WIRRAL HOSPITALS’ SCHOOL

PRESENTATION TO ACAMH Conference

24.05.12.

Mr Derek Kitchin, B.Ed (Hons), NPQH.

Mainstream Mainstream ‘adjusted’ and/or ‘supported’‘Mainstream’ with ‘Units’ attached

(geographical inclusion?)Special EducationUnits / alternative providers (e.g. WHS /

PRU’s / Orrets Meadow)Outreach packages from any of aboveHospital EducationHome EducationPrivate education‘Education otherwise’ !!!

‘EDUCATION PROVISION ’ (with / without Statements of SEN)

Part-time, small group provision at the Joseph Paxton Campus (JPC)

Education for school-aged pupils in hospital (Age 5-16)

Adcote assessment unit primary & secondary classrooms (with CAMHS)

Education for pregnant school girls and young mums

Home Education Service for pupils too unwell to attend school

WIRRAL HOSPITALS’ SCHOOL

Pupils with medical conditions that make full-time, mainstream education impossible

Pupils for whom there are serious concerns about their psychological, emotional and/or social well-being

Pupils who are unable to attend school but are not considered truants

JPC is not a school for pupils with (outright) behaviour / conduct issues

JOSEPH PAXTON CAMPUS

Physical health issues, leading to difficulties accessing school (Equalities Act!) or maintaining attendance due to treatment / hospitalisation

Physical Health issues such as ME / CFSPhysical health issues, leading to difficulties

accessing school … because of psychological and anxiety issues created by their management / reception

Teenage pregnancy

ISSUES OUR YOUNG PEOPLE FACE …

Mental health / well being issues leading to heightened anxiety, depression, self-harm, eating disorders, suicidal tendency, OCD …

Self-image / identity issues leading to attention being drawn to themselves, inability to cope with uniform / PE / communal eating etc.

Self image and issues of acceptance around gender / sexuality

ISSUES OUR YOUNG PEOPLE FACE …

COMORBIDITY

All of above can be heightened by comorbidity …

And further intensified through Aspergers / ASC (Autistic Spectrum Condition) …

Leading to social / communication and inter- peer relationship and friendship difficulties (perceived as ‘bullying’)

CAMHSMainstream schoolsCommunity paediatriciansESWsYPC Pine Lodge (Chester)CYPDAlder Hey (Dewi Jones Unit)

WHO REFERS PUPILS TO JPC?

Young person identified with physical/ mental/emotional health issues that affect access to full time education

Support put in place by mainstream school does not resolve problems

Referral form completed and admissions panel considers each referral at half termly meetings

Appropriate cases are offered a trial placement

WHAT IS THE REFERRAL PROCESS?

WHAT HAPPENS WHEN PUPILS ARRIVE AT JPC?

Young person is inducted into a calm, safe and quiet environment

The education ‘offer’ to the young person is tailor made to meet his/her individual and specific needs

Staff are understanding and have vast experience of a wide range of medical conditions

Outside support is engaged at every opportunity

WORKING WITH PARENTSWe develop and maintain effective

partnership working with parentsWe support parents and respond to their

needs in engaging positively with their child’s learning and development

We support parents and respond to their needs in sustaining and developing their parenting skills

We provide accessible information, explanation, guidance and signposting

OUTCOMESAttendance has improved massively for

almost all our studentsStudents now report enjoying the idea of

going to schoolParents/carers are comfortable engaging

with school to talk about their child’s problems

The school works with families to engage/re-engage students in their education

Physical and mental health improvement through:Reduction of anxiety / depressionImproved sleep and eating patternsReduction in severity of skin problems / epileptic

attacks etc exacerbated by stress.Learning takes place leading to prep for working life,

to / transition to Further Ed, GCSE’s or other.Huge increase in self confidence / self esteem and

… RESILIENCE

OUTCOMES

OfSTEDSchool was inspected in mid November 2011 and OfSTED made these comments:

“Wirral Hospital School is a good school with many outstanding features which cares exceptionally well for its students.

It provides a happy, safe and caring environment for young people who have often experienced failed placements in previous settings or whose health has prevented them from being able to attend school regularly.”

OfSTED

“As a result of the outstanding care, guidance and support, most students begin to develop coping skills they will need for their future lives.

Partnerships with other schools and with agencies to promote the welfare of students are excellent.”

OfSTED“Parents and carers were overwhelmingly positive in their praise for the school, what it does for their children and the support it provides for them.

There were many moving testimonies to the difference the school has made in the lives of students and their families.

For example a parent said that ‘after a very difficult and traumatic period this school has been our saviour’ and another ‘without this school we would not have known where to turn, our daughter has come on so much in confidence, education and so many other ways.”

OfSTED“Developing students’ resourcefulness, resilience and independence underpins the work of the school and generally results in good improvements in their well-being. Students feel exceptionally safe in the nurturing environment of the school.

Relationships between all staff and students are exceptionally positive. The level of care is outstanding.”

KEY STAGE 2A number of young people ‘disappear’

from the education system during years 5 and 6

For many of these pupils the next contact with education is their transfer to secondary school

Often the time they have had away from school compounds their problems and makes a successful transition to KS3 almost impossible

Great success with Year 6 students at JPC in 2010-2011

KEY STAGE 2 at JPCYoung people in Year 5 and 6 who struggle

to attend school regularlyYoung people who benefit from extremely

small groups (max 5)Young people who need 1:1 support in the

classroom situationYoung people who respond positively to a

quiet, secure and pressure-free learning environment

Young people who require a flexible, individually-focused curriculum

Assessment placement, 8 weeks … ;

Testing and assessment of a child’s psychological / emotional and cognitive development.

