Oxfordshire Hospital School (OHS) – Charging Consultation

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Please consider the consultation information below and offer your response.  Please note, this consultation is being carried out at the request of The Schools Forum.  The findings will be considered as part of a wider review of the use of High Needs Funding.

To submit your response, select 'Respond by filling in the online questionnaire' at the bottom.

The Context

  1. OHS operates under the duties described under Section 19 of the Education Act.
  2. OHS operates under 2 funding streams:
    1. Hospital School Fund (a direct DfE grant covering inpatient provisions: Highfield Adolescent Unit; Helen House Hospice; Children’s’ Hospital Teaching Sector; Nuffield Orthopaedic Centre; Horton Hospital, Banbury)
    2. The national funding formulae for schools and high needs 2019 to 2020 sections 39-40
    3. High Needs (provided for Outreach).
    4. High needs funding 2018 to 2019: operational guide, Section 107
  3. OHS participation in, and commitment to collaborative working is increasing services to Oxfordshire schools. Uncharged support through the Medical Needs in Schools project in the Outreach Teaching Service is a key focus at the OHS.
  4. The existing Service Level Agreement between Oxfordshire County Council (OCC) & the OHS details the delivery mechanism for the education of children with medical conditions who are unable to attend school.
  5. Following discussions with Schools Forum, Oxfordshire County Council seeks the views of School Leaders on the current funding arrangements for provision of education for pupils with medical needs. To that end, three options are outlined at the end of this document for your consideration. Please indicate which funding model you would support.

Budget Summary for 2018-2019


The OHS works within the financial framework for schools. The allocation of resources and functions to schools allows the Governing Body and Headteacher substantial autonomy, having due regard to Financial Regulations, advice and guidance provided by the local authority finance team. The Education Funding Agency produces separate guidance for the funding of Hospital Schools as previously referenced and this will be subject to the National Funding Reforms. Oxfordshire adheres to the Fair Funding Arrangements for all schools. Each year the local authority has the opportunity to submit an exceptional case where growth and demand exceed thresholds specified in the guidance.

The allocated budget to maintain the Outreach Teaching Service at the OHS is £450,000 funded by the OCC for 45 fte places per annum.

Additional places for children who are Electively Home Educated or not on a school’s roll, will be funded on a per pupil basis.

A charging policy is in operation that requires a nominal contribution (AWPU) to be recovered from referring schools. The OHS Charging Policy is available on the school website.

Table 1:


£     450,000

LA allocation resource base rate

£10,000 per pupil (x45)


£       83,000

Recharges to schools & academies for the number of weeks support provided based on AWPU


£   533,000



The additional and very separate income streams are not ring fenced although budget monitoring accounts for proportionate spend across each of the OHS settings and activities. The Outreach Service benefits from this approach by having many back-office costs to the infrastructures already established in the inpatient settings; as can be seen in the comparable costs table (table 3) where a shortfall in funding for the service is noted for the Outreach Teaching Service.

Within this context, dedicated operational costs associated with running the Outreach Sector in particular and in its current form for staffing include:

  • Strategic direction by the Headteacher;
  • Line management by an Assistant Headteacher;
  • Quality Assurance of the curriculum and teaching and learning by an Assistant Headteacher;
  • 1 x sector lead teacher;
  • 1 x admin;
  • 5 sector specific teachers;
  • 3 HLTAs.

Income achieved through charges made to schools for pupil facing work are minimal when set against actual cost. It is the ambition of the OHS to provide an increasing presence in schools through the Medical Needs in Schools (MNIS) project which provides professional support for colleagues working with children with medical conditions.

Table 2:

Comparable costs for the Outreach Teaching Service 2018-19




£              533,000

£              546,074.33

-£            13,074.33


The actions undertaken by Outreach Teaching Service staff in this spend include:

a. Admission – the organisation of the referrals & admissions processes involves multiple layers of intervention and management:

  1. Administration relating to telephone calls, maintenance of management information systems, emails, letter writing etc;
  2. Communicating with schools and professionals.

b. Pre-teaching period – to ensure our work and associated interventions are successful

  1. Booking and conducting the initial home visit;
  2. General administration including write ups and risk assessments etc;
  3. Admin contact home-school for curriculum contacts / content;
  4. Create bespoke timetable.

Engagement – a personalised 4 session assessment programme for all pupils referred pupils are often disengaged at the point of referral;

d. Tuition

  1. Academic support with the pupil’s home school curriculum
  2. A Personal Development Curriculum including:
    • PSHE & C
    • Careers advice & guidance
  3. Access to digital technologies to assist, where appropriate
    • Google classroom
    • Kindles
    • Telepresence robots
    • Chromebooks

e. Reintegration – supporting pupils back to school

  1. Support for the school – Home School Staff CPD; design of Individual Healthcare Plans (a statutory requirement);
  2. Support for the pupil overcoming any anxieties.

f. Ongoing professional advice

  1. Attendance at TAF, CP, EH & SEND meetings;
  2. Multi-disciplinary team & pupil pathway planning meeting;
  3. Safeguarding related activities including sighting;
  4. Access to psychologist [from OUH CPM] team support where needed;

g. Other ongoing professional essentials – to include:

  1. Safeguarding discussions;
  2. Safeguarding follow ups;
  3. Pupil Progress Meetings to quality assure work;
  4. Daily briefings & Staff Management / Supervision;
  5. General administration including weekly timetable to home-school and parents and attendance management.

h. Other costs in this spend include:

  1. Travel costs & expenses;
  2. Non-GCSE qualification entry fees;
  3. Maintenance & replacement of all resources required to manage the Outreach Teaching Service including the developing use of robot technologies;
  4. Rents and utilities for premises;
  5. Communication systems to safeguard systems and processes;
  6. Teaching & learning resources;
  7. Associate teacher costs when demand increases.

