Making sure children with health conditions get the support they need

Our Work

The HCSA works to ensure that children with health conditions receive the care and support they need to be safe, well supported, fully included and able to thrive in education.

We engage with government, education bodies, regulators, and stakeholders to raise standards, campaign for better implementation of existing laws, and provide evidence to inform future policy.

Some highlights of our work are below: 

Monitoring Compliance and Driving Accountability
Since the introduction of the statutory duty on schools in 2014, the HCSA has consistently monitored how well it is being implemented, and pushed for improvement where needed.·
 
In a 2016 Investigation, we found that:
• 78% of schools did not demonstrate that they had a medical conditions policy
• Of those that did, 46% were not compliant with statutory requirements
• This was despite the fact that a medical conditions policy is legally required.· 

When we revisited in issue in a 2017 follow-up, we found that:
• Only 11.5% of schools in England could provide a policy that met the legal standards
•Additionally, 72% of schools reported that Ofsted had not asked about their medical conditions policy during inspection, despite its critical role in pupil welfare
• We also received reports of schools rated “Good” or “Outstanding” by Ofsted, even while failing to meet their statutory duties, putting children’s health and inclusion at risk

Engaging with Ofsted
• In response, the HCSA worked to raise awareness of the importance of the duty with Ofsted
• In 2017, Sean Harford, then National Director for Education at Ofsted, sent a message to all school inspectors highlighting the statutory duty and its relevance in assessing pupil welfare. 
• You can view the full message that was sent in their newsletter of March 2017 here: School inspection newsletter

2021 Re-Investigation and Policy Engagement
• In November 2021, we repeated our investigation and found that only 27% of schools had an adequate, publicly available medical conditions policy.
• We wrote to the then Children and Families Minister, Will Quince MP, sharing our findings and calling for renewed focus on implementation.
• In a January 2022 response, we were advised that the SEND Review would be an opportunity to re-engage on this issue and that the Department for Education was exploring an update to the statutory guidance. 

Contributing to the SEND Review in 2022
•In Spring 2022, we engaged with DfE officials and arranged a dedicated feedback session for HCSA members to share their expertise and recommendations directly.
• We submitted a detailed written response to the Green Paper, making the case for:
          o Strong, consistently implemented medical conditions policies
          o Universal access to individual healthcare plans (IHPs)
          o These tools can prevent escalation of health-related issues and reduce pressure on wider SEND systems. 

Re-engaging with Ofsted in 2025
• In 2025, we responded to the consultation ‘Improving the way Ofsted inspects education’, highlighting that proposals to add Inclusion to the evaluation framework inspectors must make explicit reference to how schools support learners with medical conditions
• We also met with a representative from Ofsted’s SEND and Alternative Provision team to discuss these key points.

Update of the Wales ‘Supporting Learners with Healthcare Needs’ guidance· 
• In 2026, we engaged with Welsh government regarding the proposed updated of the ‘Supporters Learners with Healthcare Needs’ guidance· 
• HCSA members have joined an advisory group developing updated guidance to ensure the needs and voice of children and young people with health conditions are considered within this

England statutory guidance update and ongoing SEND Reform· 
• The HCSA have been stakeholders for the update of the ‘Supporting pupils with medical needs’ guidance for England – welcoming the DfE’s announcement to update this in 2026 and supporting with its development through meetings and consultation responses. Our priorities include:
          o Strengthening the guidance on Individual Healthcare Plans and their benefit as communication tool
          o  Aligning attendance guidance to promote inclusion and wellbeing
          o Better partnership working between healthcare and education staff·
• We have also responded to the 2026 SEND Reform white paper ‘Every child achieving and thriving’ and continue to engage with DfE and other organisations to ensure the needs of pupils with health conditions are supported through these proposals.

The HCSA continues to push for accountability and improvement across the system, because every child with a health condition deserves safe, inclusive, and supportive education.