All-in-one care plan for school children There is a ‘pivotal role’ for school nurses in the new system for children with special educational needs and health conditions, reports Jennifer Trueland
SUMMARY
In what has been billed as the biggest reform in special educational needs in 30 years, nurses and other health professionals will play a larger role in meeting the needs of children with disabilities or additional needs. From this month the old system of ‘statements’ and other assessments ends, to be replaced by a single education, health and care (EHC) plan (see panel for a summary of the reforms). The aim is to force the different care and support agencies to work together in the best interests of the child, to remove duplication and to improve collaboration. According to Wendy Nicholson, a professional officer for school and community nursing at the Department of Health (DH) in England, school nurses have a ‘pivotal role’ in the development of EHC plans. She says they are ideally placed in local communities to work with schools, children and families. ‘They have specialist skills and knowledge to be able to
help parents navigate their way through the health and social care system. This is something parents find invaluable, particularly at times of stress or during transition phases in the child’s life.’ Ms Nicholson stresses that the guidance does not place any additional burden on school nursing services, but rather clarifies the roles and responsibilities of all the
FOR SCHOOL NURSES IT IS A GREAT OPPORTUNITY TO SUPPORT CHILDREN BY LOOKING AT THE WHOLE CHILD
Government reforms introduced this month aim to streamline and improve the support given to school children with special educational needs, disabilities or medical conditions. They place legal responsibilities on school nurses who will have a pivotal role in their implementation. Author Jennifer Trueland is a freelance journalist
20 september 10 :: vol 29 no 2 :: 2014
Nurses may have to contribute to the assessment process that will go into drawing up a child’s EHC plan, notes Ms Fitch. In addition, there will be a legal requirement for school nurses to help schools fulfil their new obligations to support pupils with medical conditions. ‘For school nurses, the reforms are a great opportunity to support children much better by looking at the whole range of needs, not just the health needs,’ says Ms Fitch. ‘It’s about looking at the whole child.’ Dan Leighton, policy and parliamentary officer at the National Autistic Society, says: ‘This has the potential to
different agencies, removing duplication and promoting a more collaborative delivery. ‘This has to be better for the child and family,’ she adds. ‘And it makes it easier for parents, who can sometimes find it difficult to understand the different roles and responsibilities within health, education and social care. The reforms offer consistency and a more streamlined approach.’ Kate Fitch, deputy director of policy with the deafblind charity Sense, believes there is a need to raise awareness among healthcare professionals. ‘I’m not sure how much knowledge there is in health care that big changes are happening,’ she says. ‘Health professionals will have legal requirements to fulfil.’
improve the lives of children and young people with autism across England.’ But he agrees it is vital that nurses and other health professionals get the resources they need to understand and implement the changes.
e-learning
Ms Nicholson says the DH is taking action to improve awareness among nurses. ‘We are developing a professional partnership pathway, which aims to clarify the role of the school nurse and provide examples of good practice, together with links to useful resources, guidance and training resources. We envisage this will be available in the autumn. ‘Additionally, we have commissioned the development of new e-learning aimed at
NURSING STANDARD
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GETTY IMAGES
HOW THE PLAN WILL AFFECT CHILDREN AND YOUNG PEOPLE From September 1, the system of statements of special educational need (SEN) and learning difficulty assessments was replaced by a single education, health and care (EHC) plan for children and young people with complex needs (tinyurl.com/npq39fn). The EHC plan places more emphasis on personal goals and there will be support for those aged up to 25 in further education – replacing the previous ‘cliff edge’ where it was cut off at age 16. Parents with a plan will have the option to have a personal budget to pay for the support that has been deemed necessary in the assessment. health visitors and school nurses to extend their knowledge and support those new to this area of work. The material will be developed with professionals and experts, and we anticipate it will be ready for early spring.’ Alison Barlow, a school nurse in Leicester, says that she and her colleagues are already helping their schools to meet the new
NURSING STANDARD
Local authorities and health services will be required to link together services for disabled children and young people so they are jointly planned and commissioned. And local authorities will have to publish a ‘local offer’ showing the support available to disabled children and young people and those with SEN and their families. Plus a system of mediation will be introduced for disputes. If a child already has a statement or a learning difficulty assessment, they will be transferred to the new system within the next three and a half years – probably at some natural point of
statutory requirements for medical conditions. But she concedes there is less awareness of the special educational needs reforms. ‘There are a lot of changes around school nursing at the moment – including how we are commissioned. Obviously, we’ll be interested to see if the reforms help children and their families,
transition, such as moving from primary to secondary education. Support for SEN children will also be introduced to schools, nurseries and colleges to replace School Action, School Action Plus and equivalents (for children without an EHC plan). The Children and Families Act 2014 also places a duty on schools to make arrangements to support pupils with medical conditions (tinyurl. com/mgmkx6c). The guidance says that school nurses are responsible for notifying the school when a child has been identified as having a medical condition, such as diabetes or asthma, which may require support in school.
