Physical and neurological impairment (PNI)

Governing bodies of maintained schools, proprietors of academies and management committees of PRUs have a duty to support pupils with medical conditions.

Section 100 of the Children and Families Act 2014 makes the following key points:

• pupils with medical conditions should be properly supported so they have full access to education including school trips and physical education
• governing bodies must put arrangements in place to support pupils at school with medical conditions
• governing bodies should make sure school leaders consult health and social care professionals, pupils and parents so the needs of children with medical conditions are properly understood and effectively supported

This covers children needing to sleep during the school day as a result of medical conditions which cause fatigue and tiredness.

This may be triggered by some of the following conditions:

• ​​cancer and cancer treatments such as chemotherapy and radiotherapy
• diabetes
• Ehlers-Danlos syndrome
• epilepsy
• narcolepsy
• juvenile idiopathic arthritis (JIA)
• neurofibromatosis
• muscular dystrophy
• stroke

Talk to families

In the first instance, discuss a child’s tiredness and how this impacts their school day with their family.

This can be highlighted through reduced attendance, unexpected lateness and changes in patterns of attendance.

In some instances, children may require a longer night’s sleep to account for disruption to sleep. In these cases, it would be better for a child to start later in the school day.

In collaboration with families and headteachers, children can have a flexible timetable to compensate for their medical needs.

Develop a sleep plan

There are situations where a short sleep (less than 1 hour) helps children feel refreshed and able to carry on with their learning.

In these cases, schools should consider having a sleep plan covering the child’s needs including:

• setting out protocols
• detailing location and duration
• monitoring and wake-up procedures

The sleep plan should be included as a section on their care plan.

Find a suitable space

Having a suitable place and space to sleep is easily managed with a flexible approach.

Children are equally comfortable sleeping on large cushions and bean bags as in beds. This can be in the corner of a classroom, library, soft seating within a corridor or any other suitable, quiet space.

It does not need to be in the medical room as this is often used for emergencies.

Some schools may wish to provide a screen to maintain dignity, although this is not necessarily required. It’s also helpful to have a small pillow and blanket available, should children want them.

Agree on the length of sleep

The length of the sleep must be discussed with parents as they will know how long their child typically needs. If it is more than 1 hour then the sleep plan will need to be reviewed.

Monitor their sleep

Keep a sleep monitoring chart to log:

• each sleep children have
• how long they sleep for
• their reason for sleeping

This should be shared with families to demonstrate sleep patterns. While children sleep they must be checked frequently to ensure they’re safe.

Review your plan

Monitoring charts should be reviewed each week with sleep plans reviewed when there are any changes in sleep patterns and medication.

We recommend reviewing care plans each half-term to make sure the details and training are up to date and actions are agreed with parents.

For more information visit Supporting pupils with medical conditions at school on GOV.UK