Complex needs: improving access to out-of-school activities.

All children, regardless of the extent of their disability, should be able to attend school and access the curriculum in the fullest way, including school trips. A significant increase in the number of profoundly disabled children who require healthcare interventions may mean that school nursing services can no longer provide a direct service to facilitate each child's full access to the curriculum, especially support for out-of-school activities for children with complex medical needs. With the support of the Local Education Authority, education staff in one area in England were trained by school nurses to undertake a number of healthcare interventions. This training programme is underway and is proving to be effective: pupils have been able to go out of school and have had their varying healthcare needs met by education staff who have been assessed as competent in their care. The project has become an integral part of the joint working of health and education to provide the best care possible for disabled pupils. This can be seen as a good example of inter-agency collaboration in an effort to provide a needs-led, seamless service.