Supporting children and young people with healthcare needs in schools: guidance

This is a guidance document for NHS Boards, education authorities and schools about 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

131. Staff in schools and the wider school health team must make reasonable adjustments for children and young people with disabilities, in line with the provisions of the Equality Act 2010, 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 school trips, sporting activities and work placements. On paragraph 6.48 of the EHRC Technical Guidance for Schools [95] it states that schools are not required to eliminate all risk. Suitable and sufficient risk assessments should be used to help the school to determine where risks are likely to arise and what action can be taken to minimise those risks. Risk assessments should be specific to the individual pupil and the activities in question. Proportionate risk management relevant to the disability should be an ongoing process throughout a disabled pupil's time at the school.

School trips and other outdoor learning activities

132. 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 children and young people with healthcare needs 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. School management teams should ensure 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. Risk assessments for trips abroad should also take into account additional circumstances e.g. the need for a nurse to accompany the child or young person.

133. The planning process should take into account the appropriate lines of communication in an emergency. The arrangements for taking, and storing, 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.

134. 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.

135. 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 Education Authority. The Scottish Government published information about Health and Safety on Educational Excursions [96] .

Sporting activities

136. Most children and young people with healthcare needs can participate in extracurricular 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.

Social/fund raising activities

137. Children and young people with healthcare needs should be encouraged to fully participate in class social or fund-raising activities. Some of the activities are likely to involve food, such as charity bake sales, which can bring potential risks to children with severe food allergies. Teachers should be aware of those allergies with the aim of eliminating the risk of children coming into contact with food they are allergic to when purchasing food for a special event such as a class Christmas party. School staff should also be consider those healthcare needs when inviting pupils and/or parents to bring in home baking for class bake sales.

Work placements and vocational pathways delivered through school-college Partnerships

138. 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 (see paragraph 88 above on sharing information and confidentiality), 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.

139. 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 [97] .


140. 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.

141. 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. More detailed information on planning transport is contained in Chapter 6 of the guidance for educational excursions (see footnote 96 above).


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