Skip to Content

NAPCE News – January 2020


NAPCE News – January 2020. Making a positive difference to young people through pastoral care. Pastoral care in schools across the UK and further afield is proven to be critically linked to the academic and personal-social development of young people. NAPCE continues to support education providers in the process of pastoral care implementation and development. It is here that we share important news of our latest activities, events and best practice guidance. 

FEATURE ARTICLE: NAPCE Officer & School Counsellor Paula Spencer discusses managing GCSE exam stress & supporting students

GCSE Exam stress and student support It was interesting to read the article by Tim Roome and C.A. Soan; published in the recent edition of NAPCE’S quarterly journal Pastoral Care in Education ‘GCSE exam stress: student’s perceptions of the effects on wellbeing and performance.’

(Vol.37, NO. 4,297-315.  December 2019)

They explored the views of students who had recently taken GCSE exams, how they felt their GCSE experiences affected their wellbeing and performance, factors that contributed to or alleviated their levels of exam stress, and whether theories  relating to exam stress such as Achievement Goal Theory could be used to explain the individual differences in levels of exam stress. (p297)

Since the start of the school year in September, several year 11 students have self-referred to the school’s student counselling service to talk about their thoughts, feelings and concerns about year 11, before moving into further education. Teacher training days have focused on raising year 11 achievement and putting strategies in place to support different students both academically and emotionally.

Students who use the counselling service talk about their fears, anxieties, concerns and how the pressure of GCSEs affect them. One student explained  ‘GCSEs  are scary. Before GCSE year I didn’t have panic attacks, it’s a fear of failure, teachers tell us if we don’t get GCSEs we won’t get this job or that job, it is not okay to fail, this is the message we get a lot from teachers’.

Another student said ‘I can’t stand year 11, everything about it is horrible.  There is one subject that is driving me crazy, I hate this subject and the teacher, and this is the subject that stresses me out the most. The taster lesson made it seem that it was interesting.  In fact, the reality is starting to get to me, I am starting to panic about finishing course work and revision. Each subject comes with its own stresses, I am genuinely scared of failing, and I won’t even have the qualifications to work in McDonalds.  Then there are the constant reminders from teachers and counting down the weeks before the start of exams’.

One student told me that she had no worries about GCSEs for now ‘it just hasn’t hit me yet’. Others describe difficulty sleeping, those who sleep sometime talk about their dreams where they get exam results and have failed. Some put off doing course work and homework because they believe that they have already failed and will not do well, they are revising but not sure what they are revising, or not knowing how to revise.   Some students from different cultural backgrounds describe feeling anxious about parental and cultural expectations, not wanting to let their parents down, while others talk about wanting to do well because failure will impact on their career choices or where they continue their further education and A Level options.  While stress is a normal part of everyday life, the extra pressure caused by GCSEs clearly affects students mental and emotional wellbeing, some more than others.

The research by Roome and Soan highlighted ‘the need for school staff to provide support specifically  for students who have high levels of or are susceptible to exam stress….School staff would benefit from training to increase awareness of how they can contribute to or alleviate stress… Advice for students could be offered by school staff or specialist in mental health, such as educational psychologist…students should have an awareness of their goal mindset orientations and given strategies to cope with exam stress. (P311-312)

The students who use the counselling service often welcome the opportunities to say how and what they are feeling and what they are thinking. I work with each student to develop a range of individual coping strategies to help them deal with their anxieties. Sometimes this can involve working with parents who have their own anxieties, they too often feel helpless, they are not sure what strategies to use to support their child.

Anxiety affects performance and performance affects the future.

The organisations listed below provide information and strategies  to cope exam stress, the NHS site has a page for parents.

Paula Spencer
NAPCE Officer & School Counsellor

AWARDS: Sponsors line up to support first National Awards for Pastoral Care in Education

A host of influential organisations have lined up to support the first National Awards For Pastoral Care In Education which launched last year.

