DELIVERY OF HEALTH APPOINTMENTS TO SPECIAL SCHOOLS.

Abstract

Objective There are a range of health needs for children and young people who attend special schools. Some have regular paediatric and specialist outpatient appointments whereas some are discharged from formal paediatric follow up. These health appointments were traditionally delivered within the SEND school itself. The Covid-19 pandemic gave the opportunity to explore alternative methods of paediatric health appointments. Face to face appointments in school have advantages and disadvantages. Professionals, teachers and parents have different opinions and preferences about how we should move forward delivering health reviews for this complex group of children and young people. But this needs to take into account the facilities, time and support available to professionals to deliver meaningful health reviews. We sought to gather opinions regarding health appointments, including preference of patient’s families to help formulate recommendations for service delivery moving forward. Methods An online survey was conducted to obtain feedback from parents/carers, special school teachers and health professionals regarding different types of appointment, availability of staff, and information sharing. Results 71 parents/carers; 11 teachers; 4 health professionals responded: 60% of parents/carers expressed preference for all face to face appointments (school based with or without TA or hospital appointment) over video consultations. 42% of parents/carers expressed preference for appointment at special school. 68% of clinicians prefer face to face appointments (school based with or without TA or hospital appointment) but expressed preference for an opportunity to speak to teachers pre/post appointment. 50% of clinicians expressed preference for appointment based at the special schools. 84% of parents/carers feel having teachers attend the appointment would be valuable. 100% of clinicians reported having a teacher who knows the child, at the assessment is valuable (or at least a pre/post appointment). Conclusion 42% parents/carers and 50% health professionals preferred face to face appointments within the special school setting, despite lack of secure private clinic room, examination couch and handwashing facilities. Therefore there is an argument that to provide appropriate, safe and meaningful health appointments, facilities in hospital would be better than school setting. It would be difficult to deliver a service where only some SEND schools were offered onsite clinics. Video clinic can be useful for children who have mostly behavioural problems and less physical concerns, allowing the option of video consultations. Liaison with schools is needed to discuss their important contribution and how that can be managed.