Our Work

Some highlights of our work are below: 

Monitoring Compliance and Driving Accountability
Since the introduction of the statutory duty on schools in 2014, the HCSA has consistently monitored how well it is being implemented, and pushed for improvement where needed.·
 
In a 2016 Investigation, we found that:
• 78% of schools did not demonstrate that they had a medical conditions policy
• Of those that did, 46% were not compliant with statutory requirements
• This was despite the fact that a medical conditions policy is legally required.· 

When we revisited in issue in a 2017 follow-up, we found that:
• Only 11.5% of schools in England could provide a policy that met the legal standards
•Additionally, 72% of schools reported that Ofsted had not asked about their medical conditions policy during inspection, despite its critical role in pupil welfare
• We also received reports of schools rated “Good” or “Outstanding” by Ofsted, even while failing to meet their statutory duties, putting children’s health and inclusion at risk

Engaging with Ofsted
• In response, the HCSA worked to raise awareness of the importance of the duty with Ofsted
• In 2017, Sean Harford, then National Director for Education at Ofsted, sent a message to all school inspectors highlighting the statutory duty and its relevance in assessing pupil welfare. 
• You can view the full message that was sent in their newsletter of March 2017 here: School inspection newsletter

2021 Re-Investigation and Policy Engagement
• In November 2021, we repeated our investigation and found that only 27% of schools had an adequate, publicly available medical conditions policy.
• We wrote to the then Children and Families Minister, Will Quince MP, sharing our findings and calling for renewed focus on implementation.
• In a January 2022 response, we were advised that the SEND Review would be an opportunity to re-engage on this issue and that the Department for Education was exploring an update to the statutory guidance. 

Contributing to the SEND Review in 2022
•In Spring 2022, we engaged with DfE officials and arranged a dedicated feedback session for HCSA members to share their expertise and recommendations directly.
• We submitted a detailed written response to the Green Paper, making the case for:
          o Strong, consistently implemented medical conditions policies
          o Universal access to individual healthcare plans (IHPs)
          o These tools can prevent escalation of health-related issues and reduce pressure on wider SEND systems. 

Re-engaging with Ofsted in 2025
• In 2025, we responded to the consultation ‘Improving the way Ofsted inspects education’, highlighting that proposals to add Inclusion to the evaluation framework inspectors must make explicit reference to how schools support learners with medical conditions
• We also met with a representative from Ofsted’s SEND and Alternative Provision team to discuss these key points.

The HCSA continues to push for accountability and improvement across the system, because every child with a health condition deserves safe, inclusive, and supportive education.