Each of the four entities have put their name to one of the Awards for the scheme, which is a collaboration between NAPCE and UK Pastoral Chat.

Staff performance software pioneers Blue Sky Education will sponsor the Pastoral School of the Year category.

The award-winning company is celebrating its 20th anniversary inn 2020 and successfully continues to roll out its universal time saving software solution in schools across the UK.

The Pastoral Team of the Year accolade is being backed by The Thrive Approachwhich offers online and in-school training to help teaching staff to develop an education setting to engender healthy, happy children.

Their training model is supported by neuroscience and focuses on individual child development.

Taylor and Francis, one of the world’s leading publishers of scholarly journals, books, eBooks, text books and reference works, is sponsoring the Pastoral Leader of the Year award.

Taylor & Francis Group publishes more than 2,600 journals and over 5,000 new books each year including NAPCE’s quarterly journal Pastoral Care in Education.

The Raising Awareness about Pastoral Care Award is being supported by ASCL, the Association of School and College Leaders.

ASCL is the leading professional association and trade union for all school and college leaders.

They support and represent more than 19,000 school and college leaders of primary, secondary and post-16 education from across the UK.The team at ASCL works to shape national education policy, provides advice and support to our members and deliver first-class professional development.

Welcoming each of the four sponsors on board Chair of NAPCE Phil Jones said: “We are absolutely delighted that each of these four fantastic organisations is supporting the awards and we are very grateful for their support.

“The reaction to the first National Awards for Pastoral Care in Education has be very encouraging and to have such prestigious and credible organisations involved gives the awards even more of a boost.

“We have received some great entries so far but would like to receive many more so please encourage your school or team to get involved if you’d like to be in with a chance of winning one of these prestigious awards and the one hundred pound prize.”

If you work for an organisation that would be interesting in sponsoring the National Awards for Pastoral Care in Education please contact

About the Awards and How to Enter

This is the first time ever an event has being organised to recognise the fantastic achievements across schools in the UK on pastoral care.

It has been created to provide much deserved recognition to the people and schools who are doing great work and to shine a light on good practice in pastoral care.

There are seven categories to enter in the NAPCE Awards and 11 under the UK Pastoral Chat scheme.

Entry for both sets of awards is separate, although the closing date for both is Monday 2nd March, 2020.

Both organisations will work in partnership to organise the first ever National Awards for Pastoral Care in Education under one awards ceremony which will take place in 2020.

You can enter the NAPCE awards now here:

NAPCE is inviting nominations in the following categories;

  • Pastoral School of the Year
  • Pastoral Team of the Year
  • Pastoral Member of Staff of the Year
  • Pastoral Leader of the Year
  • Pastoral Development of the Year
  • Raising Awareness about Pastoral Care
  • Outstanding Contribution to Pastoral Care

Nominations are encouraged for awards in different categories from schools and educational institutions.

UK Pastoral Chat is inviting nominations for awards in the following categories;

  • SLT
  • Head of Year (Including Head of 6thForm)
  • Head of House/Head of Boarding
  • PSHE Lead
  • Nurse/ Counsellor
  • Pastoral Support Staff (including Learning Mentor)
  • Tutor/Classroom teacher
  • Unsung Hero
  • Guidance teacher
  • DSL/CP Co-ordinator
  • Governor

Details about how to make nominations can be found on the UK Pastoral Chat Twitter pages.

The Awards will be an excellent opportunity to share good practice in pastoral care and through the social media and websites of both organisations to raise awareness of where pastoral support is making a real difference in the educational experience of young people.

The awards will encourage new initiatives and ideas in pastoral care and will recognise the contributions being made to developing policy and practice in pastoral support.

This is an opportunity to recognise the impact the work of pastoral staff is having on the achievement and well being of young people. The decisions about prize winners in each category will be made by a panel of invited professionals who work in pastoral care.

There will be a prize of £100.00 for the school or institution for the winners of each category and individuals will also be recognised for their achievements.