Section 19 of the Education Act requires Local Authorities to provide a ‘suitable education’ for pupils who because of illness are unable to receive an education through usual means. Assuming that a ‘suitable education’ refers to the tuition phase, the outstanding and successful service that the OHS provides significantly exceeds this.

The eight areas described above provide an holistic provision for pupils that works. Whilst tuition forms part of these costs, it is by no means the largest cost.

For schools to continue providing successful alternatives for pupils, all eight areas of work need to be included in the offer.

The OHS is currently auditing costs at a macro level in order that full transparency can be provided. Given the nature of the services provided within the offer, this is a highly complex process that will take some time and is not currently available.

Benchmarking Information

National funding for hospital schools is notoriously fragmented and routes beyond High Needs allocations are now not available (except for where new inpatient facilities are provided). The OHS is one of only 13 national Hospital Schools (i.e. not under the funding parameters of Alternative Provision), all of which are funded differently. All 13 Hospital Schools offering outreach services charge as per the OHS parameters. In the absence of a DfE led solution for any common funding formula, the National Association of Hospital Educators (NAHE), provides sector-based benchmarking.

Funding for AP Outreach (for example medical PRUs) is achieved differently to that of the 13 Hospital Schools (usually with a provision for a base budget and pupil number top up).

The statutory guidance states that local authorities shall make arrangements for the suitable provision of education for children of compulsory school age who by reason of illness are unable to attend school. This guidance has been interpreted by all local authorities who have designated Hospital Schools in a similar way; a charge back model to its schools for the service.

Equal Opportunities Implications

The Outreach Service is an essential vehicle for the delivery of education to children who are protected under the Equality Act 2010. The DfE have provided a summary for schools; The Equality Act 2010 and schools.

Relevant sections from the school’s guidance:

4.4 The Act defines disability as when a person has a ‘physical or mental impairment which has a substantial and long- term adverse effect on that person’s ability to carry out normal day to day activities.’ Some specified medical conditions, HIV, multiple sclerosis and cancer are all considered as disabilities, regardless of their effect.

4.5 The Act sets out details of matters that may be relevant when determining whether a person meets the definition of disability. Long term is defined as lasting, or likely to last, for at least 12 months.

4.7 A school must not treat a disabled pupil less favourably simply because that pupil is disabled – for example by having an admission bar on disabled applicants


An Outreach Teaching Service that retains a mechanism for charging schools at AWPU costs:

  • Ensures that schools consider referrals carefully, often seeking advice from the OHS regarding reasonable adjustments prior to making a referral;
  • Provides the additional levels of funding required to operate the service at standards judged to be outstanding and that have been recognised nationally;
  • Allows the OHS to provide highly vulnerable pupils (subject to the Equality Act) with the holistic support they merit;
  • Often provides referring schools with an added motivation to be active participants in supporting pupil’s return and successful reintegration

Options being consulted on:

  1. Remain as we are with OHS charging 

All services outlined in a-h continue to be included as part of the OHS offer

    1. Admission
    2. Pre-teaching
    3. Engagement
    4. Tuition
    5. Reintegration
    6. Ongoing professional advice
    7. Ongoing professional essentials including safeguarding
    8. Other costs
  1. Remove AWPU charges made by OHS to home schools rendering schools obliged to provide themselves

Only a, d and h are provided:

a. Admission process

d. Tuition

h. Other costs

  1. Flexible charging structure based on individual needs

Charges are levied based on the needs of the pupil as assessed and agreed at point of admission to the OHS. Schools would need to attend complex case review meeting to discuss the referral and confirm the terms of the charging agreement.


  • Opened
    27 Jan 2020 at 12:00
  • Closed
    13 Feb 2020 at 17:00


Contact Name Deborah Bell
Contact Email Address Deborah.Bell@oxfordshire.gov.uk
Contact Phone Number 07909 882843

Consultation Topic
  • Education & learning
Target Audience
  • Schools
Geographical Area
  • Banbury
  • Bicester
  • Kidlington and Yarnton
  • Oxford City
  • Benson, Berinsfield and Wallingford
  • Chalgrove, Thame Watlington and Wheatley
  • Goring and Henley
  • Didcot
  • Abingdon
  • Faringdon
  • Grove and Wantage
  • Burford and Carterton
  • Charlbury, Chipping Norton and Woodstock
  • Witney