Children Missing EducationTuesday 15th July 2014 - Manchester

Derek Kitchin

Headteacher of Wirral Hospitals’ School Headteacher of Wirral LA Home Education Service

Chair NAHSL (National Association of Hospital School Leaders)

Reintegrating Children into Mainstream education.

My BriefReintegrating Children into Mainstream Education: a) Supporting students with complex health

needs by using a variety of provisions including e-learning and home tuition

b) Recognising the central role of parents and carers in securing a successful transition

Successful Transition Requires ….

Successful multi-agency working, with shared attitudes and commonly held beliefs … That are ‘child centred’ – rather than whole organisation target or outcome led …

A model or system of resources, policies, practice and provision that enable and that facilitate, successful transition…

Wirral Hospitals’ School

Joseph Paxton Campus

Wirral Hospitals’

School

Arrowe Park Hospital

Ward 53

Wirral Hospitals’ School

Adcote House Health and Education

Wirral Hospitals’ School

Seedlings based at

Joseph Paxton Campus

Home Education Service Primary Project based at Joseph Paxton

Campus

 CAMHS/NHSPine LodgeMaple Ward

 Adcote House Health and

Education Unit 

Arrowe Park Hospital

Special Schools

AndAlternative Providers

(AP’S) 

MainstreamPrimary and Secondary

Schools

Wirral Hospitals’

SchoolGoverning

Body

Local AuthorityBehaviourSupportSection

(Primary)

Local AuthorityHard to

Reach/PlaceYoung people

Home Education Service

Wirral Local Authority

 

WIRRAL HOSPITALS’ SCHOOL AND WIRRAL LA HOME EDUCATION SERVICE

HeadteacherMr D Kitchin

HeadteacherMr D Kitchin

Wirral Hospitals’ School Home Education Service Referring Agencies/Schools

WIRRAL HOSPITALS’

SCHOOLAdcote House

Seedlings Joseph PaxtonCampus APH Ward

Wirral LA Home

EducationService

• Mainstream Schools: Community/Academy/Trusts • Mainstream ‘supported’ by extra resource or people• Mainstream with ‘Units’ attached (geographical

inclusion?)• Private/Independent schools• Special Education• Units / Alternative Providers (e.g. PRU’s / Speech and

Language etc.)• Outreach packages from any of above• Hospital Education / Mental Health ward Ed / CAMHS• Home Education• Education otherwise!

To and from which organisations ……..

From and / or with … Health Needs• Mental Health – worsened by ASC / OCD’S = Anxiety, eating disorders, self-harming, suicidal ideation• CFS (ME) with co-morbid anxiety / depression• Trauma – physical and resultant mental ill health, from

accidents / assaults / abuse / loss / LTC’s / LLC’s …• Diabetes – Type 1 and 2 increasingly common in C and YP• Multiple admissions / corrective surgeries – Cerebral palsy,

scoliosis, growth disorders, skin conditions, obesity• Co-morbid – two, three or more concurrent conditions

Given that range and complexity of institutions and health issues, it’s essential to … (1)• Understand each others role and remit and

understand the barriers and restrictions each may face – which may well be different to ours e.g. Schools are set aspirations and targets nationally… Ofsted, league tables, attendance triggers, floor targets, 5 A-C inc EMa, Progress 8, Eng Bacc … !

• Locally – COMPETITION? Advertising?

Given that range and complexity of institutions and health issues, it’s essential to … (2)• Encourage solution focused approaches and

help others to a ‘can do’ approach. • Remove mystery, debunk myths, be prepared to

listen and learn yourself and show an empathetic understanding – developing a ‘We are all in this together for the good of the young people’ culture.

• Emphasise the benefits of transition to fuller education as …

… education can be a highly therapeutic tool, complimenting the work of health professionals by sustaining a student’s activities of daily living, minimising and normalising health conditions, creating diversion and distraction from pain, trauma, anxiety and depression thereby, building stamina and resilience and providing opportunities for success, reward and a feel good factor. (It’s good for the whole, wider family too!)

Interventions on a pathway to reintegration (1)

• Home Education – in the home *• Home Education – in public buildings / libraries *• Independent e-learning (e.g. VLE / NISAI) – but not without

one of the above*• Non-school interfacing! Walks, visits … building up

confidence / breaking up rigid routine patterns• Travel training and other resilience building• Home Education in the receiving school – using small rooms

after school day or weekend and slowly moving times … introducing peers / buddies to them for play … then work.

Interventions on a pathway to reintegration (2)• Supported in mainstream classes by Home Teacher

using YP’s best / least stressful subjects or groups of children or TEACHERS! Exit allowed!

• Home Ed. Free learning! Reduced subjects and timetables - with TA support on hand, exit pass, ‘escape plans’, designated staff to go to / Mum on call or in ‘parents room’!

• Phased, reviewed, re-adjusted pathways to partial, part-time and then full integration – with all staff aware of and committed to plan.

Managing the issues of… • Medication / sharps / needles / disposal• Access (Full and inclusive)• Emergency evacuation• Personal hygiene / changing and showering• Toileting / personal care / diabetes care• Emotional fragility of ‘being different’• Anxieties – missed work, deadlines, HEALTH!• Sensitivities re personal care / odours / ‘baggage’• Staying ‘safe’ – how to ask for help / intervention

Other barriers to overcome…

• Lost / absent peer friendships - isolation• Environmental tolerance – return to big, loud, fast-

moving, de-personalising environment• ‘Distances’ to travel – physical and time!• Skill gaps in Maths, Sciences and curriculum.• ‘Expectations’ and ‘culture’ of pace, targets• Geographical inclusion can still feel like ‘exclusion’• Attachment issues – Parents, C and YP / both!• LAC responsibilities – Corporate parenting

Making it work …. (1)• Is the young person ready? … and ready for what?

