication, and arrangements for cover in their absence
x. consent / privacy / sensitive information-sharing should be agreed
xi. staff training needs, such as with regard to healthcare administration, aids and adaptive technologies
xii. record keeping - how it will be done, and what information is communicated to others
xiii. 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.

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 school. Many third sector organisations have produced condition-specific template IHPs that could be used.

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 school, with specialist services (if required), assess the risks to the learner's education, health and social wellbeing.

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.

A copy of all IHPs will be sent to the Senior Specialist Teacher, c/o Additional Learning Needs Unit.

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 school. 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.

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.

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 learners 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. Unacceptable practice

It is not acceptable practice to:

i. Prevent learners from attending school due to their healthcare needs, unless their attending would be likely to cause harm to the learner or others.
ii. Prevent learners from easily accessing their inhalers or other medication, and prevent them from taking their medication when and where necessary.
iii. Assume every learner with the same condition requires the same treatment.
iv. Ignore the views of the learner or their parents / carers, or ignore healthcare evidence or opinion (although these views may be queried with additional opinions sought promptly).
v. 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.
vi. 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.
vii. 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.
viii. Request adjustments or additional time during examinations 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.
ix. Prevent learners from drinking, eating or taking toilet or other breaks whenever needed in order to manage their healthcare needs effectively.
x. Require parents / carers, or otherwise make them feel obliged, to attend the school, trip or other off-site activity to administer medication or provide healthcare support to the learner, including for toileting issues.
xi. 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 need.
xiii. Prevent or create unnecessary barriers to a learner's participation in any aspect of their education, including trips, for example by requiring a parent to accompany the learner.

Schools will be made aware of the above, through the Local Authority Policy, as set out in the Welsh Government guidance document (Supporting learners with healthcare needs, 215/2017) which in turn, informs School Policy to prevent unacceptable practice occurring.

Staff will be made aware of unacceptable practice through briefings, ALNCO Network meetings and made available online through the Hwb ALN Network group.

Please see the 'Unacceptable Practice' section in the Welsh Government 'Supporting Learners with Healthcare Needs' statutory guidance

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Last modified on 14 July 2022

Supporting learners with healthcare needs policy

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