Individual Healthcare Plans Explained

What are Individual Healthcare Plans?

An Individual Healthcare Plan (IHP) is a plan designed to support children and young people with medical conditions in schools and other educational settings. It outlines the child’s specific care and medical needs, including how their condition should be managed on a day-to-day basis and what to do in case of an emergency. IHPs should be individualised to each child and created with the child’s best interests in mind.

Not all children with a diagnosed medical condition need an IHP. An IHP is recommended in the following circumstances:

• A medical need or condition that impacts the student’s health and well-being.
• If medication is required to be taken in school.
• If the child or young person requires additional support, planning or care due to their medical needs. 

An IHP can be suggested by parents or guardians, the child’s school (e.g., the class teacher, SENDCO or pastoral team) or a healthcare provider. If appropriate, the child’s views can also be taken into account, for example, what difficulties they are facing at school and whether they feel they need additional support. 

IHPs may be required for a number of medical conditions, most typically conditions that are long-term, complex, require medication management in school or could result in an emergency situation that requires urgent intervention (such as a seizure, asthma attack or anaphylaxis). In some situations, IHPs may also be required for short-term medical needs. The child’s needs will be clearly set out in the IHP and may be met by universal, targeted or specialist provision.

When are IHPs Needed?

Educational settings, including schools and colleges, have a statutory duty to support pupils with medical conditions. Under the Children and Families Act 2014, Individual Healthcare Plans are a legal requirement for educational settings in the UK. IHPs are needed when a child or young person has a medical condition that requires specific management, support or emergency procedures in a school or educational setting. 

IHPs are particularly recommended if a student has a medical condition that is severe or complex. However, there are no specific guidelines surrounding when an IHP is required in the UK and it is up to the child’s school, their parents or medical professionals to determine whether an IHP is necessary. Even if the young person can manage their medical needs well in school and other aspects of their day-to-day life or if the condition is managed with medication, they may still need an IHP in place. 

IHPs may be needed in a variety of situations, such as:

Chronic medical conditions

Chronic conditions are those that last for at least a year and require ongoing medical attention or treatment. You can be born with a chronic condition or develop one over time and they typically have no cure. Some chronic conditions may limit activities and affect a child’s day-to-day life whereas others have less impact on the child’s life and may be well managed with medication. Examples include:

• Asthma (if frequent medication or monitoring is required).
• Diabetes (to manage blood sugar levels, insulin and diet).
• Epilepsy (for seizure management and emergency protocols).
• Severe allergies (e.g., anaphylaxis) that require an EpiPen.

Complex or chronic illnesses

A complex chronic condition (CCC) is a long-term illness that affects multiple aspects of a child’s health and may require care from multiple healthcare providers. A child with a CCC may have unique health needs, functional limitations or disabilities. Complex chronic conditions are more challenging to manage. Examples include:

• Cystic fibrosis (a build-up of sticky mucus in the lungs and pancreas that can clog airways and make it difficult to breathe and cause infections).
• Heart conditions (may cause a rapid heart rate, breathing difficulties and extreme tiredness which can affect the child’s ability to engage in everyday activities, cause attendance issues and be potentially life-threatening if not properly managed).
• Sickle cell disease (a blood disorder that causes abnormal blood cells and can lead to pain, organ damage and other serious complications, all of which can have a significant impact on a child’s education).
• Immunodeficiency (the child’s immune system is completely unable to or weakened in its ability to fight infections, which can result in frequent absences and affect the child’s ability to socialise with their peers).

Short-term medical needs

A short-term medical need is a condition from which the child is expected to make a full recovery and return to their usual state of health and independence. Although the child may require immediate care and support, this isn’t expected to be required long-term. Examples include:

• Post-surgery care requiring medication or activity restrictions.
• Temporary mobility issues needing adaptations in school.

Medication management

Medication management in schools is the process of ensuring that students receive their medications safely and effectively. It includes ensuring the student receives the correct dosage of medication and that medications are used in a manner that supports the overall health and well-being of the child. IHPs may be required for:

• Regular or emergency medication that must be administered at school.
• Conditions requiring injections, inhalers or feeding tubes.

Emergency situations

Emergency situations are sudden, potentially life-threatening or significantly worsening health events related to a student’s medical condition. The emergency would require immediate medication attention, which would be outlined in the IHP, with specific actions to be taken by school staff. Emergency situations may include: 

• Any condition that could require urgent intervention, such as severe asthma attacks, diabetic emergencies or seizures.

