Supporting Learners with Medical Needs in Wales
Supporting Learners with Medical Needs in Wales
A practical guide for ALN families on health plans, school duties, and your rights
Children and young people with medical needs are protected under Welsh education law and the Additional Learning Needs system.
Schools have clear duties to support learners with healthcare needs, whether those needs are short-term, long-term, fluctuating, mental health-related, or linked to neurodevelopmental conditions.
This guide explains what schools must provide, how Individual Healthcare Plans work, and how education and health services are expected to work together to keep children safe and included.
It also includes guidance for electively home-educated families, children with chronic illness, and those experiencing slow post-viral recovery.
1. What counts as a medical need in Wales?
A medical need is any physical or mental health condition that affects a child’s ability to:
access education
attend regularly
remain safe in school
This includes, but is not limited to:
asthma
ADHD medication needs
epilepsy
diabetes
chronic fatigue or post-viral symptoms
anxiety or panic attacks
gastrointestinal conditions
feeding or hydration difficulties
allergies and anaphylaxis
Long Covid
mobility or continence needs
mental health conditions
medication that must be given during the school day
Medical needs do not need to meet a diagnostic threshold.
If a condition affects safety, access or attendance, it counts.
Welsh Government reference:
Schools must follow Supporting Learners with Healthcare Needs (statutory guidance).
https://www.gov.wales/supporting-learners-healthcare-needs
2. When a school must create an Individual Healthcare Plan
Welsh Government guidance requires an Individual Healthcare Plan (IHP) when:
a child has a long term or complex medical condition
medication must be given in school
emergency procedures are required
a condition affects attendance
a condition affects participation in learning
adjustments, rest breaks or safety planning are needed
symptoms fluctuate or are invisible
a child cannot reliably self-manage symptoms, hydration or energy
Schools cannot refuse to create a plan because they are busy, because a condition is described as anxiety, or because a child appears to be coping or masking.
If a medical condition affects safety or access to education, a plan is required.
3. What should be in a good Individual Healthcare Plan?
A strong IHP should include:
a clear description of the condition
signs and symptoms to watch for
known triggers and how to reduce them
baseline information on energy, eating, drinking and regulation
emergency procedures
medication details, including dose, timing and storage
who is trained to deliver care
rest breaks and sensory needs
hydration or nutrition strategies
when parents should be contacted
when the child is too unwell for school
steps for return after illness
who is responsible for daily checks
an agreed communication system
reasonable adjustments during lessons, movement and breaks
The plan should be written with full parental involvement and reviewed at least annually, or sooner if the child’s condition changes.
4. Schools must involve the right people
An Individual Healthcare Plan should be written with input from:
the parent or carer
the school nurse
GP or specialist team where appropriate
the school ALNCo
pastoral or wellbeing staff
the child or young person, where possible
Schools must not write a health plan in isolation without consulting healthcare professionals.
If a child has an Individual Development Plan (IDP), the IHP should sit alongside it and inform ALN provision.
5. Medication in school: your rights
Schools must:
store medication safely
train staff to administer it
keep clear records
allow children to carry inhalers where appropriate
make reasonable adjustments for sensory needs around medication
support hydration and food needs linked to medication side effects
Schools cannot require a parent to attend daily to administer medication unless this is by parental choice.
6. When medical needs affect attendance
Where a condition causes fatigue, pain, anxiety, dysregulation or difficulty managing a full school day, families may request:
a reduced timetable
a phased reintegration plan
temporary home tuition
rest breaks or quiet spaces
adjusted start or finish times
a review of the IDP
If a child is too unwell to attend long term, families may request:
medical needs tuition
Education Otherwise Than At School (EOTAS) where attendance becomes medically impossible
Parents are not required to provide repeated GP notes. Schools must accept parental explanation unless there is a clear safeguarding concern.
7. What happens for electively home-educated children?
Health support does not end with deregistration.
Electively home-educated children continue to have access to:
school nursing services
vaccinations
health checks
continence services
paediatric referrals
long-term condition monitoring
Families can contact their local health board directly.
8. When you should request a review or change of plan
Request an urgent IHP review if:
Symptoms worsen or fluctuate
medication changes
attendance drops
fatigue or sensory overwhelm increases
the child cannot regulate without breaks
staff say they cannot meet health needs
Request an IDP review if:
medical needs impact learning
health and education provision need alignment
reduced timetables become prolonged
anxiety or EBSA develops due to health
If attendance becomes medically impossible, request EOTAS consideration.
9. Where to find the official Welsh Government guidance
The statutory duties are set out in:
Supporting Learners with Healthcare Needs (Welsh Government)
This document is essential for families and professionals.
10. Disclaimer and safety notice
Learn Without Limits CIC provides general information about education rights and public guidance. We do not provide clinical or legal advice.
If your child is unwell, seek appropriate medical support.
NHS Wales 111 for non-emergency advice
Your GP for ongoing or worsening symptoms
Call 999 immediately if a child has difficulty breathing, seizures, severe drowsiness, chest pain, dehydration symptoms, or any sign of serious illness
Always trust your judgement and use the appropriate service.
11. Coming later this month
We will publish a two-part series:
Long Covid in Welsh children
These posts explore slow recovery, post-viral fatigue, school anxiety, pacing and support for ALN learners, building directly on the issues raised here.
We will also be hosting an online session for parents to support our Long Covid series in early March, and you can book a place via our website here https://learnwithoutlimitscic.org/events.en.html
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This Blog is the official publication for Learn without Limits CIC
https://learnwithoutlimitscic.org/