Healthcare in schools: draft guidance

Guidance for NHS boards, education authorities and schools on supporting children and young people with healthcare needs in schools.

Chapter 5 - Circumstances Where a School May Need to Make Special Arrangements for Supporting Children and Young People with Healthcare Needs

The need to make reasonable adjustments

118. Staff in schools and the wider school health team must make reasonable adjustments to ensure that children and young people with healthcare needs are enabled to participate in the opportunities that learning provides. Where safety permits, this includes including school trips, sporting activities and work placements.

School trips and other outdoor learning activities

119. Plans for school trips and other outdoor learning should take the healthcare needs of all children and young people into account from the outset. As part of this, school staff may wish to work with the disabled children and young people and their parents, who will have experience of taking their children on trips and outings or learn from the experiences of other schools to ensure that everyone is able to benefit from the trip activity. Risk assessments should be carried out in advance and take into account the healthcare support needs of all children and young people who are attending and how they would benefit from participating. The assessment should take into account the real risks involved, and identify proportionate actions and reasonable adjustments that ensure the participation of children and young people wherever possible.

120. The planning process should take into account the appropriate lines of communication in an emergency. The arrangements for taking any necessary medication will also need to be taken into consideration. Sometimes an additional supervisor or parent might be invited to accompany a particular child to ensure that child or young person is able to attend and participate in the trip or activity.

121. Staff supervising excursions should be aware of a child's needs, and relevant emergency procedures, and information about the child or young person's medical needs and medication should be accessible in the event of an emergency.

122. If staff are concerned about whether they can provide for a child's safety, or the safety of other children or young people on a trip, they must seek advice in advance. Such advice may come from a parent or carer, a member of the school health team, the child's GP or EA. The Scottish Government published information about Health and Safety on Educational Excursions. [80]

Sporting activities

123. Most children and young people with healthcare needs can participate in extra-curricular sport or in physical education. However, some activities may need to be assessed and modified with precautionary measures or reasonable adjustments that may need to be taken, e.g. children with asthma may need to take their reliever inhaler before exercise. Teachers should be aware of which children and young people have specific health needs and be included in the arrangements for planning support where appropriate. Any restrictions to a child or young person's ability to participate should be noted in their individual healthcare plan and considered as part of any risk assessment of the activity.

Work placements and vocational pathways delivered through school-college partnerships

124. Again, where appropriate, children and young people with healthcare needs should receive the appropriate support to enable them to make the most of any work experience or college placements. When a work placement has been arranged it is the responsibility of the work placement organiser to ensure that the placement is suitable for the individual with a particular medical condition. Similar considerations apply when a child or young person attends another establishment for part of their course. In both circumstances the school management team should ensure that organisers are aware of relevant medical conditions, all reasonable adjustments are in place and ensure that a risk assessment is carried out so that the individual's needs are met appropriately and proportionately. Children and young people may also be encouraged to share relevant medical information with employers.

125. When children and young people attend college as part of the arrangements made for their education, the education authority should liaise with the college to ensure that any are supported in line with the policy framework, taking account of the Scottish Funding Council's annual guidance to the sector [81] .


126. Education authorities arrange home to school transport where legally required to do so. It may also provide transport in other situations, for example, to and from a school trip. In all circumstances, consideration needs to be given to ensuring that the specific healthcare needs of the children and young people are supported when they are travelling.

127. Transport escorts and others should only be provided with the information necessary for them to meet the health and wellbeing needs of the child or young person. It may be necessary to ensure that the driver or any accompanying adults have access to a phone to ensure they are able to call an ambulance in the event of an emergency. Again, these arrangements should be covered in an individual healthcare plan, considered as part of any risk assessment and are covered by the duty to make reasonable adjustments.


Email: Laura Meikle

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