If a child’s condition significantly affects their ability to participate in school safely and comfortably, an IHP should be considered. It is important to bear in mind that each child experiences medical conditions differently and the same condition may manifest in different ways and affect different children in different ways, including the amount of care and support they need. This means that if two children have the same diagnosis, one may require an IHP and the other may not.

IHPs are not just solely focused on the child’s medical needs. A medical condition can affect many areas of a young person’s education and their school experience, including:

• Absences; Young people with a medical condition may have a higher number of absences, whether because of medical appointments or their medical condition causing them to be unfit to attend school. An IHP can outline the specific healthcare needs that may lead to a young person missing school and can include strategies to minimise absences by including a plan to support the child and parents in getting into school.
• Social impacts: Children with complex medical needs may experience social isolation, particularly if their medical needs cause them to miss a lot of school or if they feel different from their peers. An IHP can look at whether there are any social and emotional needs the school can offer support with. For example, if a child has a medical need that affects their physical mobility and means they are unable to engage in some physical activities, such as football, the school may set up a buddy system to support the child’s friendships or support the child in engaging in other playground games the child is able to take part in, so they have opportunities to socialise with their peers.
• Emotional and psychological impact: Some children with long-term medical needs may experience fear and anxiety being in school and away from their parents, depression, low self-esteem, difficulty managing emotions and feelings of isolation, often stemming from worries about their health, potential medical procedures and how their illness might affect their daily life and social interactions with peers. An IHP can help to support the child’s psychological well-being. 

An IHP should always consider the views of the child or young person. It should also include targets of how the individual can take more control of their care as they get older. 

Individual Healthcare Plans in Schools

An individual healthcare plan outlines the student’s medical needs and how the school can support them. It is created collaboratively with the student their family and the relevant healthcare professional. 

IHPs have several goals, for the child and the school, including:

• Clarify medical needs: The IHP should describe the child’s medical condition, how it affects them and how it impacts their learning and behaviour. Ensuring school staff have a thorough understanding of the child’s medical needs helps the child get the medical, educational, social and emotional support they need in school.
• Ensure the school knows how to support the child: The IHP should be designed to help the school manage the student’s medical condition. This includes outlining the child’s daily care needs and how to handle a medical emergency.
• Improve the management of medical symptoms: An IHP can help in the management of symptoms by providing the school with detailed information on how to support the child’s medical needs. Better management of symptoms helps to keep the child safe at school and can help prevent the medical condition from worsening.
• Provide reassurance: An IHP can reassure the child and their family that the school is aware of their condition and is committed to supporting them. This can help the child feel safer in the school environment and reduce feelings of stress and anxiety.
• Help the student participate in school activities: An IHP not only focuses on a child’s medical needs but also their educational, social and emotional needs. This can provide better access to learning activities and social activities and help improve the student’s school experience.
• Prevent medical emergencies: An IHP can outline practices that can prevent medical emergencies from occurring. For example, if schools are aware of how to properly manage a student’s diabetes and administer insulin injections, the student is less likely to have a diabetic emergency (which could be life-threatening).
• Improve attendance: Because IHPs help support students with medical conditions and create a more positive school environment, this can help to improve attendance. An IHP can include a specific focus on attendance, including attendance monitoring, developing support arrangements, identifying reasons for absences, creating appropriate interventions and communicating expectations with both the child and their family.

IHPs in schools should be confidential while still being easily accessible to any school staff who has permission to access it and any staff member who may need to become involved in the event of an emergency. This could include:

• Teachers
• Senior leadership team (e.g., headteacher, deputy head, assistant head)
• Special educational needs and disability coordinator (SENDCO)
• Teaching assistants
• School nurses or first aiders
• Lunchtime staff
• Pastoral staff

The school must decide who should have access to the IHP and clear this with the child’s parents or guardians.

Alongside the IHP, schools should provide other documents designed to support the plan. If the school is responsible for administering regular or emergency medication, the IHP should also include a separate medication form for the child’s parents or guardians to complete. This form should specify the medication name, type and expiry date, the dosage, method and timing, any special instructions or precautions and any known side effects. The form must be signed and dated by the parent or guardian. 

The school must also maintain detailed records of any medications that are administered. The record should include the child’s name, the name, strength and quantity of the medication, the date the school was provided with the medication, the expiry date and the dose and frequency of the medication. The record must then be completed every time medication is administered, providing the date and time the medication was given, the dosage given and the name and signature (or initials) of the staff member who gave the dosage. 