The criteria for the NAPCE awards are;
Award Criteria

  • Pastoral School of the Year

A school that can demonstrate a commitment to pastoral care and support for learners that makes a real difference in the progress and personal development of young people in the school

  • Pastoral Team of the Year

A team that works in pastoral care and can demonstrate a determination to support young people to achieve their full potential and a positive impact on the young people they work with.

  • Pastoral Member of Staff of the Year

A member of staff who works in pastoral care and who always makes the extra effort to support young people to enable them to become effective learners and achieve success.

  • Pastoral Leader of the Year

Has a passion for pastoral care that is shared with colleagues to inspire and motivate them to make a real difference in the lives of the young people they work with.

  • Pastoral Development of the Year

A pastoral initiative or idea that has achieved positive outcomes and has improved the learning experience and future life chances, for young people.

  • Raising Awareness about Pastoral Care

An individual, group or organisation who through their actions have raised awareness about pastoral care or pastoral issues and encouraged positive improvements for the benefit of young people.

  • Outstanding Contribution to Pastoral Care

A person, group or organisation that has made a real difference for the benefit of young people in the area of pastoral care.Nominations for the NAPCE Awards are welcome from member schools and institutions and from schools and institutions that are not currently members of NAPCE.

Nominations can be made online via this link:

You can also enter by e-mail to NAPCE Base at or they can be sent by post to National Association for Pastoral Care in Education, (NAPCE), PO BOX 60005, Nuneaton, CV11 9GY, with the following information:

Award                          __________________________________________

Nomination                  __________________________________________
Support for nomination (maximum 100 words)

Nominated by _______________________________________________

Email contact _______________________________________________

The Awards Programme and partnership with UK Pastoral Chat is an exciting opportunity to raise the profile of Pastoral Care and give hard working pastoral staff and schools with positive approaches to supporting learners the recognition that they deserve.

Please be part of this process by sending your nominations.

Phil Jones
National Chair
National Association for Pastoral Care in Education

ARTICLE: Fabricated or Induced Illness  – A matter for schools? By Andrew Martin of Safeguarding Network


NAPCE recently teamed up with Safeguarding Network to publish a series of articles concerned with keeping children and young people safe in the school environment.

We are now delighted to bring you the second instalment, which focuses on the subject of Fabricated or Induced Illness.

Safeguarding Network was established in 2017  by John Woodhouse and Andrew Martin,  two social workers with more than 40 years combined experience working with children and young people.

The organisation is concerned with the increasing requirement on schools to fill the void left by decreasing social care budgets and the sparse support available for schools when responding to a matter not deemed to meet the social care thresholds.

Fabricated or induced illness: a matter for schools? By Andrew Martin

Why do I need to know about fabricated or induced illness (in 60 seconds)

Fabricated or induced illness (previously commonly known as Munchausen’s by proxy) is a lesser known form of physical abuse.  Although the illness is primarily a health issue, there are significant implications for schools.  Fabricated or induced illness is considered to cover a spectrum of issues, ranging from over anxious parents to parents who are deliberately harming their children for their own gain.

As professionals working with children and young people daily, staff in schools are in a prime position to identify inconsistencies in what they are being told about the needs of the child versus how the child is presenting.  Numerous Serious Case Reviews tell us that there is also a need for schools to maintain a respectful uncertainty and ensure that they challenge where necessary – including challenging the parent and health professionals, regardless of where they may be on the perceived hierarchy within the health system.

School staff are also best placed to hear the voice of the child – something which is often lost in cases of fabricated or induced illness.


Due to the nature and levels of workloads that as professionals we must deal with daily, as soon as we see the word illness there is a natural response to classify that as a health issue and – at most – make a mental note to speak to the school nurse.  Therefore, to be considering fabricated or induced illness as an issue for schools we have to be aware that we may be pushing at a closed mental door. As we will see however it is something that we do need to be aware of.

