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Hertfordshire Send Local Offer

Education support for medical absence (ESMA) is provided by specialist teachers who work with young people aged 5-16, whose attendance has been significantly affected by a medical condition or special educational needs or disabilities (SEND).

What we do

ESMA supports schools that have pupils who are temporarily unable to attend school for medical reasons, and work towards getting the pupil back into school life as soon as possible.

We offer:

  • Guidance about the impact of medical conditions on school access, including the best ways to support re-integration
  • Advice to schools so they can develop strategies to manage pupils with health needs
  • Anxiety courses for parents and pupils
  • Teaching support for pupils whose medical condition is preventing them from accessing school  
  • Advice to governing bodies in respect of their statutory duties for these pupils.

More information about missing education due to ill health.

How to access the service

Referrals, usually by the school,  are made through completing a Service Request Form. We also require this additional form from schools  to provide us with more detail on current school support.

All referrals to ESMA must provide details of the school support currently in place and be accompanied by a letter from a medical practitioner (Consultant Paediatrician or Child and Adolescent Mental Health Service) who is actively involved with the young person. The evidence from the medical practitioner should specify the impact the medical condition has on the pupil’s ability to access education in school. 

ESMA will contact the school once a referral has been received to offer advice to the school/setting or arrange an initial meeting with school and family to agree the next steps. 


Sue Bramley is the Lead Practitioner for Education Support for Medical Absence (ESMA) and can be reached on 0300 123 4043.

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