Committee publication · Correspondence · 28 April 2026
Correspondence from Unison - Follow up on 18 March session
From: Health and Social Care Committee
Inquiry: Delivering health aspects of Education Health and Care Plans
Summary
UNISON follow-up letter to the Health and Social Care Committee regarding the 18 March 2026 session on Education, Health and Care Plans. The union raises serious legal and regulatory concerns about the delegation of clinical nursing tasks to school staff, inadequate NHS continuing care thresholds, and home-to-school transport gaps. UNISON argues current arrangements lack a clear legal basis, expose children to unsafe care, and calls for NHS-commissioned clinical school nursing services.
Key findings
- Delegation of clinical nursing care to school staff lacks clear legal basis under current law and contradicts Nursing and Midwifery Council requirements that nurses practise within the law
- Only 4,402 children in England access NHS continuing care despite far greater need; more than half of referrals rejected, forcing families and school staff to provide complex clinical care including ventilator support and tracheostomy care
- NHS responsibilities for health provision in home-to-school transport are inappropriately shifted to local authorities and transport staff, creating accountability gaps
- Current service model depends on schools providing clinical healthcare outside proper legal and regulatory frameworks, diverting scarce education resources from educational provision
- UNISON calls for needs-led NHS-commissioned clinical school nursing service in all state-funded education settings and transparent national work on commissioning models and workforce capacity
Tone
CriticalTopics
Key actors
UNISON, Layla Moran MP, Helen Hayes MP, Department for Education, Department of Health and Social Care, NHS England, Nursing and Midwifery Council, Contact
Notable line
“… a service delivery model has developed that depends on schools and their staff providing clinical healthcare, despite this being out of step with the established legal and regulatory framework.”
Key Quotes
“… there is no cle ar legal basis for delegating nursing care to education staff. Given the Nursing and Midwifery Council's requirement that nurses practise within the law, any delegation of nursing procedures should only be undertaken where the nurse is satisfied that the delegated task i s legal.”
“… more than half of referrals are rejected, leaving families to provid e intensive clinical care at home, including ventilator support, seizure monitoring, tube feeding and tracheostomy care.”
“… pupils are denied NHS services to which they are entitled, while scarce education resources are diverted to cover gaps in healthcare provision, diluting the educational offer for all pupils.”
“We see this as a vital step in addressing the structural gap in NHS provision. Supporting arrangements for home - to - school transport and continuing care thresholds must also be grounded in delivery models underpinned by compliant delegation.”
Source · parliament.uk record ↗