5.1 Funding for Healthcare Needs

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1 Section 5: Accessing Healthcare Funding G BAND 5.1 Funding for Healthcare Needs 5.1 Some pupils with medical conditions require support so that they can attend school regularly and take part in school activities. Schools should be able to fund most of this support from their notional SEN budget, but for those pupils with extreme medical needs SEN Top Up Funding can be accessed. It must be stressed that the SEN funding for healthcare needs is targeted on ensuring that pupils have access to learning. Please note that duties under the Equalities Act require schools to meet up to the first 0.2% of their total budget for unforeseen circumstances such as making unexpected or exceptional provision for a child. 5.2 The allocation of resources to support children with medical needs is part of SEN High Needs Top Up Funding or Funding For Inclusion in Leeds (FFI) and is based on the principles outlined in the SEN Code of Practice 2014, Guidance for Supporting Pupils with Medical Conditions and SEN Top Up Funding (FFI). Schools need also to be aware of the need to refer to the DfE guidance Supporting Pupils at School with Medical Conditions. Schools now have a greater duty to ensure that they are meeting the needs of children with medical needs. Leeds City Council s Medical Conditions Policy has also been approved through collective agreement and should be used in conjunction with PG In accordance with FFI, funding will usually be allocated once a year and remain with the school or child for a minimum of two years. 5.4 Pupils in receipt of D Band funding may also be eligible for G Band funds, dependant on the nature of the medical condition. Schools should consider both aspects of D and G Band criteria for children with complex health needs where additional physical difficulties are apparent. 5.5 Funding for healthcare needs can be allocated to schools outside the normal FFI timescale. It is anticipated that children who suddenly develop short term healthcare needs such as broken limbs or post operation recovery can be supported through the notional SEN budget due to costs being below the threshold of Those who develop longer term medical conditions can have funding applications referred to the Exceptions Panel which convenes termly. Additional resources allocated to these pupils will remain with the pupil or school for the normal FFI cycle. 5.6 In some cases an accident or deteriorating medical condition can result in significant sensory impairment. In such cases when funding is allocated it will be identified under the appropriate sensory band.

2 5.7 The process by which schools can access additional resources throughout the school year is detailed below: Schools develop a Medical Intervention Plan detailing the nature and frequency of the support that will be put in place in order that the pupil can access learning. Schools should have a Medical Policy. The cost of the provision to be made should be included and clearly demonstrate the necessity for funding above the 6000 threshold If the child meets the criteria for Top Up Funding (found in Section 9) and the costs involved are above 6000, schools complete the Request for Resources to Support Health Care Needs form which includes a Data Protection section that should be signed by the child s parent/carer and/or learner if aged over 16 years of age. This can be found in Section 5 of the FFI Handbook The completed form, together with a letter or report from a medical practitioner, the intervention plan and costed provision map should be sent to the SENSAP Service at Adams Court. Requests for Top Up Funding will be considered by a panel convened for this purpose. The panel will recommend both the level and time limit of the funding to be allocated Schools will be informed of the outcome of the panel meeting. If funding has been agreed it will be allocated to the school from the beginning of the following term. 5.8 The above information will also be required for any pupils added to the IPL during the normal Top Up Funding cycle. 5.9 In line with guidance issued by the Guidance for Supporting Pupils with Medical Conditions and Early Years Settings Ref: DCL-EN,and the Children and Families Act 2014 Part 100 schools should complete an Individual Healthcare Plan (IHP) for all pupils that require either day to day management or emergency interventions for medical conditions. Pupils in receipt of medical funding obviously fall into this group. The IHP should be drawn up in conjunction with parents and where possible, the pupil and the pupil s medical carers, and should detail the measures needed to support the pupil in school. School nurses will assist schools in writing healthcare plans and provide appropriate training for school staff when required. Pro-formas contained within the DfES guidance could also be helpful to schools in drawing up the health care plan. The IHP Form is available in Section 5 of the FFI Handbook It is expected that the IHP will be reviewed in school in conjunction with parents and relevant health professionals at least annually. Where a pupil has a formal Annual Review either because they have a Statement/EHC Plan or are in receipt of High Needs Top Up funding, an IHP should be reviewed as part of this process (See Section 8 of the handbook) Any review of funding within the FFI cycle must include the submission of the updated IHP. - Section 5 Page 2 - Revised August 2014

