New guidance on providing medical support for pupils has been published amid fears that schools are being pressured to make up for poor local health services.
The advice has been launched by the National Association of Head Teachers (NAHT). The union said it strongly supports inclusive education believes children with medical conditions must be able to access and thrive in school.
But it warned that too many schools are being left to plug gaps as local health services have become increasingly stretched, leaving staff under pressure and without the expertise to offer support.
There was a growing mismatch between what the law requires and what schools are being asked to do in practice, the NAHT said, and it feared the issue could undermine the government’s reforms to the SEND system, with mainstream schools supporting more children with additional needs.
Medical interventions carried out in school include everything from administering medication to respiratory and cardiac monitoring, catheter and stoma care, tube feeding and use of hoists.
The NAHT said while some tasks could be delegated to schools with clear, robust arrangements in place, responsibilities, accountability and legal authority were often unclear, and a model had emerged that was overly-reliant on the education sector, creating risks for children and school staff.
It said some healthcare should only be delivered by qualified healthcare professionals.
Time away from class
Currently, school staff may be removed from classrooms to provide care which can require two adults, taking them away from the pupils and reducing teaching time.
The union said it had raised concerns with the government, but the promised new national guidance was delayed and unlikely to appear before the start of the next school year.
The NAHT’s guidance offers members clarity on the existing legal position.
It is an entirely appropriate and reasonable expectation that young people with complex medical needs should be supported by a health service
It follows a motion which was debated at NAHT’s annual conference in May on the ‘inappropriate at best, and unlawful at worst practice involved in pressuring education staff and settings to mitigate inadequacies in local health commissioning and resourcing’.
Paul Whiteman, NAHT’s general secretary, said: “Teachers and support staff are not medical practitioners.
“We hear increasingly from school leaders that they are being pressured to deliver healthcare without the necessary expertise and support, and there are instances where what they are being expected to do is simply inappropriate” Whiteman said.
“School staff are dealing with this issue right now, and they need help.
“This is not about basic tasks like first-aid or providing a sugary drink to a diabetic child – this is specialist, time-intensive support. Itis only a matter of time before something goes very wrong.
“Like schools, NHS services and local authorities face severe financial pressures, but they have a responsibility to arrange healthcare within the existing statutory framework.
“More investment is needed to ensure medical professionals are consistently available to support pupils with the most complex needs – especially given the government’s expectation that mainstream schools should accommodate more children with SEND.”
Statutory duties
The NAHT’s guidance outlines statutory duties across education, health and local government, and highlights the importance of legally-sound delegation of tasks to schools, covering clearly defined responsibilities and accountability, training, competency and risk assessments, supervision, monitoring, and appropriate insurance arrangements.
It contains advise for school leaders on how to identify and challenge arrangements that may be unsafe or non-compliant, and on securing lawful, sustainable and child-centred provision.
Marijke Miles, head teacher at Baycroft School, a special school in Fareham, Hampshire, and chair of NAHT’s SEND Council, said: “This guidance will help ensure that no child is subject to a two-tier health system where being school-age means they receive an inferior health provision.
“It is an entirely appropriate and reasonable expectation that young people with complex medical needs should be supported by a health service, not an education service.”
