An individual healthcare plan (IHP) sets out what support is needed for your child.  They do not need to be long or complicated.  However  an IHP is essential if your child’s needs are complex, fluctuating, long term or if there is a high risk that an emergency intervention will be needed.   Not all learners with healthcare needs require an IHP.

Some children and young people may have medical conditions which have a significant impact on the way they function in school or further education.  Their medical needs may impact on their learning and they may need specialist knowledge and skills or additional or different support and provision to help them learn. If this is the case they are likely to have additional learning needs (ALN)

If you are concerned that the child or young person’s health needs impacts on their learning you should talk to the school or college and ask them to consider whether your child or the young person has additional learning needs (ALN).  

The school or college will then have a ‘duty to decide’ if the child has ALN.  And will need to record the date the concern was brought to their attention.

If the school or LA decide the child has ALN they will have an Individual Development Plan (IDP) prepared for them.

The legal definition of ALN and additional learning provision is set out here.  What is ALN?

The ALN Code 2021 says that a medical need may have a:

• direct effect on a child’s or young person’s cognitive ability, physical ability, behaviour or their emotional state
• or disrupt their access to education through unwanted effects of treatment or through the psychological effects that serious or chronic illness or disability can have on a child or young person.

Each child or young person’s health care needs and the possibility of them having additional learning needs should be considered carefully.

A child or young person may have medical needs, but does not require additional learning provision, they may instead have an individual health plan (IHP) which would set out how they should be supported.

If a child or young person in mainstream school or college has ALN and possibly health related needs, a local authority can ask the Local Health Board or NHS trust, whether there is:

 ‘any treatment or service which is likely to be of benefit in addressing the ALN of a child or young person.’  (Section 20 of the ALN)

If the Local Authority is preparing or maintaining an IDP for a young person they can refer the child to health

The governing body of a FEI can also refer a young person to health

Before making the referral, the LA MUST discuss the matter with the child, the child’s parent or the young person and be satisfied that making the referral is in the best interests of the child or young person.

If the health board identifies a treatment or service that’s appropriate for the child or young person, it must describe the treatment or service in the child’s individual development plan (IDP)  and if the health board identifies a ‘treatment or service’ which would benefit he child or young person, it must provide it. (S20(5) and S21(5) of the Act)

It will be very clear in an IDP which agency is responsible for delivering the individual support.  The health board MUST deliver any health ALP contained in the IDP that they have agreed to provide.

Any health care provision will have to be agreed by the Health Board before it can be written into a plan.   Once provision is written in to an plan, it must be provided.

If your child has a medical condition, but no additional learning, their medical needs should be outlined in an Individual Healthcare Plan (IHPs) (See Section 3 WG guidance Supporting learners with healthcare needs)

Parents or other family members should not be expected to provide healthcare support to their child in school, or to be made to feel obliged, to attend school to give medication or provide medical support to their child.  This includes toileting where a child is disabled.

Ask for a meeting with the school to discuss this. You should ask the school to develop an individual healthcare plan or to decide  whether the child or young person has ALN.

If a child or young persons  ‘healthcare needs are not being met by the school, despite you requesting them to do so,’  you can use the school’s complaints procedure.

If you are not satisfied with the way the school has dealt with your concerns, or your child’s healthcare arrangements you can make a formal complaint in writing to the Head Teacher and contact SNAP Cymru for support.

If you are unhappy or disagree with  the healthcare provision in your child or the young person’s IDP or health plan, you should raise your concerns with the school and staff involved with the care or treatment, so that they can look at what may have gone wrong and try to make it better.

If this does not help, you can contact the Health Board or Trust’s concerns team.  In NHS Wales complaints about Health provision are made through a process known as  ‘Putting Things Right’.

Each Local Authority will also have a Designated Education Clinical Lead Officer (“DECLO”).

The role of the DECLO will include oversight over any complaint or dispute that relates to Health responsibilities in the Additional Learning Needs and Tribunal Act(ALNET Act.)

If your child has ALN and a medical need, the DECLO could be involved directly to resolve the complaint or dispute, or ensuring a robust system is in place to bring people together to attempt an early resolution.

You cannot make an appeal to the Tribunal regarding Health provision in an IDP alone.

However, the Education Tribunal when considering an ALN appeal is able to:

• insist that an NHS body provides evidence regarding health related aspects of an appeal made
• can make recommendations to an NHS body about its duties under the under the Act.

If the Tribunal makes a recommendation to an NHS body, they must report back to the Tribunal telling them

• the action it has taken or intends to take in response to the Tribunal’s recommendation
• or why it has not taken any action and does not intend to take any action in response to the Tribunals recommendation.

However, where the Tribunal orders a revision to the ALP included in the IDP, the NHS body is not required to secure the revised provision unless it agrees to do so.

Disabled children and young people should not be excluded from the education because of their disability, they have a right to receive the support needed to help them participate in all aspects of school or college life.

If your child’s medical condition amounts to a disability, EY’s settings, schools and FEI’s have duties to disabled children under the Equality Act 2010 and must make ‘reasonable adjustments’ where necessary so that a disabled child is not put at a substantial disadvantage.

There is often a significant overlap between disability and additional learning needs. Therefore, a child can be defined as being disabled, or as having additional learning needs or both Disabled and ALN.

More children are covered by the Equality Act description than many imagine.

Disabled children and those with medical needs can be covered by two different laws,  the ALNET Act 2018 and the Equality Act 2010,  there is a significant overlap between both.

Whilst not all disabled children will have ALN, research as shown that as many as about 3/4 of disabled children will also have additional learning needs.

Children who have a range of health conditions, for example: epilepsy, diabetes or more severe forms of asthma and eczema, are likely to be covered by the definition of disability but may not have additional learning needs.  They may have an Individual Healthcare Plan instead.

for more information and support > Get help with Disability Discrimination