Indeed, this sense of illness being a health issues is, in  some sense reinforced by the Department for Education.  If you search through Keeping Children Safe in Education 2018 for the term, or its shorthand of FII, you will find only one mention in the “Additional advice and support” section of Annex A, simply a link to the 2008 government guidance, Safeguarding children in whom illness is fabricated or induced.  Fabricated or induced illness is also briefly mentioned in Ofsted guidance for inspectors as an area where safeguarding action may be required to protect children and learners, but again little there is substance behind it.

Physical abuse

This lack of emphasis on fabricated or induced illness may be due to research suggesting that FII is a rare form of abuse.  The NHS cites a widely quoted study from 2000 which estimated the number of cases of FII at just 89 per 100,000 over a two year period. When compared to figures from 2016/17 for sexual offences against under 18’s which equate to around 500 per 100,000 in a one year period, this does show why it is considered rare.  However, as the research itself identifies, there are a number of caveats to the 89 per 100,000 figure, and there is consensus that the true figure may be higher.

Although not specifically referenced in the body of Keeping Children Safe in Education 2018, all staff should be aware of FII through its inclusion in the definition of physical abuse in Part one of the document:

Physical abuse: a form of abuse which may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child. (para 43, p.14, Part one, Keeping Children Safe in Education, 2018 – emphasis added)

Defining fabricated or induced illness

Most documents on FII do not provide a definition of fabricated or induced illness, instead talking about the ways in which it may occur.  The pan-London child protection procedures do however offer the following definition:

Fabricated or induced illness is a condition whereby a child has suffered, or is likely to suffer, significant harm through the deliberate action of their parent and which is attributed by the parent to another cause.

The deliberate actions of a parent or parents that tend to centre around them lying about or making up health issues fall into three main groupings:

  • Fabrication of signs and symptoms – this may include making up or altering past medical histories.
  • Fabrication of signs and symptoms along with falsification of hospital records / charts / letters and other documents. In some cases, parents may also go so far as to falsify specimens of bodily fluids.
  • Induction of illness through a variety of means, which may include poisoning and other ways.

You may hear people still refer to Munchausen’s or Munchausen’s Syndrome by Proxy – this term was replaced with the current fabricated or induced illness as Munchausen’s refers to a psychiatric illness and there was concern that this was meaning that parents who harmed their children in this way were being labelled with a psychiatric illness that they may not have.

1. Simple anxiety, lack of knowledge about illness, over interpretation of normal features of childhood that may in some cases be linked to depression in carer. Carer may be affected by issues such as inability to cope with other personal or social stresses, for example mental ill health. Carer can usually be reassured although likely to come back in the future. Seldom reaches level of significant harm
2. Symptoms are misinterpreted by carer or may be perpetuated / reinforced by the carer.  Carer may genuinely believe that their child is ill or have fixed beliefs about illness. The ‘illness’ may be serving a function for the carer and potentially older children (referred to as secondary gains). Carer can be difficult to reassure.  Carer and professionals may not agree on the cause of the symptoms and/or need to investigate further. Some risk of significant harm including emotional harm, impact on education or social isolation.
3. Carer actively promotes sick role by exaggeration, non-treatment of real problems, fabrication (lying) or falsification of signs, and/or induction of illness. There may be a history of frequent use of, or dependence on, health services.  The ‘illness’ may be serving a purpose for the carer or meeting their own mental health needs. Carer cannot be reassured, and their objectives are often diametrically opposed to those of professionals. High risk of harm, always because of over intervention and often severe.
4. Carer suffers from diagnosable psychiatric illness (e.g. delusional disorder) which leads them to believe the child is ill. The carer’s mental health is the primary underlying issue. Carer lacks insight into their involvement in the child’s reported illness. May be a risk of harm.
5. There are genuine unrecognised medical issues which become apparent after initial investigation around possible FII. Carer’s behaviour will usually be appropriate for the signs displayed by the child, although this may change if there are child protection interventions. Risk of harm due to delay in correct diagnosis and following child protection routes.

