Support for SEND
Support for children with medical needs
The laws on school attendance and education
Some children cannot attend school because of their health needs.
You can view guidance on these webpages:
- how local authorities must meet their duty to ensure children with health needs receive a good education
- how schools should support these children
- advice about the law (Independent Provider of Special Education Advice)
- general advice from Child Law Advice (including frequently asked questions)
- Emotionally-based School Non-Attendance (EBSNA)
- when your child may be entitled to alternative provision
View advice for when your child's illness may meet the definition of disability in the Equality Act 2010:
Individual Healthcare Plans (IHPs)
Schools in England have a legal duty to make arrangements to support pupils with medical conditions. This is under Section 100 Children and Families Act 2014.
An important way to do this is by creating an Individual Healthcare Plans (IHP). They're created collaboratively by:
- schools
- parents
- health professionals (for example school nurse or children's community nurse)
The pupil should also be involved whenever it's appropriate.
Schools must have a clear process to provide feedback if proper support is not given.
What is included in an IHP
An IHP explains how a child’s medical needs will be met in school, including:
- daily care
- medication
- staff training
- what to do in an emergency
They'll often be essential, for example where conditions fluctuate or where there is a high risk that emergency intervention will be needed.
Where the child has a special educational need identified in an EHC plan, the IHP should be linked to it (or become part of it).
When IHPs can be useful
IHPs can be useful in most cases, especially when medical conditions are long-term or complex.
Help with creating an IHP
View the UHP template from the Department for Education.
View some suggested wording for some of the sections:
- suggested wording for section F:
- The Educational setting should draw up an Individual Health Care Plan in liaison with parents and professionals to take into account X’s medical needs. This will be reviewed at least termly
- suggested wording for section G:
- An Individual Health Care Plan will be completed in liaison with parents and professionals to take into account X’s medical needs
Get advice from trained healthcare staff
View the different places you can get support.
You can visit wellbeing hubs at Friars Square Shopping Centre or High Wycombe Library.
There are companies that offer a text message service. You would usually receive a response within 24 to 48 hours.
If you need help in the meantime, you can:
- contact your doctor
- visit an NHS walk-in centre
- call 111.
If it is an emergency, call 999 or visit Accident & Emergency at a hospital.
Visit the Buckinghamshire Health for Teens website or send a text message to:
- 07312 263295
- open Monday to Friday (except bank holidays)
- 9am to 4pm
They will contact you back within 24 hours.
Visit Chat Health (0 to 5 years). You can also use the Chat Health (0 to 5 years) online chat, or send a text message to:
- 07312 277363
- open Monday to Friday (except bank holidays)
- 9am to 4pm
They will contact you back within 24 hours.
Visit the Buckinghamshire 5 to 19 Parentline. You can also use the 5 to 19 Parentline online chat or send a text message to:
- 07312 263175
- open Monday to Friday (except bank holidays)
- 9am to 4pm
They will contact you back within 24 hours.
Visit children and young people's therapies by Buckinghamshire Healthcare NHS Trust.
They offer support for children aged 0 to 19 for difficulties with:
- physical movement
- communication or swallowing
- participating in everyday activities
Their support includes fact sheets, advice sessions and webinars.
You can ask questions about a child's speech, language, functional difficulties or movements using their text chat service 'BHT Therapy Link'.
You can also send a text message to:
- 07312 263754
- open Monday to Friday (except bank holidays)
- 9am to 4pm
They will contact you back within 48 hours.
If the child has urgent health needs or equipment, you will need to complete a referral form referral form.
View more help with:
When a therapy is considered a health or educational need
A health need for therapy
A therapy is considered a health need when it is required to:
- treat or manage a medical condition,
- improve or maintain physical or mental health, or
- prevent deterioration in health,
regardless of education. The therapy is needed because of the child’s health, even if the child were not in school. Examples:
- Physiotherapy to prevent joint contractures or manage pain
- Speech and language therapy to support safe swallowing
- Occupational therapy to manage fatigue, posture, or daily living skills
Health‑related therapy is normally commissioned and provided by the NHS and is recorded as health care provision.
An educational need for therapy
A therapy is considered an educational need when it is required to:
- help the child access education,
- enable learning or communication in school, or
- remove barriers to participation in lessons and school activities.
The therapy is needed so the child can learn and take part in education. Examples:
- Speech and language therapy to support understanding, expressive language or social communication for learning
- Occupational therapy to develop handwriting, fine motor skills or classroom independence
- Physiotherapy to enable safe movement around the school environment
Educationally‑required therapy is classed as special educational provision, even if it is delivered by a health professional. If therapy educates or trains a child, or is necessary for them to access education, it is an educational need, not just a health one. This is why the same therapy (for example, speech and language therapy) can be:
- a health provision for one purpose, and
- an educational provision for another.