Report and recommendations of needs, strategies.

Health Service CAMHS (Child and Family) facility

WHS manage 2 x classroom: 1x primary 1x Secondary

Classroom allows some continuation of education, but primarily, to provide a classroom setting to allow observation and assessment to take place.

Referral: Through Health / CAMHS.

ADCOTE HOUSE

Teacher on Children’s ward at APH, during term time, mornings only.

Classroom gone, Teachers take ‘work to bed’ for children there longer than two days.

Longer term admissions – Alder Hey Those in APH over a week – Hospital teacher contacts school. Prioritise children taking exams (also reducing stress of child /

parents) Prioritise recurrent admissions: skin, abdo, CF and aim to

liaise with schools for those with these issues. HES, JPC and Hospital teaching closely linked, all led by same

Headteacher, to provide seamless, prompt pathways back to education.

HOSPITAL TEACHING

Access to Education document: If unable to attend school for more than 15 consecutive days, they are entitled to education at home.

Requirement on LA = Home Education Service. Medical Criteria: Referral must be from a Consultant e.g.

Paed, CAMHS, Health Changing client group, hospitals discharge earlier (weekends

/ holidays!!) Longer term conditions CFS / Mental Health Object of service to maintain Education whilst off school,

remain the responsibility of the school

HOME EDUCATION SERVICE

HOME EDUCATION SERVICE Works best when close liaison between school / HES At Primary, entitled up to five hours, depending on medical

needs. For continuity of education for those with complex, chronic

and recurrent conditions, or those with pre-planned, elective surgery, the 15 day rule may be waived. (Pre-planning reduces anxiety for child / family)

HES, JPC and Hospital teaching closely linked, all led by same Headteacher, to provide seamless, prompt pathways back to education.

Referral process: Schools can fill in a referral, but need Consultant letter.

UNDERSTANDING THE IMPACT OF ANXIETY ON

PUPILS’ BEHAVIOUR

Tracking three pupils through their education prior to and during their

attendance at JPC

Pupil A – Year 11 boy

Pupil B – Year 9 girl

Pupil C – Year 10 boy

Pupil A

Attendance in Year 7 at Mainstream

School deteriorated from October

Mainstream School

offered internal

support

Reason for non-attendance

unclearOffered ‘Managed’ transfer to another mainstream school –

Spring Year 7 (Declined)

By Early Year 8 had become a non-

attender

Referred to Home Teaching

CAMHS involved by mid Year 7

Home Teaching put in place

Early Year 8: Initially reluctant to

engage due to anxiety

Home teacher slowly built up working

relationship until pupil was fully engaged by

end of Year 8

By start of Year 9 pupil expressed a wish to integrate back into mainstream school Re-integration did not work due to

continued anxiety around larger settings – Home Teaching continues – Spring Year 9

Pupil offered JPC – Early Summer Year 9

Pupil reluctant to engageAgrees to a gradual

integration timetablewith Headteacher -

Summer Year 9

Pupil started fully with JPC Year 10

Anxieties reduced almost immediately

Pupil taking full range of GCSEs –

Year 11 Confidence high and will move

onto post 16 provision (College)

Pupil B

Transfer to Mainstream School not without issues

Able to sustain Yr 7 & 8

Supported by

CAMHS whilst in

Primary

Triggers: Early onset of Puberty (Year 3)

Parental Separation, Rejection Student perceives

difficulties with peer relationships.

Mainstream School perceive her as

‘Coping’

Return to Year 9 hampered by bad experiences –

thoughts of self harm

Referred to Adcote House

Additional triggers:Bad experience on

holiday (intimidated by older man) - felt vulnerable. Difficult

start to Year 9

Started Adcote House

Settled quickly engaged well in

small settingAutumn Year 9

Low self esteem & anxiety around others

still evident

Student not able to go backto mainstream (too large) Early

Spring Year 9 Referral to JPC (with support of CAMHS)

Mid Spring Year 9

Pupil offered JPCLate Spring Year 9

Accepts place Summer Year 9

Initial 6 week review goes well

Attendance 100% Summer year 9

Pupil still needs support for Anxiety & Social, Emotional Aspects of Learning

(SEAL)

Pupil C

Attendance in Year 7 deteriorated from

October

Parents thought support for transition to ‘Secondary’ was not enough – Year 6

Early Involvement of CAMHS in Year 7

Diagnosis of ASC

Triggers: Coping with

change – Early Year 7

Ceased attending‘Fragile Health’

Early Year 7

Parents decide to educate

Depression sets in:Prescribed medication

Early Year 7

Educated at Home

Involvement with Adolescent Psychiatrist

– Year 8

Referral suggested to JPC – Early Spring Year 9

Gradual transition to JPC negotiated with Headteacher –

Mid Spring Year 9 Involvement of Complex Social & Communication Support Team to

assist transition – late Spring Year 9

Student & family agree with Headteacher to a trial at JPC –

Summer Year 9

Begins integration into JPC at start of

Year 10

Settles remarkably well & quickly, forming

friendships - anxieties greatly reduced

late Autumn Year 10

Pupil working towards GCSE’s

excellent student Summer Year 10

Wirral Hospitals’ SchoolJoseph Paxton Campus,157, Park Road North,

Claughton,Birkenhead,CH41 0EZ

Tel: 0151 488 7680Fax: 0151 653 8342

schooloffice@wirralhs.co.uk