Whilst most of us can identify parents who fit the detail in example 1 (and not just in relation to medical needs), the greatest risk is presented by those parents who fit the detail in example 3.

Impact on schooling

Whilst research shows that the most severe and dramatic events are usually seen in children under the age of five, FII is seen in children of all ages (NSPCC, 2011).  Arguably, the reason for the greater severity in under 5’s is that FII requires acts to be done to children (either by the parent or by doctors) and therefore as a child gets older they are more likely to ask questions and start to challenge the “perceived wisdom” of the parent.  However, as identified by the NSPCC (ibid.) some children can become so indoctrinated in their “sick” persona that they may go on to simulate their own illnesses or start to act in a way that supports their parents’ position (as seen in this Serious Case Review).  Cases are also seen where the description of the child and their illness does not fit the child that is seen in school.

Any child’s medical needs can have an impact on their day to day schooling, however in cases of fabricated or induced illness, the impact is likely to be significant.  Schools may find themselves having to adjust premises, routines, etc. to ensure that they are compliant with the Disability Discrimination Act 1995 and Equality Act 2010, and that they have staff who are trained in various medical procedures.  A child’s attendance at school may be severely disrupted due to medical appointments or having days off due to being unwell.  Cases often identify that the abuser can be highly manipulative and frequently well informed about the different features of the ‘illness’, meaning that they are very hard to challenge.

As a school there is therefore a need to be aware of patterns of absence (does your data manager / business manager regularly report any concerns?), and whether staff asking questions leads to increased absence.  Schools should also be aware of cases where there are multiple moves of school or the suggestion of home schooling for an ill child and should question what the reason for this may be. Evidence suggesting that this is part of the pattern when there are cases of fabricated or induced illness.

Respectful uncertainty

Respectful uncertainty was introduced as a concept by Lord Laming in his enquiry into the death of Victoria Climbié.

The concept of “respectful uncertainty” should lie at the heart of the relationship between the social worker and the family. It does not require social workers constantly to interrogate their clients, but it does involve the critical evaluation of information that they are given. People who abuse their children are unlikely to inform social workers of the fact. For this reason at least, social workers must keep an open mind. (para 6.602, p.205, The Victoria Climbie Enquiry)

For our purposes, the term “social workers” can be replaced by “professionals”.  This approach is key when considering cases of suspected fabricated or induced illness.

Serious Case Reviews demonstrate that often there is a mismatch between information being presented to one agency and information being presented to another.  Schools see the children for prolonged periods of time throughout the year.  During this time there can be significant differences between what the parents report as happening whilst the children are in their care and what the staff see daily.

Another term that can be applied here is professional dangerousness. The term is attributed to Tony Morrison (1990) and describes the process where the behaviour of professionals involved in child protection work means that they inadvertently collude with the family they are working with or act in a way that increases the dangerous dynamics that are present.  In cases of fabricated illness there is a risk that human nature will mean that subconsciously we do not want to countenance the idea that parents, and particularly mothers, would want to seek medical assistance that would harm their child.  For most parents, the natural response would be to only agree to what can be highly invasive procedures if they were convinced that they were absolutely necessary. Therefore if a procedure is being recommended and the parents are agreeing to it, it is natural to think it must be necessary.

Daniel Pelka

A lack of respectful uncertainty was seen in the case of Daniel Pelka.  Whilst the case is more commonly known for the alcohol misuse and domestic abuse in his mother’s relationships and the physical abuse of Daniel, there was also a lesser identified element of fabricated or induced illness present.