Eligibility for therapy from Buckinghamshire Children and Young People’s Therapy Service
For children with an educational need for therapy: Currently Buckinghamshire children who attend an Out of County education provider are not able to access Buckinghamshire children and young people’s therapies service for educational needs.
Those with an Education, health and care plan (EHCP) have therapy provision from spot purchased providers commissioned by Buckinghamshire Council. Those children without an EHCP may be able to access the education provider’s local therapy provision but this is dependent on local therapy commissioning arrangements.
For children with a health need for therapy: If your child has a health need and their GP practice is within Buckinghamshire Oxfordshire Berkshire Integrated Care Board area, Buckinghamshire children and young people’s therapies service may offer clinic or home visits and may share findings with your child’s education provider.
Buckinghamshire children and young people’s therapies service will try to work out the best solution for your child with the therapy service in the area the education provider is in.
If your child lives in Buckinghamshire, but their GP practice is not within the Buckinghamshire area of BOB ICB, then any health needs will need to be met by the ICB commissioned service in the GP practice’s ICB area.
Buckinghamshire Children and young people’s therapies may also offer support to the education provider, but this depends on commissioning arrangements. To find out which ICB your GP practice is part of, type your practice’s postcode in Find your local integrated care board (ICB) - NHS
School nurses can support children and young people (and the local community) with:
- medical needs
- social needs
- emotional needs
- physical needs
When a school has a concern, they will first contact the relevant school nurse.
Making a referral to a school nurse
Children over 4 years and 6 months who attend a mainstream school in Buckinghamshire can be referred to the school nurse by a parent, carer or healthcare professional using the school nurse referral form.
A child or young person cannot be referred to another specialist service for assessment at the same time.
The referral must show that:
- self‑help strategies have been used consistently (but have not led to lasting improvement), and
- the parent or carer has completed a relevant parenting programme and used the strategies, with little or no sustained improvement.
The School Nursing Services also provides face to face training to schools or recommends e-learning in the instance of a new diagnosis or for cases that are more complex for asthma, epilepsy, continence and epipen training.
Contacting a school nurse
You can contact a school nurse via the Children and Young People Administration Team on 01296 838000 (option 5) or [email protected]
Community Paediatricians care for children and young people aged 0 to 18. Children may be referred to their local Community Paediatrician if they have a Buckinghamshire GP. If the child's GP is from another county, they will see one there instead. They can assess, diagnose and support children with neurological and developmental conditions including:
- cerebral palsy
- developmental delay
- muscular dystrophy
- autism spectrum conditions
- attention deficit hyperactivity disorder (ADHD)
Children aged 5 to 18 are usually assessed for autism and ADHD via the Buckinghamshire CAMHS referrals Single Point of Access (SPA). You can view more information including short videos and information sheets at Community paediatrics - Buckinghamshire Healthcare NHS Trust. Contact Community Paediatricians’ Secretaries:
- 01296 566056
- [email protected]
Young people (up to 18) can get mental health advice and support from CAMHS. Schools are encouraged to refer children and young people directly to CAMHS. You can call CAMHS on:
- 01865 901951
- [email protected]
You can watch videos that explain more about their service. You can read the Parent's Guide to CAMHS which includes guidance if your child does not engage with CAMHS.
Different teams within CAMHS
They have specialist teams for:
- neurodevelopment (for diagnosis and support for conditions including autism and ADHD)
- intellectual disabilities (for assessment or diagnosis of a learning disability including challenging behaviour)
- eating disorders (for support and treatment of eating disorders)
- Child & Adolescent Harmful Behaviour Service (for response to problematic and harmful sexual behaviour)
- Bucks Mental Health Support Team (for evidence-based therapeutic support and training of school staff)
Medication reviews
If your child needs medicine prescribed by a paediatrician or psychiatrist (and your child was diagnosed in Buckinghamshire) you will receive invitations to medication review.
If you need an early review
You can contact Buckinghamshire CAMHS referrals Single Point of Access (SPA).
If your child was diagnosed privately or abroad
You will need to contact Buckinghamshire CAMHS referrals Single Point of Access (SPA) to request a medication review and shared care agreement with GP.
Some GPs may allow a shared care agreement with a private provider (this is where the GP prescribes the medication and the original prescriber does the oversight health checks).
Paediatric outreach team
The paediatric outreach team provide a link between the hospital and the community.
