Supporting Learners with Medical Needs in Wales

Supporting Learners with Medical Needs in Wales

A practical guide for ALN families on health plans, school duties, and your rights

Children and young people with medical needs are protected under Welsh education law and the Additional Learning Needs system.

Schools have clear duties to support learners with healthcare needs, whether those needs are short-term, long-term, fluctuating, mental health-related, or linked to neurodevelopmental conditions.

This guide explains what schools must provide, how Individual Healthcare Plans work, and how education and health services are expected to work together to keep children safe and included.

It also includes guidance for electively home-educated families, children with chronic illness, and those experiencing slow post-viral recovery.

---

1. What counts as a medical need in Wales?

A medical need is any physical or mental health condition that affects a child’s ability to:

• access education

• attend regularly

• remain safe in school

This includes, but is not limited to:

• asthma

• ADHD medication needs

• epilepsy

• diabetes

• chronic fatigue or post-viral symptoms

• anxiety or panic attacks

• gastrointestinal conditions

• feeding or hydration difficulties

• allergies and anaphylaxis

• Long Covid

• mobility or continence needs

• mental health conditions

• medication that must be given during the school day

Medical needs do not need to meet a diagnostic threshold.
If a condition affects safety, access or attendance, it counts.

Welsh Government reference:
Schools must follow Supporting Learners with Healthcare Needs (statutory guidance).

https://www.gov.wales/supporting-learners-healthcare-needs

---

2. When a school must create an Individual Healthcare Plan

Welsh Government guidance requires an Individual Healthcare Plan (IHP) when:

• a child has a long term or complex medical condition

• medication must be given in school

• emergency procedures are required

• a condition affects attendance

• a condition affects participation in learning

• adjustments, rest breaks or safety planning are needed

• symptoms fluctuate or are invisible

• a child cannot reliably self-manage symptoms, hydration or energy

Schools cannot refuse to create a plan because they are busy, because a condition is described as anxiety, or because a child appears to be coping or masking.

If a medical condition affects safety or access to education, a plan is required.

---

3. What should be in a good Individual Healthcare Plan?

A strong IHP should include:

• a clear description of the condition

• signs and symptoms to watch for

• known triggers and how to reduce them

• baseline information on energy, eating, drinking and regulation

• emergency procedures

• medication details, including dose, timing and storage

• who is trained to deliver care

• rest breaks and sensory needs

• hydration or nutrition strategies

• when parents should be contacted

• when the child is too unwell for school

• steps for return after illness

• who is responsible for daily checks

• an agreed communication system

• reasonable adjustments during lessons, movement and breaks

The plan should be written with full parental involvement and reviewed at least annually, or sooner if the child’s condition changes.

---

4. Schools must involve the right people

An Individual Healthcare Plan should be written with input from:

• the parent or carer

• the school nurse

• GP or specialist team where appropriate

• the school ALNCo

• pastoral or wellbeing staff

• the child or young person, where possible

Schools must not write a health plan in isolation without consulting healthcare professionals.

If a child has an Individual Development Plan (IDP), the IHP should sit alongside it and inform ALN provision.

---

5. Medication in school: your rights

Schools must:

• store medication safely

• train staff to administer it

• keep clear records

• allow children to carry inhalers where appropriate

• make reasonable adjustments for sensory needs around medication

• support hydration and food needs linked to medication side effects

Schools cannot require a parent to attend daily to administer medication unless this is by parental choice.

---

6. When medical needs affect attendance

Where a condition causes fatigue, pain, anxiety, dysregulation or difficulty managing a full school day, families may request:

• a reduced timetable

• a phased reintegration plan

• temporary home tuition

• rest breaks or quiet spaces

• adjusted start or finish times

• a review of the IDP

If a child is too unwell to attend long term, families may request:

• medical needs tuition

• Education Otherwise Than At School (EOTAS) where attendance becomes medically impossible

Parents are not required to provide repeated GP notes. Schools must accept parental explanation unless there is a clear safeguarding concern.

