Health board condemned for leaving severely vulnerable children without nursing support

Martin Shipton

A health board has been criticised for not providing a nurse at a special school where some children are prone to life-threatening emergencies.

Hannah Coles’ son Seb, now aged nine, has attended Ysgol Heol Goffa in Llanelli since he was three, at which time he was first placed in the MSU (Multi-Sensory Unit) due to his complex medical needs.

His mother said: “Seb is tube fed, has epilepsy, is under palliative care, and has a symptom management plan.

“When we were choosing a specialist provision for him, finding a school that could safely manage his medical needs was, quite honestly, the most important factor. He is extremely vulnerable and has already survived three cardiac arrests, so as you can imagine, he is incredibly precious to us.

“I was shocked to learn that there is no registered nursing staff within the school to manage children’s medical needs. Like many of my friends whose children attend specialist provision, our children can deteriorate very quickly, and it was frightening to place him in the care of teaching staff alone. Please don’t misunderstand me — the staff at Heol Goffa have been amazing in every aspect of managing his care, but they are not clinically trained to assess complications or changing medical conditions.

“This is unsafe for students and unfair to staff. How can teachers be expected to focus on teaching when their days can be filled with managing tube feeds, monitoring seizures, administering medication, and supporting complex personal care needs? These are medical responsibilities that should not fall solely on education staff.

“Having a registered nurse in the school would also support parents. A nurse who can observe children regularly and link directly with paediatricians and other registered health professionals would reduce the need for parents to act as the ‘middle person’ between health and education services. For families already managing complex medical care at home, this would make a significant difference.”

Disheartening

Ms Coles said it was also very disheartening to know that in other areas of Wales, children in specialist provision do have access to a registered nurse within their school.

She said: “This makes families in Carmarthenshire feel that our children are not valued enough to receive the same level of healthcare support in their education setting.

“Having a nurse on site could also allow Heol Goffa to be used for certain health reviews. The school is fully accessible, with Changing Places facilities, hoists, and beds. In contrast, the Elizabeth Williams Clinic in Llanelli is not fully accessible, and appointments there can be undignified if personal care needs must be managed in a treatment room.

“For children with complex disabilities, healthcare is not separate from education — it is essential to enabling them to attend school safely and with dignity. A registered nurse in specialist schools should be seen as essential, not optional.”

‘Concerned’

Llanelli Labour MP Dame Nia Griffith said: “I am very concerned that in spite of repeated requests to the Hywel Dda University Health Board for a school nurse for Ysgol Heol Goffa, in keeping with similar schools across Wales, the school is still without a nurse. This issue was highlighted for concern in the recent Estyn inspection report, which praised the excellent work of the staff at Heol Goffa, in spite of the limitations of the building. I am calling on the health board to address this as a matter of urgency.”

Llanelli town councillor Shaun Greaney, who represents the area in which the school sits, said: “It is scandalous that young children with severe and complex life-threatening conditions can be jeopardised by the failure of Hywel Dda University Health Board to provide a nurse on site.

“Speed of action and a high degree of medical expertise is vital should an injury or accident occur.

“I am staggered that Hywel Dda has run away from its responsibilities to over a dozen children at the school for years and years. I think this amounts to a shocking neglect of the most vulnerable children in our society, placing their families, and the school’s teachers and teaching assistants, in an intolerable situation.

“A nurse must be provided now before there’s a tragedy.”

‘Priority’

Sharon Daniel, Director of Nursing, Quality & Patient Experience at the health board, said: “The health and wellbeing of all children and young people is fundamental to their ability to learn, thrive and reach their potential, and is a priority for the health board. We support the children and young people at Ysgol Heol Goffa with a dedicated school nurse to meet their universal health needs, and through the provision of training for staff at the school.

“The health board provides specialist support, ensuring each child and young person with healthcare needs can be cared for competently and confidently within the school environment.

“The health board has taken on board the recommendations made by Estyn to the school and Carmarthenshire County Council and is working to understand the additional needs of the school and the staff. Through continued partnership working and a shared commitment to improvement, the health board will support ongoing actions to strengthen provision and ensure the best possible outcomes for the pupils and staff at Ysgol Heol Goffa.”