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Medical conditions in schools alliance – response to advancing our health: prevention in the 2020s

Taking care of our mental health

How can we support the things that are good for mental health and prevent the things that are bad for mental health, in addition to mental health actions in the green paper?

Every school has to protect its pupils from harm and provide support for pupils with mental and physical health issues. The Department for Education will revise statutory guidance to make sure that schools understand how mental health is embedded in existing requirements so that they ensure staff can identify and support children with mental health issues and how this can be delivered within whole school approaches to mental wellbeing led by senior mental health leads

Note for HCSA members: The health prevention green paper (p.41)


Safeguarding includes ‘preventing impairment of children’s health or development’ and schools have a legal duty to support pupils with physical or mental health conditions under section 100 of the Children and Families Act 2014.

The Department for Education’s statutory guidance on the duty explains that the aim is ‘to ensure that all children with medical conditions, in terms of both physical and mental health, are properly supported in school so that they can play a full active role in school life, remain healthy and achieve their academic potential’ (p.5). The statutory guidance sets out what schools should be doing to support children with medical conditions, including having a specific medical conditions policy, individual healthcare plans for children and training for staff.

However, evidence gathered by the Health Conditions in Schools Alliance showed that only 47.5% of schools had a policy in place to support children with medical conditions. When these policies were subjected to further analysis, only 11.5% of schools had a policy which complied with Government standards.

Schools should be required to publish their policies on supporting pupils with medical conditions on their website. This would increase awareness of schools’ responsibilities and would aid the inspection of schools’ safeguarding arrangements to prevent impairment of children’s health.

Local action

What more can we do to help local authorities and NHS bodies work well together?


The role of the Designated Medical Officer (DMO) / Designated Clinical Officer (DCO) should be sufficiently resourced in every local area, to facilitate joint working between education and health. The DMO/DCO role is set out in the SEND Code of Practice. The Ofsted and CQC report ‘Local area SEND inspections (one year on)’ found that:

In successful local areas… [leaders] focused on improving the impact of joint working across services to ensure that they could improve outcomes in areas of weakness. For example, giving the designated medical officer (DMO) or designated clinical officer (DCO) sufficient time resulted in improved joint commissioning arrangements.

Local area SEND inspections: one year on (p.6)

In the nine local areas where a written statement of action was required, there were three common areas of “significant concern”, including:

Leaders’ strategies to implement the reforms were weak and lacked impact. For example, the role of the designated medical officer (DMO) or designated clinical officer (DCO) was underdeveloped or underresourced. As a result, leaders were unable to secure much needed joint working, leading to poor collaboration and commissioning between professionals from education, health and care.

Local area SEND inspections: one year on (p.14)

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