3 5.12 FFI will not fund diabetes as it is anticipated that the costs associated with provision for this need falls below 6000, consideration will be given to applications for funding where diabetes is a part of a pupil s medical condition alongside other medical needs The Table below details the types of intervention that schools can be expected to undertake, it also indicates the anticipated duration of the interventions. This information can be used when considering a costed provision map and generating plans to ensure access to the pupil s curriculum / time caught up from the interventions. It is important to note that only those trained should perform these actions. - Section 5 Page 3 - Revised August 2014

4 Types and Anticipated Times per Intervention Intervention Time taken (in minutes) which includes, preparation, intervention, clearing up and any documentation Administering medicine in accordance with prescribed medicine in pre-measured dose via nasogastric tube, gastrostomy tube, 15 orally or applied to skin, eyes and/or ears. Inserting suppositories with a pre-packaged dose of a prescribed medicine. 20 Rectal medication with a pre-packaged dose i.e. rectal diazepam. 30 Administration of buccal Midazolam 30 Hypo stat or GlucoGel (Used for diabetic patients). Ref 5.12 for diabetes. 60 Injections (intramuscular or subcutaneous). These may be single dose or multiple dose devices which are pre-assembled with 15 pre-determined amounts of mediation to be administered as documented in the individual child s care plan (preloaded devices should be marked when to be administered) e.g. for diabetes where the dose might be different am or pm. In many circumstances there may be two different pens, one with short-acting insulin to be administered at specified times during the day and another for administration at night with long-acting insulin. Ref 5.12 for diabetes. Blood Glucose monitoring as agreed by the child s lead nursing/medical practitioner i.e. GP, paediatrician or paediatric diabetes 10 nurse specialist. Ref 5.12 for diabetes. Assistance with inhalers and nebulisers as part of other medical needs. 10 Tracheostomy care including suction using a suction catheter. 10 Emergency change of tracheostomy tube. 15 Oral suction with a yanker sucker. 10 Assistance with prescribed oxygen administration. 10 Ventilation care for a child with a predictable medical condition and stable ventilation requirements (both invasive and noninvasive ventilation). NB: Stability of ventilation requirements should be determined by the child s respiratory physician and will include consideration of the predictability of the child s ventilation needs to enable the key tasks to be clearly learnt. Bolus feed via a gastrostomy tube. 30 Continuous feeds using a pump via a gastrostomy tube. 20 Continuous feeds using a pump via a jejunostomy 30 Bolus feed via a jejunostomy 30 Intermittent catheterisation and catheter care 30 Care of Mitrofanoff 30 Stoma care including maintenance of patency in an emergency situation 20 (requires constant supervision) - Section 5 Page 4 - Revised August 2014

5 5.14 Additional factors to consider when supporting a child with Healthcare Needs. When considering healthcare funding and levels of intervention, it is important to considering the following factors: Consideration of parent and child s views. Consideration of other factors including sensory impairment, learning difficulty, mental health problems or social factors. Children require regular reviews to reassess their nursing needs. This, for some children, may indicate a change in the level of nursing support they require e.g. a deterioration or improvement in their condition. Physical access to the site e.g. lifts and ramps. Correct equipment and staffing levels to aid moving and handling e.g. hoists, two members of staff. Satisfactory risk assessment of the site e.g. to ensure the safe storage of oxygen. Facilities for providing personal care should be private and appropriate to the care being delivered. Adequate and safe storage facilities for equipment. School staff have received training on procedures which underpin the intervention e.g. moving and handling, life support. It is the responsibility of the setting to provide this training. School staff are trained and update their skills on a regular basis. Staff feels confident to undertake the required interventions Further information can be found in Section 9 of the FFI Handbook under G Band Support will be offered to schools through the Inclusion / Community Specialist Nursing Teams depending on the individual needs of the pupil. In the majority of cases children and young people requiring this level of intervention will already be known to these services. Service and intervention would follow the pupil as does funding For further information or to discuss an individual case please contact your FFI Co-ordinator on The table below indicates the funding request process.

6 Protocol for Requesting Top Up Funding for Healthcare Needs SCHOOL Create Intervention Plan and complete Band G Top Up Funding request form and Costed Provision Map Supported by letter/report from medical practitioner Form sent to SEN, Statutory Assessment and Provision Team with appropriate evidence Decision Making Panel Does the child meet criteria for funding? No Child not eligible for funding Yes Child eligible for funding Letter to school and parents Funding level and starting date agreed Letter to school and parents School completes IHP, sends a copy to Parents Funding allocated and put in place in school - Section 5 Page 6 - Revised August 2014