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Background Info

In the course of our work we have found that the problem is Scotland wide and not confined to one local authority area. The reality is that depending on where a child or young person lives they may or may not receive adequate, or any, educational provision when they are absent from school, either in hospital or at home due to illness. While the guidance is clear and specifies ‘that education authorities are under a duty in relation to pupils unable to attend a suitable establishment as a result of their prolonged ill health,’ the fact is that some local authorities fail to comply with this and action needs to be taken to ensure that authorities do comply.

1. There are varying practices by different local authorities. For example—

a) One local authority pays for teaching in hospital, but only after it has given approval. The hospital teachers must tell the local authority about patients and ask for permission to teach. This means that by the time the local authority gives approval many children will have left hospital. This local authority will however only fund hospital teachers to teach if the child has certain chronic conditions eg cystic fibrosis and cancer.

The Guidance on the Education of Children Absent from School through ill - Health (point 37) states that teaching in hospital should normally begin after five working days following admission providing the child’s state of health allows for this, but that education should start immediately if it is known in advance that a child’s stay is likely to exceed five days. NHS Scotland’s ‘Better Health Better Care: Hospital Services for Young People in Scotland’ (para. 123 also states this).

b) Some local authorities will as a standard not provide hospital education to children until they are in hospital for ten days unless they have been admitted to hospital for the same condition previously. For a child newly admitted without previous treatment at hospital, education is not provided before ten days.

c) Another local authority in February 2010 decided to no longer subscribe to the hospital teaching service and to send their own teachers to hospitals. Our view is that it is preferable for teaching in hospitals to be delivered by hospital teachers because although the legislation does not preclude external teachers they need to be briefed in advance and be aware of NHS protocols and we have found that in practice these teachers are often discouraged from coming into a hospital for the following reasons:

3- Hospital teaching is a specialised skill
- External teachers may not have been briefed about that particular hospital’s governance issues
- Infection control may be compromised
- Child protection rules don’t allow external staff to come and work in the hospital

In addition the external teacher may often have a wasted journey, if the patient isn’t well or unavailable because of treatment. Hospital teachers are much more flexible and do not incur the additional cost of travel incurred by external teachers.

We know of one hospital where external teachers are not admitted for some of the above reasons. All children treated there therefore depend on the hospital teachers and will lose out, if their local authority does not give
permission for the hospital teachers to work with their children.

Another hospital treats children from a local authority area which does not subscribe to hospital teaching but instead chooses to send its own teachers, the result being that some of their patients will miss out on teaching provision because of the problems that external teachers face.

2. Young people in adult hospitals or wards also face problems in accessing teaching services. We know of a young patient with an acquired brain injury who had been in hospital since January 2010 and was only referred to teaching services in May 2010.

3. Privately educated children and young people: The Additional Support for Learning Act (Scotland) 2004 states that local authorities do not have to teach privately educated children, as they have ‘opted out’. In some parts of Scotland, many children are taught in private schools and if they do receive tuition at the hospital school, the cost cannot then be recovered from the local authority. ACS(S) considers that a system should be in place to ensure that these children are being taught and are not disadvantaged.

4. It is the duty of local authorities to provide teaching for children and young people who are absent from school due to ill health and to record this information. But how can the government ensure that schools and local authorities adhere to the legislation and guidance and fulfil their duty to provide education to these children (after 5 days in hospital or 20 days of being ill at home)? How does the government ensure that all children receive the same access to education regardless of where they live or the nature of their illness? How does the government ensure that all children, including those who are educated privately, receive their right to education? ASC(S) feels it would be helpful if local authorities could provide the Scottish Government with information that would ensure that local authorities are complying with the legislation and also to identify where there are problems in the provision of education to children when absent from school due to illness.

There are examples of good practice in hospitals throughout Scotland. In one local authority all children who qualify under the criteria are taught, regardless of where they come from. The teacher collates all teaching on a monthly basis and submits this to the local authority. She was not able to tell us how the local authority bills for the service. Occasionally a local authority might get in touch to clarify the number of hours taught, but all children, including those from private schools receive teaching in the hospital. They also receive home tuition which is sometimes just 3 hours a week. Outreach is only done locally with further away patients being picked up in their own authority. Recurring patients like those who have Cystic Fibrosis or cancer are taught immediately.

Privately educated children are the same – no issues at all.

In another hospital, the teacher and medical team plan well ahead of surgery how a patient needs to be supported during recovery. Apart from medical and occupational health support, they assess educational needs and arrange for teaching to be in place. This kind of good practice should become standard across Scotland.

ASCS(S) asks the following questions:

1. Some local authorities normally provide education to children and young people at hospital after ten days admission, while others provide hospital education after five days admission. What will you do to ensure that, as
recommended in the Standards in Scotland’s Schools etc Act 2000 Education of Children Absent from School through Ill Health Point 37, that the teaching of children in hospital begins after five working days following admission provided the child’s state of health makes this desirable?

2. What can be done to ensure all local authorities provide hospital education to all children and young people irrespective of their illness or condition and not just to those with particular conditions or illnesses?

3. Can action be taken to ensure that local authorities cannot opt out of subscribing to the hospital education service where this service exists?

4. Currently local authorities charge different rates for the provision of hospital education. Can local authorities be asked to agree standard charges for hospital provision?

5. What action will you take to ensure that children and young people educated at private schools receive the same access to education provision at hospital or at home during times of illness as children who attend local authority schools?

6. Can local authorities be asked to provide the Scottish Government with the following information about education provision relating to children in their areas who are absent from school due to illness?

• where education was provided (at home or in hospital);
• how many days a child was in hospital before teaching was provided;
• the number of days a child was off sick before home teaching was provided ;
• the total number of hours provided for the child and the number of weeks education was provided;
• the child’s condition/illness.

7. Can the Government ensure that a national pathway is in place which sets out in detail what needs to be done, the timescales and staff responsible in order to ensure that all involved in the provision of education to children and young people absent from school at times of illness, (local authorities, health boards, schools) adhere to the Guidance on the Education of Children Absent from School through ill-health. (Examples of pathways already exist within systems such as GIRFEC and the pathway of care for children with exceptional healthcare needs. www.sen.scot.nhs.uk/pathways-care).

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