Schools should proceed cautiously and seek legal advice if it looks like they are taking on healthcare activities for pupils with medical conditions outside of their statutory powers, a union has warned. The NAHT school leaders’ union has published its own guidance today for schools on supporting pupils with medical conditions. It has done this in absence of promised revised government guidance on this and the delegation of healthcare tasks to schools. It follows concerns from the union that schools are increasingly being pressured to provide medical support for pupils without the necessary resources and expertise. A Schools Week investigation last year found a dwindling number of nurses in schools meant junior staff were forced to undertake complex medical procedures on vulnerable pupils. The government held back from publishing guidance on supporting pupils with medical conditions this week, after an eight week consultation. The Department for Education admitted further work was needed to “clarify the respective roles and responsibilities of education settings and of healthcare professionals”. “We will take this forward with the Department of Health and Social Care before publishing updated statutory guidance for education settings on supporting children and young people with medical conditions in due course.” Separate guidance on delegation of healthcare activities is also yet to be published, despite pledges that it would be published last autumn. ‘Rare circumstances’ NAHT’s 58-page guidance aims to help members understand statutory duties across education, health and local government. It highlights the importance of legally-sound delegation of tasks to schools covering clearly defined responsibilities and accountability, training, competency and risk assessments, supervision, monitoring, and appropriate insurance arrangements. The union’s guidance states that within the existing laws, there are “limited circumstances in which schools have the legal powers required to accept responsibility, accountability and liability for healthcare activities that generally fall under the NHS Act 2006. “In practice, these circumstances are likely to be rare and tightly constrained.” They added that where schools are asked to accept delegated healthcare activity without a clear “organisational-level legal basis, this creates risk”. “NAHT is concerned that such arrangements may expose schools and trusts to challenge, particularly where they rely on informal practice rather than explicit statutory authority. “Where arrangements appear to require schools to assume responsibility for healthcare activities that may fall outside their statutory powers, NAHT advises members to proceed cautiously and to consider whether independent legal advice would assist in clarifying the lawfulness of current or proposed arrangements.” NAHT also believes that activities such as administering insulin, catheter care and clinical observations should “not be managed under the school’s general health-related duties”. These activities should be subject to a “compliant arrangement” with healthcare services. ‘Two-tier health system’ Marijke Miles, head teacher at Baycroft School, a special school in Hampshire, and chair of NAHT’s SEND Council, said: “This guidance is about giving school leaders the tools to insist upon the quality of care to which children and young people are entitled. “It will be transformational for me in providing a sound, lawful and transparent basis for upholding the rights of my children and their families. “It will help ensure that no child is subject to a two-tier health system where being school-age means they receive an inferior health provision.” The guidance does state is intended to support NAHT members in navigating a complex area of practice and does not constitute legal, medical or other professional advice. It was created with Emma Smith, from ESC Management Services. The DfE was approached for comment.