Developing and implementing individual HEALTHcare plans for children with more complex medicalneeds

An individual health care plan formalises the plan of support for children with complex health/medical care needs. A template is available to draw up the plan if required. (In addition separate guidance and templates are available for medical emergencies and risk assessments.)

The Manager, SENCO and or Designated First Aider and parents as well as any supporting specialist nurse will initiate the development of a health care plan in the following circumstances or when the situation is complex or where a plan would be of assistance in managing support for the child.

Individual health care plans should be developed for:

  • severe asthma, type-one diabetes, anaphylaxis, kidney issues and epilepsy -
  • any child who is diagnosed as being at risk of an emergency
  • any child who requires the administration of specific health care procedures and or medicines, over and above those attributed to every day medical issues such as coughs and colds.

Information from the child’s medical practitioner, provided by parents, will inform the planning process. Children with diabetes and epilepsy will have a Community Nurse assigned to them, who must lead the set-up of the plan. The plan will describe the child’s needs and how the nursery plans to meet these needs during the day, on excursions and in other variations in routine.

If required an ‘Emergency Medical Plan’ must also be drawn up detailing procedures to be followed if an emergency arises for those children whose condition could give rise to life- threatening situations. Procedures need to be agreed between the parent and the nursery, following consultation with the relevant medical practitioner/s.

Plans should be reviewed as needed and at least annually, when the child transfers into a different room or when the parent notifies the nursery that the child’s health needs have changed. A review of a child’s health care plan can also be instigated by the Manager, SENCO and or designated First Aider, parent or medical professional at other times.

A risk assessment will be carried out regularly and following a specific medical or emergency incident.

The setting’s insurance company should be informed of the child’s condition.

The individual health care plan will:

  • specify the child’s specific health care needs
  • describe agreed actions to meet these needs
  • include emergency phone numbers for ambulance, the parent and an emergency contact if required and any code words or numbers for access to hospital
  • include the name and phone number of the child’s medical practitioner(s)
  • include attachments as relevant such as:

an emergency care/response plan

a risk assessment and or review

a schedule for the administration of prescribed medication

a plan for administering controlled medicines such as those used in epilepsy

a schedule for the administration of health care procedures

an authorisation to contact the medical practitioner

evidence of appropriate training received to administer injections, administer controlled medicines and to dispose of used medical equipment safely i.e. sharps box

The individual health care plan must address circumstances that may impact on the child’s health care needs, such as variation in nursery routine, absence of staff, special transport arrangements, physical activity and environmental conditions.

The possible effects of emergencies arising at the same time involving more than one child need to be considered and addressed in individual health care plans.

The Manager and SENCO/designated First Aider are responsible for in consultation with appropriate nursery staff, the parent and the Community Nurse if assigned or medical practitioner, assessing how the nursery will meet the health care needs of the child.

The development of the individual health care plan may incorporate a risk assessment process to manage risk to the child or other children or staff. (See separate risk assessment template)

The Manager, SENCO and or Designated First Aider will arrange a meeting with the parent and appropriate nursery staff to discuss the management of the child’s health care needs.

The meeting with the parent & setting may be supported by input from the Early Years Inclusion Advisor

A copy of the individual health care plan should be provided for the parent.

When a child transfers to school, the setting should provide a copy of the individual health care plan for the new head-teacher. A transition planning meeting may be required. This can assist the process of health care planning in the new school and can also assist the child’s transition to that school.

KAH - Early Years Inclusion Advisor.July 2016

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