IDP Series, Health & Social Care: What Must Be Included, What Local Health Boards Owe Your Child, and What to Do When They Refuse
Health and social care support are two of the most inconsistently applied parts of the ALN system in Wales — yet the legal duties are extremely clear.
This article explains what MUST go into an IDP, based on the Additional Learning Needs and Education Tribunal (Wales) Act 2018 (ALN Act), the ALN Code for Wales (statutory), and the Social Services and Well-Being (Wales) Act 2014 (SSWBA).
1. The Law: Health and Social Care MUST Contribute to IDPs
A. Duties Under the ALN Act (2018)
Health advice (ALN Act 2018, s.20)
A Local Health Board must provide the local authority or school with whatever advice and information they reasonably require to support an IDP.
Health-related ALP (ALN Act 2018, s.18–19)
If a Health Board agrees that something is health-related Additional Learning Provision, then they must secure that provision. This is a binding statutory duty.
Multi-agency working (ALN Act 2018, s.77)
Local authorities, Health Boards and social services must cooperate with each other in supporting children with ALN.
B. Duties Under the ALN Code (Statutory Code 2021)
Evidence must be considered (ALN Code 20.2)
Evidence may come from other services, the child, or the child’s parents.
Evidence can include specialist services (ALN Code 20.3)
This includes NHS and private specialists (EP, SALT, OT, physio, CAMHS, paediatrics, audiology etc.).
Schools/LAs must seek specialist advice (ALN Code 20.20)
Authorities must request advice from appropriate specialist services where needed.
Health must provide advice (ALN Code 21.6)
Health Boards must respond to requests for advice and information.
Social care must contribute (ALN Code 21.10)
Local authorities must ensure social services provide advice and information to support IDP development.
Health ALP in the IDP (ALN Code 23.55–23.63)
Medical, sensory and therapeutic needs and provision must be recorded in the IDP.
When the LA must take over (ALN Code 23.67)
If the ALP required cannot be delivered in full at any maintained school, the LA must take responsibility for the IDP.
Right to request a review (ALN Code 25.21)
Parents may request an IDP review at any time, and the school or LA must arrange it unless unnecessary.
C. Duties Under the Social Services & Well-Being (Wales) Act 2014
Disability duty to assess (SSWBA 2014, s.21(5))
If a child may need care and support, the local authority must assess them.
Rights regardless of education setting
Disabled children retain their rights to social care even if they are:
• in school
• EOTAS
• EHE
• not in education at all
Social care support must appear in the IDP
Any disability-related need that affects learning must be recorded in the IDP, including home adaptations, equipment, handling plans, PAs, short breaks, or safeguarding involvement.
2. What Health MUST Provide for an IDP
Based on the ALN Act s.20 and ALN Code 21.6, health bodies must provide:
• written advice
• medical information
• care plans
• therapy recommendations
• sensory profiles
• positioning/handling plans
• risk assessments
• feeding/ swallowing guidance
• fatigue and pacing strategies
This is required even if:
• the child is not on a waiting list
• the service has “no capacity”
• the child is on a diagnostic pathway
• the child is EHE or EOTAS
• the child has been discharged
3. What MUST Appear in the IDP (Health Section)
Under ALN Code 23.55–23.63, the IDP must include:
• medical diagnoses
• sensory and motor needs
• therapy guidance
• physical disability requirements
• mental health needs
• safety plans
• seizure plans
• feeding/swallowing risks
• fatigue and pain
• specialist equipment
• personal care needs
These must be written in even if NHS staff do not supply full recommendations.
4. What Social Care MUST Provide
Under ALN Code 21.10 and SSWBA 2014, social care must provide advice and support where a child’s disability or home situation impacts learning.
This may include:
• disability assessments
• home adaptations
• equipment
• manual handling plans
• PA support
• short breaks
• risk management
• safeguarding advice
• support for family wellbeing
These must appear in the IDP whenever they affect access to learning.
5. Multi-Agency Examples
Autism / Sensory / Communication (SALT, OT, CAMHS)
• sensory diet
• AAC
• anxiety plan
• joint attention work
• environment adjustments
Physical Disability (Physio, OT, Social Care)
• equipment
• handling and seating plans
• mobility support
• PA or two-person transfers
Chronic Illness (Nursing, Paediatrics)
• glucose monitoring
• seizure plan
• pacing
• medical access
• risk plans
Mental Health (CAMHS / community services)
• safety and anxiety plans
• graduated engagement
• trauma-informed approaches
6. What If Health Will Not Engage?
If health refuses, delays, or says “lack of capacity,” parents can use this wording:
“ALN Act s.20 and ALN Code 21.6 require the Health Board to provide advice when requested.
Could you confirm in writing whether this advice will be provided?”
The IDP must still record:
• the need
• the provision required
• that health advice is pending
The ALN system cannot leave gaps because a service did not reply.
Parents can escalate through:
• ALN Lead Officer
• Health Board complaints
• Welsh Ombudsman
• their MS
• safeguarding if relevant
7. When Health Needs Trigger an LA-Maintained IDP
Under ALN Code 23.67, if the required ALP:
• involves daily therapy programmes
• requires medical oversight
• involves multi-agency input
• needs specialist equipment or training
• is beyond school staff expertise
• poses significant risk
• cannot be delivered consistently in school
…the Local Authority must take over the IDP.
Schools cannot legally continue to maintain an IDP they cannot deliver.
8. Parent Scripts (Legally Grounded)
When school tries to remove health needs:
“ALN Code 23.55–23.63 requires health-related needs and ALP to be included in the IDP. Could we ensure this is recorded?”
When health claims ‘no capacity’:
“Under ALN Act s.20 and ALN Code 21.6, the Health Board must provide advice when requested. Could you confirm in writing whether advice will be provided?”
When requesting a review:
“I am requesting a review under ALN Code 25.21 due to new evidence or changes in need.”
Summary
✔ Health must provide advice (ALN Act s.20; ALN Code 21.6)
✔ Social care must contribute where relevant (ALN Code 21.10)
✔ Needs must be written into the IDP even if services do not engage
✔ Health ALP must be included (ALN Code 23.55–23.63)
✔ LA must take over the IDP when ALP is beyond school capacity (ALN Code 23.67)
✔ Parents can request a review at any time (ALN Code 25.21)
✔ The Social Services & Well-Being Act guarantees disability support regardless of school attendance
✔ All multi-agency needs must be recorded clearly in the IDP
Health and social care are not optional extras in IDPs — they are essential components backed by binding statutory duties.
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This article provides general information about the ALN Act and ALN Code in Wales.
It is not legal advice. For individual cases, families may wish to seek independent specialist advice if needed.
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