---

7. What happens for electively home-educated children?

Health support does not end with deregistration.

Electively home-educated children continue to have access to:

• school nursing services

• vaccinations

• health checks

• continence services

• paediatric referrals

• long-term condition monitoring

Families can contact their local health board directly.

---

8. When you should request a review or change of plan

Request an urgent IHP review if:

• Symptoms worsen or fluctuate

• medication changes

• attendance drops

• fatigue or sensory overwhelm increases

• the child cannot regulate without breaks

• staff say they cannot meet health needs

Request an IDP review if:

• medical needs impact learning

• health and education provision need alignment

• reduced timetables become prolonged

• anxiety or EBSA develops due to health

If attendance becomes medically impossible, request EOTAS consideration.

---

9. Where to find the official Welsh Government guidance

The statutory duties are set out in:

Supporting Learners with Healthcare Needs (Welsh Government)

This document is essential for families and professionals.

---

10. Disclaimer and safety notice

Learn Without Limits CIC provides general information about education rights and public guidance. We do not provide clinical or legal advice.

If your child is unwell, seek appropriate medical support.

• NHS Wales 111 for non-emergency advice

• Your GP for ongoing or worsening symptoms

• Call 999 immediately if a child has difficulty breathing, seizures, severe drowsiness, chest pain, dehydration symptoms, or any sign of serious illness

Always trust your judgement and use the appropriate service.

---

11. Coming later this month

We will publish a two-part series:

Long Covid in Welsh children

These posts explore slow recovery, post-viral fatigue, school anxiety, pacing and support for ALN learners, building directly on the issues raised here.

We will also be hosting an online session for parents to support our Long Covid series in early March, and you can book a place via our website here https://learnwithoutlimitscic.org/events.en.html

________________________________________________________________________________

This Blog is the official publication for Learn without Limits CIC 
https://learnwithoutlimitscic.org/

 

IDP vs IHP in Wales

A Clear Guide for Parents on the Difference Between Education Plans and Health Plans

Many parents in Wales read advice online that is written for families in England. This causes understandable confusion because the English EHCP system is very different from the Welsh Additional Learning Needs system.

One of the most common misunderstandings is the difference between an Individual Development Plan (IDP) and an Individual Healthcare Plan (IHP).

These two documents serve very different purposes, follow different laws and offer different protections. Here is a simple clear guide explaining what each one does and when your child might need one or both.

---

1. What is an IDP in Wales

The Individual Development Plan (IDP) is the legal education plan for children and young people with Additional Learning Needs under the Additional Learning Needs and Education Tribunal Wales Act 2018.

✔ It is a legally binding document

✔ It can be enforced at the Education Tribunal

✔ It replaces Statements of SEN and IEPs in Wales

An IDP must:

• Identify a child’s additional learning needs

• Describe the barriers they face

• Detail the support required to overcome those barriers

• Specify who delivers each part of the provision

• Explain how often and in what way the support must be delivered

• Include measurable outcomes

• Be reviewed at least annually

• Be maintained by the school or the local authority

The IDP is about learning, access and educational progress.

It is similar to an EHCP in England, but it is not the same and parents should NEVER rely on English EHCP guidance when understanding IDPs.

For more information about what should be included in an IDP, please see our previous article here https://learnwithoutlimitscic.blogspot.com/2025/11/idp-series-what-must-be-included-in-idp.html

---

2. What is an IHP in Wales

The Individual Healthcare Plan (IHP) is the document used to support a child’s medical needs in school.
It follows the Welsh Government guidance Supporting Learners with Healthcare Needs.

✔ It is a health and safety document

✔ It is not legally enforceable at tribunal

✔ It is created with input from health professionals

A good IHP should include:

• The child’s medical condition

• Symptoms warning signs and triggers

• What to do if the child becomes unwell

• Medication names doses timings and storage

• Who is trained to administer medication

• Emergency procedures

• Hydration and nutrition needs

• Rest break or sensory regulation needs

• When the child is considered too unwell to be in school

• Communication methods between school and home

The IHP is about health care and safety, not education.

