UNISON calls for action on school children with health needs

UNISON and the Royal College of Nursing (RCN) are calling for urgent action to protect children and young people with health needs in schools.

A survey of school support staff and school nurses for UNISON and the RCN reveals a worrying picture. Despite many examples of good practice, a growing number of children with increasingly complex health needs are being put at risk as staff are being pressurised into caring for them without enough training, supervision and support.

As teacher’s contracts do not include giving or supervising medicines, the responsibility often falls onto school support staff. More than one in four (28%) of support staff say that they do not feel comfortable or competent to give pupils medicines, or to support their health needs. This can include tube feeding, airway suctioning, tracheostomy care and catheterisation.

Children with long-term conditions including asthma, diabetes, epilepsy or anaphylaxis also need support, while some children have restricted mobility which requires standing frames and hoists.

The majority of support staff do not receive regular training, and some report never having any training at all before being expected to provide health care support to pupils.

Nearly one in five support staff say they feel forced to take on the responsibility for administering medicines or healthcare procedures as they did not want to let children down.

Two-thirds of registered nurses who oversee health care provision in schools say that specialist care plans are not always in place. These nurses play a crucial role in developing individual care plans and providing an important link between school, home and the community.

To keep children and young people safe, UNISON and the RCN believe that:

· Every school child with health needs should have an up-to-date, individual care plan, drawn up with a healthcare professional.

· Staff must have specific training for each child, which must be supplied by an accredited healthcare trainer and be regularly refreshed.

· Schools and local authorities must ensure they match staff, with sufficient training and pay, to the specific needs of the children in schools.

· Every school needs to have a clear policy on the management of medicines and health care support in schools, which is understood by staff, parents, and pupils.

Dave Prentis, UNISON General Secretary, said:

“The lack of training and support for school staff who have to deal with a growing number of children with increasingly complex health needs is a tragedy waiting to happen. And as budget cuts hit schools, our fear is that this will only get worse.

“We want every child to enjoy school life to the full – so do teaching assistants and other school support staff. But all too often, that relies on pressurising staff into administering medicines or complex procedures that they do not feel confident or trained to do.

“To keep children safe we need clear policy and guidance and for children to have individual and regularly reviewed care plans.”

Dr Peter Carter, Royal College of Nursing Chief Executive & General Secretary, said:

“This survey clearly highlights the risk to children and young people when authorities and schools do not have robust arrangements in place to support pupils with health needs.

“While there are a number of examples of good practice, it is clear that more needs to be done to ensure all schools are able to provide safe and well-planned health care support. There is also a clear need for more school nurses, community children’s nurses and children’s nurse specialists to adequately train and support staff in schools to meet the needs of their pupils. Currently, there is a chronic underinvestment in these areas, with a recent survey revealing that one in six school nurses had seen posts cut in the last year.”

Key findings

– Two thirds of the nurses surveyed say that specific healthcare plans are not always in place to ensure that pupils with health needs are properly supported at school. – School support staff, such as teaching assistants, are being expected to provide healthcare support to pupils, ranging from administering prescribed medication, to toileting and dealing with soiling incidents. They are increasingly expected to give mental and emotional support. – The majority do not receive regular training from a healthcare or training professional. Some do not receive training at all.

– Nearly one in three say they do not feel confident or comfortable with the responsibility of administering medicines or providing healthcare support to pupils.

– A shocking 18% of school support staff say they feel forced into taking on these duties by their employer. Their desire not to let pupils down meant that they take on tasks that leave them feel worried and vulnerable.

– The majority of school support staff – the lowest paid workers in schools – do not receive any extra pay for taking on this extra responsibility.

– A quarter of support staff who support pupils have not seen a copy of their school’s policy on the management of medicines in schools and 82.6% do not know if they are covered by their employers liability insurance.


This survey received 2,322 responses, 39% (906) were registered nurses, and 57% (1,330) were school support staff, 4% (86) were other registered health care professionals such as physiotherapists, occupational therapists and speech and language therapists.

· Supporting pupils with health needs in schools – RCN and UNISON survey 2012 ( full report)

(Link: http://www.unison.org.uk/acrobat/21163.pdf

· Supporting pupils with health needs in schools RCN and UNISON survey 2012 (executive summary only)

(Link: http://www.unison.org.uk/acrobat/21242.pdf)

· Providing support for children and young people with health needs in schools – a joint statement from the RCN and UNISON

(Link: http://www.unison.org.uk/acrobat/20539.pdf)