Written evidence submitted by The National Association for Hospital Education


NAHE response to C19 call for evidence

The National Association for Hospital Education is an organisation that supports professionals working in hospital education. This could be within a hospital school, medical PRU, CAMHS inpatient unit or as part of an outreach service such as home tuition. In fact, anyone who works with children and young people who are unable to attend school due to physical and / or mental health difficulties. We aim to act as a unified voice to ensure staff within our sector are well supported in delivering the very best education to every child under our care. We aim to represent the views of our sector at a national level, to liaise with key partners such as the Department for Education and Ofsted, to undertake research into ‘best practice’ for teaching and to provide bespoke continuing professional development opportunities for those who work in our sector. We also broker peer to peer support for school improvement as we know that we need people who understand the challenges of our sector to support us in our school improvement work.

Promoting the educational needs and rights of children with medical and mental health difficulties who cannot attend school is also part of our remit. We were part of the recently produced ‘Invisible children’ report looking at the fact that there is no data to tell us how many of children in the UK are missing out on their education because they are too unwell.

       The implementation of the critical workers policy, including how consistently the definition of ‘critical’ work is being applied across the country and how schools are supported to remain open for children of critical workers

The implementation seems to be very much localised, with LAs making the decision on who they want to interpret the guidance. In some areas, it seems to have become a competition with LAs saying that they have more pupils and more schools open than others. Some are being pushed to stay open. The part being missed is that if children are safe to be at home, then that is where they should be. All of the children are risk assessed to see if they are safe to be at home.

Interestingly, in AP, we have looked flexibly at the definition of ‘critical workers’ and tried to support our parents to remain in work ads much as possible, aware of the possible economic impact on our families.


       The capacity of children’s services to support vulnerable children and young people

Mixed response from different local authorities. Common themes seem to be the expectation of social workers to be able to remain at home and do all of their work remotely, but schools are expected to go out and do face to face. Stepping down child protection to a child in need, not based on the needs of the child but because the process was too complex to manage in this situation which leaves us feeling frustrated.



       The effect of provider closure on the early years sector, including reference to:

       Children’s early development

       The early years funded entitlement and the childcare market



       The effect of cancelling formal exams, including the fairness of qualifications awarded and pupils’ progression to the next stage of education or employment

There have been mixed responses from our pupils. As they are all children with medical and mental health difficulties, some are delighted that they do not have to go through the anxiety of sitting exams, and others a feeling robbed as they were only just beginning to engage fully with their education following a period of illness and were relying on being able to cram for the exam. I think that Ofqual have done a good job at making the guidance as fair as possible and they have been responsive to queries that we have had.

Huge concerns over the statistical model being applied as this is negatively impact on some of our learners in our cohorts this year who are gifted and talented, and their results will be out of step with our normal set of results.

Very difficult in AP to look at historical data as we have different cohorts each year, with different educational journeys to that point.

Most pupils in AP have missed most of year 10 and we provide them with the learning to help them ‘catch up’ and take their GCSEs


       Support for pupils and families during closures, including:

       The consistency of messaging from schools and further and higher education providers on remote learning

I think that parents have been bombarded with information and there is so much, it is overwhelming and they don’t know where to look. We have ensured that we interpret the information that comes from DfE and send out regular briefings for parents that summarise the key points. We also just add in key resources and advice and anything in addition has been done via a phone call so that parents have the chance to chat it through and ask questions.

The advice from the DfE is designed to be ‘nuanced’ - what that means in effect it that it is more open to interpretation and parents need to know that leaders now what they are doing and can make that information they need to know accessible to them and their child.

Pupils need to be engaged in communications in the same way - treat them with respect and give the the information that they require in order to remain informed and manage their unknowns, of which there are so many. The only change to make is the language/communication that is used so that it is accessible to the child


       Children’s and young people’s mental health and safety outside of the structure and oversight of in-person education

This has been a real challenge for pupils with medical and mental health difficulties. Many of our pupils already had significant mental health difficulties which is why they were not accessing their mainstream school and are being educated through an alternative provision. The keeping of their routine of the offline timetable in the online space has been helpful, being able to ‘see’ their teachers and other peers (if they choose to), and not overdoing the direct lessons has been helpful. Much of the CAMHS support has been withdrawn, so education staff are doing weekly mentoring with all pupils and providing additional support and signposting to pupils who are struggling. AP staff are also providing support for parents too, as often their mental health support has been withdrawn and they are struggling to cope with their own mental health and their child who is deteriorating.  Information about online support and helpful apps have been shared across our association.

HUGE concerns about managing their anxiety once we are given the go ahead to reopen physically and how we can support them manage this anxiety.

For pupils with complex medical needs, they have had the opportunity to access their own school in the same way as their peers, because schools have had to look at how they provide remote learning for all of their school cohort. This has lessened the feeling of social isolation that they feel every day and we need to ensure that this continues post lockdown. This is because for some pupils, they will not be able to come out of isolation for at least 12 months. They have probably had a positive experience from the lockdown which has allowed them to reconnect with their home school community which may have helped their mental health. However, they are much more at risk of potentially dying from C19, and we cannot ignore the impact on those pupils.


       The effect on apprenticeships and other workplace-based education courses



       The financial implications of closures for providers (including higher education and independent training providers), pupils and families

Purchase of equipment for staff to be able to work effectively from home e.g. white boards, special chairs, printers etc, purchase of hardware, wifi dongles (we can’t wait for the DfE scheme as too  much will be lost), impact on families of losing their jobs, not having family support for childcare etc.


       The effect on disadvantaged groups, including the Department’s approach to free school meals and the long-term impact on the most vulnerable groups (such as pupils with special educational needs and disabilities and children in need)

Planning for FSM distribution for dual registered pupils was a challenge  - who was responsible for what and ensuring that no families missed out. Many AP providers do not attract free school meals as most of our pupils are dual registered.


       What contingency planning can be done to ensure the resilience of the sector in case of any future national emergency

Head teachers have always had critical incident plans and pandemic plans - this was our learning from the SARs, avian and swine flu times. We have been looking at research from other countries who have suffered disasters and how they managed to engage their pupils in learning whilst they were closed, and how they planned for reopening e.g. New Zealand earthquakes, Ebola outbreak, Australian bushfire. All heads will now have a much more robust contingency plan.

Learning from the heads that were involved in previous disasters e.g. Grenfell Towers, Manchester Bombing and how they brought their school communities back and supported them to re-engage with learning whilst in recovery.


Future proofing depends on finance and whether you live in a local authority that is in special measures for finance and safeguarding, then any additional financial resources for their planning to support us is severely restricted.


Checking and providing for appropriate infrastructure in all pupil homes would be essential. Changing basic hygiene and health and safety procedures to reflect ongoing risks.

Training for pupils, their parents and staff in good hygiene practices.

Consider the current accountability framework in schools - it is all about how you do in the Ofsted inspections - no one inspects you on your systems and procedures to keep your pupils safe and your ability to respond in a crisis.

Closer work between education providers and post 16 provisions so that transitions can be more effectively managed if there were ever any future periods of lockdown.

Possibly starting transition planning (to include year 6 into year 7) much earlier





May 2020