An individual healthcare plan (IHP) details exactly what care a child needs in school, when they need it and who is going to give it. This should be drawn up with input from the child (if appropriate) their parent/carer, their PDSN school nurse and relevant school staff.
The IHP can be thought of as a type of written agreement that’s drawn up with school, so it needs to be as detailed as possible.
The IHP should include the following:
- Written permission from the parent/carer and the head teacher for insulin to be administered by a member of staff, or self-administered by the child during school hours.
- Exactly what help the child needs with diabetes management – what they can do themself and what they need from somebody else.
- Who is going to give that help and when.
- Details of the insulin needed, the dose needed, when it’s needed and the procedure for injecting or using a pump.
- Details of when the child needs to test their blood glucose levels, the procedure for testing them and the action to be taken depending on the result.
- Description of the symptoms of hypo and hyperglycaemia (and possible triggers) and what staff will do if either of these occurs. It should also include when the parent/carer should be contacted and when an ambulance should be called.
- Details of when the child needs to eat meals and snacks, what help they need around meal or snack time, eg whether they need to go to the front of the lunch queue, need help with carbohydrate counting or have any other special arrangement around meal/snack time.
- The things that need to be done before, during or after PE, eg blood glucose testing or having an extra snack.
- Details of where insulin and other supplies will be stored and who will have access to them. It should also include what supplies will be needed, how often the supplies should be checked and by whom.
- What to do in an emergency, including who to contact.
- Any specific support needed around the child’s educational, emotional and social needs, eg how absences will be managed, support for catching up with lessons or any counselling arrangements.
- A description of the training that has been given to whom.
- What plans need to be put in place for exams (if appropriate).
- What plans need to be put in place for any school trips (including overnight) or other school activities outside of the normal timetable.
This is not an exhaustive list, and the IHP might also include other aspects of a child's care.
The help a child needs is likely to change as time goes on, and so their IHP will need to change to reflect this. At the very least it should be reviewed annually, but must also be reviewed when diabetes management changes or the level of care a child can do for themselves changes. So also included in the IHP should be:
- when it will be reviewed
- who can alter the plan and which parts they can alter
- what is the process for reviewing the plan.
Once the plan is in place and the child (if applicable), parent/carer, school and PDSN are happy with it, the parent/carer (and child, where appropriate) should sign it, as should relevant school staff and the PDSN.
You can download a sample IHP from this page. (This plan has been designed by a subgroup led by Sandra Singleton; with Margot Carson, Elaine McDonald, Dawn Anderson, Paula Maiden, Jayne Johnson, Jill Cullen, Helen Nurse, Linda Connellan and Daniel Hyde, on behalf of the North West Paediatric Diabetes Network.)