Evidence? Assessment? Mentally and physically? Full / part-time / partial / phased reintegration. Don’t set them up to fail! It may be the last chance!• Check out your receiving school first, before moving too far

with other stakeholders … do they meet the ‘spec’ below?• Do they understand the needs? Needs impact on the

young person and learning? Are they able to meet them fully and inclusively? Will they support the approach you advise?

Making it work …. (2)• Will there be a responsible, co-ordinating, contact

person at the school WHO is able to make decisions? • Aspirations for C or YP … too much, too little – WHAT

is right?• Agreed on a child-centred, flexible pathway, which

may sometimes need to pause or take a temporary backward step?

• Identify and provide a clear written ‘offer’ or agreement and share.

Making it work …. (3)• Prepare the family … school website, driving round

external site in the evening, Saturday school visits, gentle accretion of resilience and anxiety reducing exposure! Meet the link person.

• Sell the vision … To parent / carers, young person and receiving school. We CAN do this together.

• Assure stakeholders of your continued support THROUGH the process.

• Help ALL by re-evaluating the aims and outcomes you aim for, comparing them carefully to those aims and aspirations you had before the illness/absence.

Why do we need the parents?

Recognising the central role of parents and carers in securing a successful transition.

Without them it won’t work, so …• Identify parent / carers fears, anxieties,

confidence and past experiences which may be being ‘passed onto’ the YP … sabotaging. Give parent / carer a ‘script’!

• Explain the pathway, the reasons for it!• ‘Coach’ – reduce their expectations that their

child will have the same feelings and anxieties they have – breaking the cycle.

Without them it won’t work, so … (2)

• Instil confidence – involve parents in visits etc. (Gently but firmly, coaching and challenging parent ‘contributions’ if necessary. “Stick to the script Mum”!)

• Work with parents to set up reward and praise systems for ‘success’ in reintegration (x box points work wonders)

• Have a no failure culture “Mum … Remember the agreement we all made … RPI – Reward, Praise, Ignore”

• Support the building up of effective relationships and communication with key persons in the school, from the outset – maintain and challenge if ineffective.

There is no better time for transition than now ….

The law says !

Supporting Parents at School with Medical ConditionsStatutory Guidance – April 2014

• School leaders must consult with Health & Social Care

• Children and young people with medical conditions (physical and mental health) are entitled to a full education and have the same rights as other children

Supporting Parents at School with Medical ConditionsStatutory Guidance – April 2014

• Support must be provided for pupils’ education, social and emotional needs including managing absence, additional; time for exams, rest periods, resources and staff training.

• Must provide for needs related to easing access to education; medication, treatment, equipment, environment and travel time between lessons etc.

Ensuring a good education for children who cannot attend schools because of health needs

Statutory Guidance- January 2013

• Effective collaboration between CAMHS/LA/Schools • Links with hospitals regarding the admission, stay and release

dates. • On discharge, hospital should give medical advice

– How much education?– Return to school date and whether phased or not?

Ensuring a good education for children who cannot attend schools because of health needs

Statutory Guidance- January 2013

• Children with health needs must receive a ‘suitable’ education that meets their needs without intervention of the LA

• If not, LA must arrange ‘suitable’ ‘full time’ education, or as much as the child’s health condition allows

• What is ‘suitable’? Full or part time subject to age, attitude, ability and health condition… to include English, Maths and Science

SEN Code of Practice Statutory Guidance – September 2014

• Commission Services jointly for children and young persons with SEN

• Promotion and integration of services, LA and CCG• NHS, CCG and Health Trust boards must ‘promote’ integration

of services, and provide medical advice and information • Collaboration/ close co-operation between education, health

and social care • Health commissioners must have arrangements in place to

secure health elements of the Education Health and Care Plan

Implications of the new, 2014,SEN Code of Practice

• Health aspects will form an important part of our personalised Education, Health and Care Plans

• Health professionals will need to tell us clearly what education, how much education and how often we provide education to their ‘patient’

Implications of the new, 2014,SEN Code of Practice

• Professional discussion, challenge and agreement will be important in agreeing the right provision

• ‘Prescriptions’ for adjusted, personalised, flexible education packages are the way forward.

Educationalists … consider…

• Teachers currently focus on education, dwelling less on medical or mental health

• For a number of reasons… schools may have the same attendance, attainment and achievement expectations for all children, irrespective of health…

Educationalists … consider…

• Can we reasonably ask students to leave their mental or physical health condition at the door?

• Education can allow students to be like their peers and to forget about their ill health for a while; this being helpful to their recovery and why education is a key part in any young persons recovery plan…

Acknowledgements Jo Burton, Deputy Headteacher, Wirral Hospitals School.Annette Owen-Petkova, SENCO, Wirral Hospitals School.Ian Dickson, Head of Computing, Wirral Hospitals School.

And especially to:

Maureen Bowsley, Home Education Co-ordinator, Wirral LA Home Education Service.

Retiring July 2014, after many successful years of life changing intervention work with vulnerable young people and families of Wirral.