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Education support for medical absence

The Education Support for Medical Absence (ESMA) team is a teaching service for students who are unable to attend school for medical reasons.

We support students to continue their education and work towards getting them back into school as soon as their health allows.

Who do we support?

We support:

  • students of statutory school age (5 - 16 years old) who have medical evidence that they are unable to attend school
  • students who are Hertfordshire residents with medical evidence for non-attendance 
  • a student who is pregnant from 29 weeks, or young mothers whose physical or mental health issues are affecting attendance.

What can I expect from the service?

We work with schools and students to offer additional support alongside the education provided by schools in the core subjects (English, Maths and Science). We aim to support students to go back into school, as soon as they are well enough to do so.

The ESMA Teaching Service uses a variety of tools to support students including:

  • written advice and guidance on reasonable adjustments in school
  • virtual or face-to-face guidance meeting(s) on reasonable adjustments in school
  • the use of a telepresence robot (this device sits on the student's desk and through an app they can see, hear and speak through it)
  • live online group teaching by an ESMA Teacher (the number of hours will depend on the student's health needs)
  • face-to-face group teaching by an ESMA Teacher at one of our teaching bases (the number of hours will depend on the student's health needs)
  • Reintegration support offered via weekly 1:1 or small group intervention with an ESMA Reintegration Education Officer (REO) in the community or on site at school.
  • Weekly ESMA Thrive group to help students access activities in the community alongside a peer group, developing social skills and resilience.
  • Weekly ESMA Music Workshop for students of any ability, providing an opportunity to learn guitar, keyboard, drums and develop musical skills.

  • ESMA Teaching Service Advice Line

01442 454802
email: ESMAEnquiries@hertfordshire.gov.uk

How to refer

Referrals are made by the schools via the online Hertfordshire service request form, along with the baseline information form, to the relevant area email address on the form. The referral should include:

  • Signed parental consent
  • Copy of school reduced timetable, in line with HCC guidance on reduced timetables
  • Copy of the Assess, Plan, Do, Review cycle
  • Copy of the current treatment plan and the named medical contact
  • For students receiving additional funding (through either EHCP or Local High Needs Funding and/or Pupil Premium Grant) the school should state in the re-integration plan how this funding is being used
  • School attendance record

What happens after the referral is submitted?

We discuss referrals on a weekly basis, and inform the school of our decision within 5 days. 

Once support has been identified, the ESMA Teaching Service will attend a planning meeting with student, family, school and health professionals. 

All students will have a Holistic Support Plan - a plan of support agreed with the student, their family, school, health and ESMA.  As part of the plan, the student's progress will be discussed and targets and next steps will be identified.  Regular reviews of the Holistic Support Plan are held during the period of support with the student, family, school and health professionals.  

Independent organisations who can help

We work with many support agencies in Hertfordshire, including School Health, Families First, specialist nurses, NHS teams and HCC Services for Young People.

If you would like to seek some support yourself, there are some organisations you can try.

SENDIASS

Provide impartial and confidential information, advice and support to parents and carers of children with special educational needs and disabilities (SEND)

SFYP Wellbeing projects

Services for Young People wellbeing youth work projects support young people aged 11-17 with their mental, emotional and physical health and wellbeing. Young people learn how emotional and mental wellbeing can affect physical, social and mental health. The projects also develop self-esteem and help young people manage anxiety or low mood.

Page was last updated on: 14/07/2026 13:17:20