Healthcare needs in schools guidance consultation: response analysis report

Chapter 1 - The legislative and policy context

Question 2: Are there any areas missing, requiring strengthening, or which are not required?

15. A small majority felt there were areas where this chapter could be amended, whilst one-third of respondents felt no further change was required. Of those saying no further change was required, there were very few comments with only one of those referring to paragraph 27 concerning named person reference.

16. There were 42 responses which felt amendments should be made - there were further points made regarding paragraph 27 and its references to named person. Responses highlighting this felt schools should work closely with external bodies to manage and address long-term health conditions and that children with long-term conditions should have individual healthcare plans.

17. Responses from professional bodies noted the target audience of the guidance should be considered. Two responses noted, whilst the document was intended for use at strategic level, the responsibilities of school nursing teams and health and education professionals should be more strongly articulated. Other responses raised points concerning parents and guardianship, these included the guidance referencing the Scottish Schools (Parental Involvement) Act 2006 ^[5] ; guardianship in respect of young people over 16 with additional support needs, regarding who can make decisions on their behalf in cases where the young person themselves do not have capacity to do so.

18. The final notable theme from those providing response to this question covered staff training. Those responses stated the school should be responsible for sourcing appropriate staff training, rather than individual staff members; training be provided on mental health disorders; and the guidance should clarify which school staff are responsible for providing healthcare. Other responses, outwith the themes already covered, included guidance on the administration of medicines; a mention about independent schools which have nurses on during the day; and reference to Getting it Right for Every Child ^[6] .

Question 3: Does this chapter provide sufficient reference to the relevant policy and legislative provisions?

19. The views in respect of this question were more mixed. Whilst many respondents agreed the chapter did provide sufficient reference to the relevant policy and legislative provisions, a sizeable minority of respondents did not share this view.

20. There were 35 responses providing comment to suggest amendments. Generic comments noted the wide range of legislation involved and those legislative Acts with the most prominence should be signposted within this chapter. There was also support for an Executive Summary at the start of the guidance which would be a ‘one stop shop’ highlighting the most relevant pieces of legislation, whilst another response preferred the legislation to be categorised by subject rather than the proposed chronological order in the current document. Some respondents suggested referencing relevant publications such as ‘Ready to Act’ ^[7] with regards to children and young people requiring support from allied health professionals.

21. Some comments made specific references to legislation including raising awareness about the General Data Protection Regulation, which will change current data protection laws in 2018. The Care Inspectorate felt it appropriate that the guidance highlights legislation applicable to those services regulated by them. The issue of drugs was also raised, stating the guidance should consider the role schools have a role to play in preventing substance misuse, and how they could tackle situations involving controlled drugs or psychoactive substances, therefore the guidance should reference the Misuse of Drugs Act 1971 ^[8] and Psychoactive Substances Act 2016 ^[9] . In the case of health conditions, further references asked for consideration of the effect on mental health and wellbeing and its impact on ability to engage with learning.

22. Some comments suggested changes to specific sections of this guidance. There was a desire to see reference to the public sector equality and diversity week in paragraph 13; SHANNARI wellbeing indicators ^[10] between paragraphs 23 and 27; and, in paragraph 36, noting the role of the Child Health Commissioner is to provide strategic leadership. Finally, one comment asked the for all links to be up to date ahead of formal publication of the guidance.

Question 4: Does the information provided under each heading in this section adequately explain how the legislation or policy applies in relation to provision of healthcare or administration of medicines in schools?

23. Just over half of all respondents agreed with the question, with the remaining respondents split fairly evenly between disagreeing and don’t know/no answer. 27 responses answered the question on whether amendments should be made.

24. Specific comments to this question included reference Article 12 of the United Nations Convention on the Rights of the Child ^[11] - the right to have views heard and taken into consideration. In paragraph 10, make clear ‘pupils with a disability’ are defined in the Equality Act 2010. Paragraph 5, in relation to Age of Legal Capacity (Scotland) Act 1991 ^[12] , this paragraph should be reviewed to incorporate all healthcare practitioners who have authority under this legislation otherwise it could restrict access to treatment.

25. Also, in a legislative context, several responses noted the Human Medicines (Amendment) (No. 2) Regulations 2014 ^[13] regarding school having powers to buy inhalers for children diagnosed with asthma, and prescribed an inhaler. Those comments say it should be clarified that the provision of emergency medication is the responsibility of the parent/carer rather than the school.

26. On providing clarity, responses suggested the guidance make clear the legal definition of ‘disability’ can include long-term conditions, such as epilepsy; the implementation of care plans for individual children should be mandatory and reviewed annually; the impact of resources within schools due to reduced numbers of school nurses and health visitors and recognition of the needs parents of children with multiple and/or profound learning disabilities, highlighting PAMIS model of having parents participate in the facilitation of training due to their knowledge of their children’s needs.