Councillors in Carmarthenshire have backed a motion calling for permanent nursing provision at all specialist additional learning needs (ALN) facilities in the county.
The motion, brought by Labour councillors Martyn Palfreman and Edward Skinner, said pupils in such sites often needed complex medical interventions during the school day.
Complex medical needs highlighted
These interventions include tube feeding, catheterisation, tracheotomy care, monitoring and responding to seizures, and the timely administration of prescribed rescue medication, according to the motion.
It said educational staff in such establishments provide outstanding care and have undertaken training to meet individual healthcare needs, but they are not medically qualified. As such, they should not be expected to be responsible for recognising clinical deterioration, assessing complex medical symptoms or responding to potentially life-threatening medical emergencies that arise during school time.
Focus on Ysgol Heol Goffa
Particular focus was placed on Ysgol Heol Goffa in Llanelli, where many pupils have very complex needs. According to the motion, the head teacher has sought permanent onsite nursing provision for more than five years.
Parents have expressed serious and continuing anxiety about the safety of their children in the absence of a registered nurse permanently based on site, the motion said.
Discussions have taken place between the council and Hywel Dda University Health Board. The motion called for an urgent meeting between them and other parties to agree a funded and time-bound plan. It also said a jointly-commissioned clinical risk assessment for every pupil with complex or life-limiting medical needs should be done immediately.
Council and health board responses
Speaking at a meeting of full council on November 11, Cllr Palfreman said providing the right support could in some cases be a matter of life or death. He and others praised the work of teachers and teaching assistants.
Cllr Crish Davies said every parent deserves peace of mind that comes from knowing their child is in safe hands. Some of them, she said, lived with worries we can barely imagine.
Cllr Deryk Cundy said five children at a special school had palliative care, seven had feeding valves, three had shunts, and 22 had epilepsy. He added that many children could not articulate their concerns.
Cllr Gareth John supported the motion with two reservations: that it was logical for the outcome of discussions between the council and the health board to reach an outcome before cabinet discussed the motion, should it be approved, and an acknowledgement the council could lobby but could not create a health workforce that may not even exist.
Cllr Jane Tremlett, cabinet member for integrated health and children and adult services, said every child with complex needs should be able to attend school safely, with dignity and with confidence that the appropriate support is available if they need it.
She said school staff should not be expected to be healthcare professionals. We need absolutely clarity about where professional responsibility sits and how that provision is commissioned and funded, she said.
Cllr Tremlett said different schools might need different models of provision, adding that what matters is it is safe, clinically approved and sustainable.
Cllr Glynog Davies, cabinet member for education, called on the health board to take up their responsibility seriously and said the Welsh Government should provide clarity on what they expected councils to provide. The motion received cross-party support.
Sharon Daniel, director of nursing, quality and patient experience at Hywel Dda University Health Board, said the health and wellbeing of all children and young people is fundamental to their ability to learn, thrive and reach their potential, and is a priority for the board.
She said the board supports the children and young people at Ysgol Heol Goffa with a specialist/community children nursing service to meet their universal health needs, and through the provision of training for staff at the school.
We provide specialist support, ensuring each child and young person with healthcare needs can be cared for competently and confidently within the school environment, she said. Through continued partnership working and a shared commitment to improvement, we will support ongoing actions to strengthen provision and ensure the best possible outcomes for the pupils and staff at Ysgol Heol Goffa.
