Ignoring care plans and now want Consultants letter!

[LottienHuw]

Can a school choose to ignore a care plan for a child on the basis it is 3 years old and doesnt have a recent letter from a consultant regarding the condition ?

My daughters school are choosing to ignore her care plan because last year she had 'no problem' with her long term health condition (snapped achilles tendon) .

I have made an appointment with the Head but I want to know if I can make them follow the care plan.

I have not withdrawn the plan at any time and the fact no-one felt it was needed last year is a testament to how her last Teacher handled my daughters condition.

They now want a Consultants letter otherwise theyre just going to refuse to follow the advice on it. Surely they have a duty of care to provide a safe place for my daughter free from pain/discomfort.

What is the advice they have to follow? Just curious really.

It shouldn't take that long for it to heal should it??

And if they thought it not needed last year and she is fine is there and issue here?

I'm not suprised they want a medical opinion. From the brief description you've given it seems unusual for there to be issues after 3 years. Ruptured tendons heal in 6 to 8 weeks, if not then there is a surgical repair option and whilst sometimes it can take up to a year to heal completely and allow return to strenuous sports it is the usual outcome.

So why not just get them the medical opinion they require and it will be sorted for you.

Care plans should be reviewed annually at least

If possible she should sit on a chair and not the floor with the her legs crossed. (not always possible we understand that but generally it is possible even in assembly especially when all the staff are sitting on chairs)

If she is in pain or discomfort they must allow her to perform her stretches as prescribed by her physio to help reduce the pain, she uses a wall to lean against and a chair to help.

She needs to do extra warm up excercises before doing PE on her legs.

If during PE she suffers burning pain she must be allowed to sit out until it has eased and then slowly reintegrated into the lesson.

We have no problems with PE, she loves it and she is very active and is willing on occasions to continue even though she is in some discomfort. Her new Teacher (who is also new to the school as well as this year group) is protesting as though my daughter is trying to get out of her lessons which can not be further from the truth.

She knows how to do her exercises unsupervised and she knows when she has done too much. Her teacher is objecting most to her sitting on a chair instead of on the floor with the other children. She is claiming its unfair on the other children. Surely its unfair on my daughter to have to put up with pain and discomfort in a place that is supposed to be safe and fun.

There's clearly more to her condition so why can't you get a consultants letter?

She is no longer under a consultant but she still sees a physio. The car accident we were in was severe and her tendon was severred.

She had surgery and we were told 3 - 5 years for a complete recovery. It will be 3 years in December.

The school wont take a letter from the Physio.

I can understand the need to review the care plan but cannot for the life of me understand why they wont accept a letter from the physio who is, after all the most appropriate professional to advise them on this.

A letter to the HT pointing out that your DD recovery was expected to take 3-5 years and she is still under the care of the physio should be enough. If not then I would advise going higher.

Get GP and physio to write one

They can't insist on consultant if they have a medical opinion

Any Care Plan should be reviewed annually at the very least.
I'm not medical so can't comment at all on what she ought or ought not to be able to do, but if there is an ongoing difficulty, then the care plan needs to be current.

x-posted. Yes, a physio can be the 'health' person advising on the Care Plan.

Make an appointment to see your GP. Ask for a letter. You may have to pay.

All the previous letters from the consultant and physio will be in your daughter's record.

All the GP has to do is copy the relevant ones and attach a covering letter confirming what you have said about the predicted recovery time.

You need to get it reviewed.

It should have healed some over the past 3 years and so whatever was in the careplan is probably out of date.

I think it depends what the care plan says so can't really conclude whether YABU or YANBU.

I do think it's actually reasonable of the school to expect that a care plan would be likely to change and evolve over 3 years, as presumably your DD has had physiotherapy etc and isn't in exactly the same state of need as she was 3 years ago. They are therefore not being unreasonable to want un updated plan. However, they should have a policy which doesn't spring this kind of thing on you. i.e. they could require that any care plan states within it a date for next review (whether in 6 months, 1 year etc, or could state if a condition is expected to be permanent) so that both you and they know when any update is going to happen. Waiting for 3 years and then refusing to cooperate without warning is not right.

I totally agree that care plans should be update and followed.

However as a physio I see no real reason why a chair or the floor make any difference. In both she can sit in the same ankle position. Possibly cross legged may be different, but as long as she can sit with legs straight out there is no difference to the achilles.

If this is causing pain I'd be more worried that your daughter needs further treatment or investigation. Therefore I would want further consultant review and I'm sure he will happily provide a letter then. Win win for all, school happy and your daughter has the care she needs.

Whilst a long recovery is predicted by three years this should not be effected by sitting. Certainly the warm up etc will be a longer process.

Careplans written by healthcare professionals etc (the only ones schools really use) should all have a review date. What was ur review date?
Who wrote the care plan?

p.s. Have now read the further detail which wasn't there while I was composing ... I think they are being unreasonable not to accept a letter from the physio, but are still reasonable to need an update after 3 years so if only a consultant's letter is any good that's what you'll have to get - but a GP letter should be sufficient if a Physio isn't.

Been off digging out paperwork. My original copy states as below, but includes medication for tendonitis which she no longer receives and a few other bits and bobs that are no longer relevent.

My 2nd copy dated 14 months ago has no medication on it but to continue with the exercises etc until discharged by the Physio.

I went into the school in May this year to say theres no change, she still has physio and that her GP was happy for her to continue as we were although is giving her 6 months before sending her for another ultra sound to check the tendon. They (the school) said this was fine at the time with no mention of them needing anything else.

Now they are saying this is not fine and they do need a letter. I will get that sorted as she has her physio session again next Thursday so I should be able to get a letter sorted to go on her file.

What I am concerned about is that they have said they will just be ignoring the care plan until they have their letter from a Consultant. Can they do that ? It says it was applicable 'until discharged by her Physiotherapist' so surely they have to carry on following it until that time?