Children and Young People with Complex Health Needs

Published: 27 September 2023

First Aid Kit

First Aid Kit

Joined Up Care Derbyshire

C/o Derby and Derbyshire Integrated Care Board
1st Floor North
Cardinal Square
10 Nottingham Road



The NHS in Derby and Derbyshire, in agreement with the Integrated Care Board (ICB), is undertaking a project to implement a new model which will provide additional support to education settings to support children and young people with complex health needs. This project will begin imminently and will complete at the end of December 2023.

Families will be offered the opportunity to be involved in the development of the delivery model, ensuring the child or young person will be at the centre of design, and their individual needs are considered.


There is NHS England guidance on what support should look like to meet reasonable health needs, which includes access to NHS support to all schools where there are children with complex health needs. The new model will ensure the creation and review of health care plans, school policies and liaison with NHS colleagues who support the children and young people in the community. We acknowledge there is a need to provide training and competency testing required of school staff to support the children in school, where this is appropriate.


The new model will be published as a single guidance document across Derby and Derbyshire. Setting out the local position, it will be based on national exemplars as to whether the task is considered the responsibility of health, social care, or education to deliver in schools. We appreciate that there will be exceptions and that this will need to be considered on a child-by-child basis. NHS colleagues, based on their clinical expertise, will be asked to formalise those tasks which can be delegated to non-clinical staff and also to formalise what is in and out of scope for the NHS.

For clarity, the NHS will not be providing the staff to meet the following needs:

  • that educate or train the child.
  • where the need can be met within 'regular and routine' school nursing provision in the scope of the 0-19 public health service
  • where the intervention is to deliver a personal care need
  • where the intervention is to deliver a social care need e.g., interaction with other children.

Current Arrangements

During the period of review and development of any new models of care, schools should continue with their current arrangements (contractual and non-contractual). We are planning a phased implementation approach on a school-by-school basis, based on our agreed model and the complexity of need.

  • The NHS will not fund any existing arrangements that education settings have in place that may or may not be in the scope of the proposed changes going forwards. The NHS recognises that there are some areas of existing pressure in the system so to alleviate this we will work with current NHS providers to look to reduce this.
  • The creation and review of Education Health and Care Plans (EHCPs) sits firmly within the scope of the local authority and not the NHS. We cannot lead on reviews as that is at the discretion of the school and local authority. NHS clinical staff will continue to contribute to the creation and review of Individual Health Care Plans in partnership with education settings.

Next Steps

We are keen to involve you and families in the development of any new model. If you would like to register your interest to join the meetings where we will be agreeing the new model, please email These meetings will be virtual via MS Teams and will be led by Will Galloway-Grant (He/Him) within his capacity as Head of Children and Young People's Commissioning at the ICB.

Please note that the oversight and sign off of the recommendations will be decided by the ICB and strategic partners. Will Galloway-Grant has been tasked to deliver within the agreed scope. These meetings are not the forum to raise your concerns about the NHS's position. If you to wish to raise any concerns please email

For those unable to join the discussion meetings with Will Galloway-Grant, we are planning a number of briefing sessions into autumn. If you would like to be included in these, we need your permission to contact you directly, please email to confirm your interest.

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