Medical support needs at school
Some children require medical and nursing care at school – for example, those with a tracheostomy, on ventilator support, receiving tube feeding or requiring continuous monitoring. First and foremost: these needs generally require qualified (specialist) nursing care, not school support. School support can assist with structure, observation and participation, but is no substitute for medical care. Every situation is different – we offer honest and personalised advice.
Tracheostomy
A tracheostomy is a surgically created opening into the windpipe through which the child breathes and which must be looked after regularly (e.g. suctioned). At school, the main requirements are professional suctioning, cannula care and immediate intervention in an emergency – this constitutes treatment-related care and must be carried out by qualified (specialist) carers, usually from a care service. A school support worker must not and cannot replace these nursing measures; they can provide support in terms of structure, observation and participation. Legal framework: Medical care is usually provided through health insurance as home nursing care / treatment care (Section 37 of Book V of the Social Code), whilst support aimed at promoting participation may be provided through integration assistance (Section 112 of Book IX of the Social Code). Please ensure you clarify on a case-by-case basis with doctors, care providers and the funding body which responsibilities fall to whom.
Ventilation
In the case of (invasive or non-invasive) ventilation, the child receives mechanical support with breathing either continuously or intermittently. The need for this at school is high and ongoing: monitoring equipment, responding to alarms, suctioning and emergency management – this constitutes demanding therapeutic care and requires qualified (specialist) nursing staff, not school support. A school support worker is no substitute for medical care; they can only provide support in terms of structure, observation and participation, provided that nursing care is guaranteed in parallel. Legal framework: Ventilator care is typically covered by health insurance (Section 37 of Book V of the Social Code), whilst participation-oriented support may be covered by integration assistance (Section 112 of Book IX of the Social Code). Please ensure you clarify responsibility and scope on a case-by-case basis with doctors, care providers and the funding body.
Tube feeding (PEG)
A child is fed directly through the abdominal wall via a PEG tube when eating and drinking by normal means is not sufficiently possible. At school, the focus is on the correct insertion and monitoring of feeding, hygiene and care of the tube site – this constitutes treatment-related care and generally falls within the remit of qualified (specialist) nursing care, not school support. School support does not replace these nursing procedures; it can provide support in terms of structure, observation and participation. Legal framework: Nursing care is usually covered by health insurance (Section 37 of Book V of the Social Code), whilst support aimed at participation may be covered by integration assistance (Section 112 of Book IX of the Social Code). Please ensure you clarify on a case-by-case basis with doctors, care staff and the funding body whether a measure can be delegated and who will take responsibility for it.
Medical monitoring
Some children require continuous monitoring of vital signs (e.g. oxygen saturation, seizures or circulatory events) with clearly defined responses in the event of abnormalities. The school’s requirement is the reliable identification of critical situations and professional, often nursing- and medical-based, intervention – this is generally not a standard service provided by school support staff, but rather the responsibility of qualified (specialist) nursing staff. A school support worker does not replace medical monitoring; they can provide support in terms of structure, observation and participation, provided that medical care is otherwise ensured. Legal recourse: Depending on the measure required, the health insurance fund (Section 37 of Book V of the Social Code) and/or integration assistance (Section 112 of Book IX of the Social Code) may be applicable. It is essential that you clarify on a case-by-case basis with doctors, care staff and the funding body which form of monitoring is necessary and who is responsible.
How Splash provides support
Where supplementary support is appropriate and eligible for funding – and always alongside, never instead of, medical care – our school support staff work closely with care services, the school and the family to ensure reliable structures in everyday school life. They are trained at our own Splash Academy. Find out more about how this works: cooperation with care providers and schools, and structuring the school day. It is important to remember that school support does not replace specialist care – where medical care is needed, it must be provided by qualified professionals.
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In a free initial consultation, we’ll clarify your needs, the application process and the next steps – with no obligation. We’ll also discuss the distinction between specialist care and support services with you in all honesty.
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Our own Splash Academy · Multi-stage selection process · Support at mainstream and special schools
This page is for information purposes only and is not a substitute for medical or legal advice. Medical and care needs generally require qualified (specialist) care; school support is not a substitute for this. The relevant funding body decides on a case-by-case basis whether school support is suitable and eligible for funding.