Education for children with health needs who cannot attend school

Section 19 of the Education Act 1996 (as amended by Section 3 of the Children Schools and Families Act 2010) provides a duty on local authorities of maintained schools to arrange suitable education for those who would not receive such education unless such arrangements are made for them. This education must be full time, or such part time education as is in a child's best interests because of their health needs.

The Department for Education says:

Local authorities must:
Arrange suitable education (or as much education as the child's health condition allows)for children of compulsory school age who, because of illness, would otherwise not receive suitable education.

Local authorities should:

  • Provide such education as soon as it is clear that the child will be away from school for 15 days or more, whether consecutive or cumulative. They should liaise with appropriate medical professionals to ensure minimal delay in arranging appropriate provision for the child.
  • Ensure that the education children receive is of good quality, as defined in the statutory guidance Alternative Provision (2013), allows them to take appropriate qualifications, prevents them from slipping behind their peers in school and allows them to reintegrate successfully back into school as soon as possible.
  • Address the needs of individual children in arranging provision. ‘Hard and fast' rules are inappropriate: they may limit the offer of education to children with a given condition and prevent their access to the right level of educational support which they are well enough to receive. Strict rules that limit the offer of education a child receives may also breach statutory requirements.

Local authorities should not:

  • Have processes or policies in place which prevent a child from getting the right type of provision and a good education
  • Withhold or reduce the provision, or type of provision, for a child because of how much it will cost (meeting the child's needs and providing a good education must be the determining factors)
  • Have policies based upon the percentage of time a child is able to attend school rather than whether the child is receiving a suitable education during that attendance.
  • Have lists of health conditions which dictate whether or not they will arrange education for children or inflexible policies which result in children going without suitable full-time education (or as much education as their health condition allows them to participate in).

For full details, please visit:

This guidance replaces the previous guidance:
Access to Education for Children and Young People with Medical Needs (2001).

Some of the options which may be available

Pupil Referral Unit (PRU)
Pupil Referral Units are centres serving young people by offering high quality personalised alternative provision with learning packages relevant to each child.

Home Teaching Services
Each local authority will have a home teaching service (they have many names, such as ‘Home and Hospital Teaching', or ‘Community Teaching') to support pupils who cannot attend their mainstream school due to medical needs. You can find details under the education section of your local authority website. 

Your school can make a referral, supported by medical evidence for why you cannot attend school. Most home teaching services will provide up to five hours teaching a week (ideally one hour per day), although this may be more or less depending on your condition. Home teachers should liaise closely with your own school for work – they may focus on the core subjects of maths, English and science because of the limited time available.

Once you are ready to move back to your own school, the home teaching staff should then move the teaching from home to school, with a plan to reintegrate back into lessons when appropriate.

Reduced timetable
Many young people with M.E./CFS attend school on a part time basis that is appropriate to their needs, such as late starts, half days and specific lessons. Managing continuity of lessons, can be challenging - catching up with missed lessons, getting and completing homework by due date and lack of social time with friends. Planning for regular meetings with school to address needs as they arise can work very well. 

If you can't manage school on a full time basis, talk to your school about what alternative provision is available to you. Details should be on each local authority website

Medical Needs Flow Chart
Children with medical needs may receive education in a range of settings. They may attend school with some support. If they cannot attend school they may be educated in a medical alternative provision setting, or in a hospital school. Or they may intermittently attend school and receive education in a medical alternative provision setting, at hospital or at home.

We have worked in collaboration with a number of organisations to design a flowchart to help schools identify the steps they should take to make sure that children with medical needs receive the support that they need.

When talking to your school (or your child's school), you may want to share this document with them for guidance.

Medical needs flow chart

Exam concessions and adjustments

Exams can be very stressful, which can make your symptoms worse so, it's better to have concessions in place even if you don't need them on the day

The aim of exam concessions is to give you an equal opportunity to demonstrate your ability in the skills being assessed when standard arrangements may make this difficult for you. Remember - all requests for exam concession need to be supported by a medical letter, which, if possible, should name the requested concessions and give reasons why it is required.

Generally speaking, examinations boards are more than happy to support young people with a medical condition, and even if their guidelines don't mention a specific concession or request, you should still ask if there is something you need that's supported by medical evidence

More information on exam concessions can be found on the '16 and over' page

Supporting pupils at school with medical conditions

Statutory guidance for governing bodies of maintained schools and proprietors of academies in England

Department for Education
December 2015

Download pdf

Key points

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

Education fact sheet

AYME's National Support Workers have collaborated with professionals across the country to produce a fact sheet for schools and their staff. Please download this fact sheet, along with a covering letter, and get circulating!

You can approach your local primary and secondary schools with the letter and fact sheet, the former of which talks about the need to raise awareness of M.E./CFS in children and young people, and explains a little bit about AYME.

"Thank you so much for all this fantastic information. The Education Fact Sheet was perfect to pass on to our son's teacher this morning. It explains our son's symptoms almost exactly!"

You can ask the school to tie the fact sheet into its annual programme: perhaps as part of an assembly, a feature in a newsletter or their website, a discussion point during PSHE classes, or crucial information for the school nurse. Please do let us know if you have used the factsheet in your school and how you got on.

Download Education Fact Sheet