---

3. The Key Difference Summarised

IDP	IHP
Education document	Health document
Covers learning barriers	Covers medical needs
Legally enforceable	Not legally enforceable
Appeal rights to Tribunal	No appeal route
Specifies educational provision	Specifies care procedures
Must be written by school or LA	Written with health professionals
Based on the ALN Act	Based on healthcare guidance

The IDP is the plan that ensures a child can learn.
The IHP is the plan that ensures a child can stay safe.

---

4. When a Child Needs an IDP

A child needs an IDP when they have an additional learning need, meaning:

• they have a learning difficulty or disability

• the difficulty impacts their ability to learn

• they need special educational provision to access education

• reasonable adjustments alone are not enough

This can include:

• autism

• ADHD

• dyslexia

• speech and language needs

• anxiety that affects learning

• emotional regulation difficulties

• learning disability

• sensory processing disorder

• long term medical conditions that affect learning or attendance

If health needs impact learning, then the IDP and IHP should work together.

---

5. When a Child Needs an IHP

A child needs an IHP when:

• they have a chronic health condition

• they need medication in school

• they require emergency procedures

• they need staff to be trained in health care tasks

• they need hydration rest or nutrition adjustments

• their condition fluctuates and needs monitoring

• their wellbeing or safety would be at risk without a plan

Examples include:

• asthma

• epilepsy

• diabetes

• severe allergies

• post viral fatigue

• migraine

• gastrointestinal conditions

• chronic pain

• mobility needs

• continence needs

• complex mental health needs

The IHP alone does not replace the IDP when health needs affect learning.

---

6. The Most Common Misunderstanding in Wales

Parents are often told:

“Your child does not need an IDP because they have a medical plan.”

This is not correct.

If a child’s medical condition causes:

• fatigue

• pain

• behaviour changes

• sensory overwhelm

• slow recovery after illness

• disrupted attendance

• difficulty accessing the curriculum

• emotional distress

• anxiety about health

…then the child may have additional learning needs and may require an IDP as well as an IHP.

---

7. How the Two Plans Work Together

Think of it like this:

The IDP supports the child’s learning.

The IHP supports the child’s health.

They are separate but must inform one another.

If a child has a medical condition, the IHP explains what the condition is and what support is needed.
If that condition impacts learning or attendance, the IDP explains what educational support is required.

Most children with both ALN and medical needs require both plans together.

For more information about how exactly health information feeds into the IDP please read our previous article here https://learnwithoutlimitscic.blogspot.com/2025/11/idp-series-health-social-care.html

If your child has a private diagnosis, we've explained how that feeds into the IDP process, Private Diagnoses and IDP

---

8. For Families Who Have Read English EHCP Advice

English EHCPs combine:

• education

• health

• social care

into a single legal document.

Wales does not.
In Wales:

• The IDP is the legal document

• The IHP is the supporting medical guidance

• Health support must be coordinated but is not legally binding in the same way

This is why England based advice does not map to the Welsh system.

---

9. When to Request an IDP Review or a New IDP

Consider requesting an IDP review if:

• health needs begin to affect attendance

• your child needs adjustments in lessons

• your child is too fatigued to manage a full day

• behaviour worsens after illness

• anxiety around health becomes a barrier to learning

• the school is relying only on the IHP and not updating the IDP

• a slow recovery after flu or a viral illness is affecting learning

Requesting a review is your right under the ALN Act.

---

10. Disclaimer and Safety Note

Learn Without Limits CIC provides general information on ALN rights and Welsh education policy.
We do not provide clinical medical or legal advice.

If your child is unwell seek professional medical assessment.

For medical concerns:

• NHS Wales 111 offers non emergency advice

• Your GP can assess ongoing or worsening symptoms

• 999 should be called immediately if a child has difficulty breathing severe drowsiness seizure chest pain a rash that does not fade dehydration symptoms or any worrying sign of serious illness

Parents should always use common sense when deciding which service to contact.