If any staff members received training on the child’s medical condition or on administering medication, detailed training records should be created. This demonstrates the school’s commitment to the child’s health and well-being, as well as its compliance with various regulations, including:

• The Children and Families Act 2014
• The Education Act 1996
• The School Premises (England) Regulations 2012
• The Misuse of Drugs Act 1971.

Some students may require both an IHP and an EHCP. An Individual Healthcare Plan (IHP) focuses on a child’s medical needs, while an Education, Health and Care Plan (EHCP) focuses on a child’s special educational needs. If a child has a special educational need or disability (SEND), alongside a medical need, they may have both an IHP and an EHCP. This helps to support the various needs of the child and outline any educational provisions. An IHP and an EHCP can be linked or can be two separate documents.

Creating an IHP

An individual healthcare plan should set out precisely what support is needed, how this support should be given, when support is required and which school staff should be providing support. The IHP should be clear, explicit and detailed. 

An IHP can be created as soon as an appropriate medical need that requires support has been identified. Unlike an EHCP, an assessment and formal statutory process are not required to create an IHP.

The key features of an IHP are:

• Personal information: The child’s name, address and date of birth.
• Medical details: The medical condition or conditions, including a description of the condition, the symptoms, triggers, daily care requirements, treatments, medications and any special requirements.
• Daily care needs: Daily care needs include instructions on how to manage the condition at school. This could include educational support (e.g., any adjustments that are required), dietary support, attendance support, physical activity restrictions and social and emotional support.
• Medication information: If daily or emergency medication is required (e.g., insulin, inhalers or EpiPens, this information should be included in the IHP, including the name of the medication, the dose and frequency of administration, clear guidance on how to administer it, any storage requirements and who is responsible for checking the medication.
• Emergency procedures: Details of what constitutes an emergency, what can trigger an emergency situation and the steps to follow in case of a medical emergency, including who to contact and who is responsible in an emergency. The emergency procedures should also specify whether the school should call an ambulance in the event of an emergency and at what point an ambulance is required.
• School information: The name of the school, the child’s class or form, whether staff training is required or was undertaken and who is responsible for providing care in school.
• Contact information: For the child’s parents, guardians, GP and other relevant healthcare providers. 
• Roles and responsibilities: The IHP should clearly define the responsibilities of school staff, parents and healthcare professionals.
• The child’s view: Where possible, the child’s view should be included in the IHP. The child should be given the opportunity to explain how their condition affects them in school, where they feel they need more support and any areas where they would rather not have support. The IHP could also include whether the child is comfortable sharing information about their medical condition with non-necessary staff members and their peers. 
• Review and updates: The plan should include the date it was created and when it is next due to be reviewed to ensure it remains up to date. Medical needs can change, particularly as children grow and develop, making regular reviews essential. Reviews usually occur annually, although an earlier review can be requested.
• Contributors: Who the plan was developed in collaboration with (e.g., the name and role of the healthcare professional, the child’s parents).

IHP Collaborators

IHPs should be created collaboratively, to provide accurate insight into the child’s medical needs, educational needs and social and emotional needs and how the child’s needs can affect different aspects of their life. Having different collaborators when writing an IHP also ensures the child is accurately represented. 

Although every IHP is different, collaborators can include:

School staff 

This could include any staff member involved in supporting the child at school, such as a teacher, teaching assistant, one-on-one support staff, SENDCO or pastoral support. These individuals can offer valuable insight into how the child’s condition impacts their learning and overall school experience.

Parents or caregivers 

Parents and caregivers often have the most in-depth knowledge of the child’s condition outside of the child themselves. Their first-hand experience in managing daily care at home makes them well-equipped to provide input on the type of support the child will require in a school setting. The parents or caregivers can also help ensure the child’s voice is represented, particularly for younger children who may not be able to contribute to the IHP process.

The child 

When appropriate, the child should be involved in discussions regarding their healthcare plan, especially if they are old enough to understand the conversation. Children and young people under the age of 16 can make decisions about their care and young people are encouraged to participate in creating their IHP, where appropriate, as this helps them take responsibility for their own well-being, encourages their independence and ensures their voices are heard. Their input is essential in identifying the support they need and ensuring their preferences are considered.

Healthcare professionals 

This may include medical professionals such as the child’s GP, hospital consultants or physical therapists. They can provide expert advice on the medical care required, including treatments and medications, as well as any necessary staff training to ensure the child’s safety, particularly in emergency situations.