This helps to:
- coordinate services
- promote continuity of care
- ensure a smooth transition from home to hospital
They can give you specialist nursing advice and care for:
- how to administer different types of medication (including intravenous, subcutaneous and intramuscular)
- central line care (chemotherapy at home, blood sampling and dressing changes)
- enteral feeding (management of children with gastrostomy devices and the teaching and management of nasogastric tubes)
- respiratory conditions (including oxygen care at home, tracheostomy care and ventilator dependent children)
- caring for wounds (post operative, trauma and pressure areas)
- renal (HSP, nephrotic syndrome and glomerulonephritis follow up)
- urology (home dialysis, catheterisation, and supportive care)
- palliative care (end of life care with a 24 hour on-call service)
They can also provide training for mainstream schools.
Eligibility and contact
A child must be under the care of a Buckinghamshire Healthcare NHS Trust Consultant for the team to visit them.
Referrals are accepted from all healthcare professionals for any child with a nursing need and can be made by your:
- hospital consultant
- school nurse
- health visitor
- GP
Parents and healthcare professionals can contact them at Stoke Mandeville Hospital:
- weekday number; 01296 838230
- weekend number; 07827 3111095
Adding a young person to the Learning Disability Register to help with appointments
The Learning Disability Register is a list held by GP practices to help identify people with a learning disability. Being on the register helps them receive reasonable adjustments and better‑coordinated healthcare, including:
- more accessible information and appointments
- extra time and support during appointments
- an annual health check from age 14
The register does not provide a diagnosis and does not replace education or social care support. It's purpose is to improve health outcomes and reduce health inequalities for people with a learning disability.
Read more about the register:
EHC plans and support from health teams
EHC Needs Assessment and Annual Reviews of EHC plans must include advice and support relating to your child’s health.
You or your young person will be asked to complete a health questionnaire as part of an EHC needs assessment.
The school, college or setting should ask parents and young people to complete a health questionnaire before the annual review meeting. This is to make sure the health information is up to date.
View the annual review health questionnaires.
If your young person is on the learning disability register and eligible for an annual health check, ensure the details are shared as part of the EHC needs assessment and annual review.
An EHC plan sets out a child’s health needs that relate to their SEN (Section C) and the health provision required to meet those needs (Section G), which the relevant NHS body (usually the Integrated Care Board) must arrange. It can also reflect health-related difficulties in Section B where these create or contribute to the child’s special educational needs. Any therapy or support that “educates or trains” the child must be treated as special educational provision and included in Section F, which the local authority has an absolute legal duty to secure, even if it is delivered by health professionals.
View more information in Securing good quality health advice for education, health and care (EHC) plans (CDC) including responses to frequently asked questions on pages 18 to 19 for example the use of private reports.
Cancer support teams at hospitals
There are teams at Stoke Mandeville Hospital and Wycombe Hopsital who can offer cancer support including:
- information
- wellbeing advice
- emotional support
- practical help
- where to find other support
The teams are staffed by Macmillan-funded professionals and they can help anyone affected by cancer including parents and siblings.
Hope Support Services for aged 5 to 25
Hope Support Services offer support to children and young people aged 5 to 25 when a close family member has a serious illness.
Their support is especially helpful for siblings and young people affected emotionally by a child’s diagnosis.
Their services are available online.
Helen & Douglas House hospice support
Helen & Douglas House is a specialist children’s hospice in Oxford that can support families by offering:
- hospice-based care
- hospice-at-home services
It provides care for babies, children and young people with life-limiting conditions.
They also offer support for parent and siblings, including:
- respite
- symptom control
- emotional support
- bereavement care
Alexander Devine Children’s Hospice Service
Alexander Devine Children's Hospice offer support for children and families in Berkshire and South Buckinghamshire.
They offer specialist palliative care, including:
- respite care
- symptom management
- play and family support
- end-of-life care
- bereavement support
Families can be referred to Alexander Device if their child has a life‑limiting or life‑threatening condition.
Forever Colours Children’s Community Hospice
Forever Colours is a community hospice that can offer support to families of children with:
- life-limiting conditions
- life-threatening conditions
- profound disabilities
They offer holistic, family‑centred support, including short breaks, advocacy, play therapy and sibling support.
You can get support from national cancer support organisations for children in the UK, including emotional and practical support:
- Children with Cancer UK : This charity funds research and can give support from treatment and beyond.
- Cancer Research UK: Offers information, support, and funds research on all aspects of cancer, including childhood cancers.
- Together for Short Lives: Supports children and families affected by life-limiting conditions, including cancer.