but it’s a challenging time.’ Ms Nicholson believes it will be worth it. ‘It is important to provide seamless support to improve health and wellbeing outcomes,’ she says. ‘We know school nursing teams have an amazing track record of doing this already, so it will be a case of embracing the opportunities the new guidance offers’ NS september 10 :: vol 29 no 2 :: 2014 21
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SUMMARY
In what has been billed as the biggest reform in special educational needs in 30 years, nurses and other health professionals will play a larger role in meeting the needs of children with disabilities or additional needs. From this month the old system of ‘statements’ and other assessments ends, to be replaced by a single education, health and care (EHC) plan (see panel for a summary of the reforms). The aim is to force the different care and support agencies to work together in the best interests of the child, to remove duplication and to improve collaboration. According to Wendy Nicholson, a professional officer for school and community nursing at the Department of Health (DH) in England, school nurses have a ‘pivotal role’ in the development of EHC plans. She says they are ideally placed in local communities to work with schools, children and families. ‘They have specialist skills and knowledge to be able to
help parents navigate their way through the health and social care system. This is something parents find invaluable, particularly at times of stress or during transition phases in the child’s life.’ Ms Nicholson stresses that the guidance does not place any additional burden on school nursing services, but rather clarifies the roles and responsibilities of all the
FOR SCHOOL NURSES IT IS A GREAT OPPORTUNITY TO SUPPORT CHILDREN BY LOOKING AT THE WHOLE CHILD
Government reforms introduced this month aim to streamline and improve the support given to school children with special educational needs, disabilities or medical conditions. They place legal responsibilities on school nurses who will have a pivotal role in their implementation. Author Jennifer Trueland is a freelance journalist
20 september 10 :: vol 29 no 2 :: 2014
Nurses may have to contribute to the assessment process that will go into drawing up a child’s EHC plan, notes Ms Fitch. In addition, there will be a legal requirement for school nurses to help schools fulfil their new obligations to support pupils with medical conditions. ‘For school nurses, the reforms are a great opportunity to support children much better by looking at the whole range of needs, not just the health needs,’ says Ms Fitch. ‘It’s about looking at the whole child.’ Dan Leighton, policy and parliamentary officer at the National Autistic Society, says: ‘This has the potential to
different agencies, removing duplication and promoting a more collaborative delivery. ‘This has to be better for the child and family,’ she adds. ‘And it makes it easier for parents, who can sometimes find it difficult to understand the different roles and responsibilities within health, education and social care. The reforms offer consistency and a more streamlined approach.’ Kate Fitch, deputy director of policy with the deafblind charity Sense, believes there is a need to raise awareness among healthcare professionals. ‘I’m not sure how much knowledge there is in health care that big changes are happening,’ she says. ‘Health professionals will have legal requirements to fulfil.’
improve the lives of children and young people with autism across England.’ But he agrees it is vital that nurses and other health professionals get the resources they need to understand and implement the changes.
e-learning
Ms Nicholson says the DH is taking action to improve awareness among nurses. ‘We are developing a professional partnership pathway, which aims to clarify the role of the school nurse and provide examples of good practice, together with links to useful resources, guidance and training resources. We envisage this will be available in the autumn. ‘Additionally, we have commissioned the development of new e-learning aimed at
NURSING STANDARD
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GETTY IMAGES
HOW THE PLAN WILL AFFECT CHILDREN AND YOUNG PEOPLE From September 1, the system of statements of special educational need (SEN) and learning difficulty assessments was replaced by a single education, health and care (EHC) plan for children and young people with complex needs (tinyurl.com/npq39fn). The EHC plan places more emphasis on personal goals and there will be support for those aged up to 25 in further education – replacing the previous ‘cliff edge’ where it was cut off at age 16. Parents with a plan will have the option to have a personal budget to pay for the support that has been deemed necessary in the assessment. health visitors and school nurses to extend their knowledge and support those new to this area of work. The material will be developed with professionals and experts, and we anticipate it will be ready for early spring.’ Alison Barlow, a school nurse in Leicester, says that she and her colleagues are already helping their schools to meet the new
NURSING STANDARD
Local authorities and health services will be required to link together services for disabled children and young people so they are jointly planned and commissioned. And local authorities will have to publish a ‘local offer’ showing the support available to disabled children and young people and those with SEN and their families. Plus a system of mediation will be introduced for disputes. If a child already has a statement or a learning difficulty assessment, they will be transferred to the new system within the next three and a half years – probably at some natural point of
statutory requirements for medical conditions. But she concedes there is less awareness of the special educational needs reforms. ‘There are a lot of changes around school nursing at the moment – including how we are commissioned. Obviously, we’ll be interested to see if the reforms help children and their families,
transition, such as moving from primary to secondary education. Support for SEN children will also be introduced to schools, nurseries and colleges to replace School Action, School Action Plus and equivalents (for children without an EHC plan). The Children and Families Act 2014 also places a duty on schools to make arrangements to support pupils with medical conditions (tinyurl. com/mgmkx6c). The guidance says that school nurses are responsible for notifying the school when a child has been identified as having a medical condition, such as diabetes or asthma, which may require support in school.
but it’s a challenging time.’ Ms Nicholson believes it will be worth it. ‘It is important to provide seamless support to improve health and wellbeing outcomes,’ she says. ‘We know school nursing teams have an amazing track record of doing this already, so it will be a case of embracing the opportunities the new guidance offers’ NS september 10 :: vol 29 no 2 :: 2014 21
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