The Serious Case Review identified that although Daniel was only at school for two terms before he died, in that time there were concerns that he was scavenging for food in bins and craving for food (he was stealing food from other children’s lunchboxes and eating secretively).  When the mother was challenged about this she stated that he had a health condition and requested that the school supported her in making sure that he only ate what was in his lunchbox.  However, Daniel’s reported obsession with food did not match up to what staff were seeing in relation to his appearance – one member of staff telling the subsequent criminal trial that he appeared to be “wasting away”.  The Serious Case Review found that assumptions were “too readily made that his problems were medically based”.  The suggestion is that the mother was falsifying the health condition to cover up the abuse that was happening at home, and that she and her partner were inducing medical problems by force feeding him salt, with this being planned as a punishment if he was considered to have been eating too much.

Disguised compliance

Common themes which potentially evidence disguised compliance include the focus on improving one issue to deflect attention from other areas, being critical of professionals, and not engaging with services or avoiding contact with professionals.  In cases of fabricated or induced illness one or more of these traits is often seen, for example:

  • Parents will pick up prescriptions but then not give the medication to the child.
  • Telling health professionals that the child’s school is not supporting the care plan, whilst telling school that none of he health professionals are able to attend meetings.
  • Parents not agreeing to referrals being made or services being provided or agreeing and then withdrawing their consent / not attending.
  • Parents blocking access to the child or making sure that they are always present when the child is seen.

It is therefore important that we focus on the question “what does this mean for the child?”, and if we are concerned about something the parent is doing, are we concerned about significant harm?


Alongside questioning what a parent’s behaviour means for a child, we also the need to feel able to challenge fellow professionals.  Within many systems there are hierarchies; however  safeguarding network are strongly of the view that there is no such thing as a hierarchy in safeguarding and child protection.  Very often it is the person who perceives themselves to be at the bottom of the hierarchy and believes that they have the least knowledge who has the most contact with the child and is best placed to know if there is something happening that is concerning.

In relation to fabricated or induced illness the power associated with the hierarchy within health can go across agencies, with other agencies deferring to the power and knowledge of others deemed to be “more experienced in these matters”.  For example, one Serious Case Review found that because the child was receiving medical care from a “centre of excellence” everyone involved relied on their skills to manage the treatment and concerns that were present in education and other health sectors were not flagged up because the involvement of the specialist service added a confirmation bias (e.g. when we want something to be true we will look for things that confirm it is true).  In this case the bias was that professionals did not want to believe that the mother was harming her children and the involvement of a specialist centre meant that the child must genuinely be ill.  No-one involved was questioning what they were being told and the situation had been manipulated by the mother.  This case review also found that the school had not made a referral to Children’s Social Care because they felt that on the basis of their concerns alone, the threshold for involvement of a social worker would not be met.  The review argued that the referral should have been made and then a discussion held.

Voice of the child

As with many other forms of abuse, evidence suggests that the voice of the child is often lost in cases of FII.  In one case that went to review the children stated:

  • Health professionals appeared very reliant on what their mother was saying, and they felt they “were not an important part of the conversation”.
  • One child knew they were having unnecessary treatment but did not feel that they had the opportunity to tell anyone.
  • Another child spoke of not wanting the treatment and being scared, but then feeling that it was OK because their mother was there.

Whilst some of these comments can be levelled arguably at health professionals, the child who did not feel that they had the opportunity to tell anyone was a school-age child and did attend school on a frequent basis.  Did he not feel able to approach school staff?  Perhaps he felt / believed he should not talk to school staff about his health issues?

In summary

Fabricated or induced illness is not as common a form of abuse as others we may see; however, there is often a significant impact for the child and their family and, in some cases the risk of harm is significant.  As non-medical professionals we may not feel able to challenge consultants and other medical professionals about specific health issues. However, as with other forms of abuse school staff will know the children they work with and will be able to identify if what they are told and what they see are not adding up.  This inconsistent information then needs to be followed up in the same way as other concerns are – and escalated if necessary.

A common message from Serious Case Reviews on this matter (including those mentioned in this article) is that where there are significant, ongoing medical issues the school should be in direct contact with the relevant health professionals to talk through the issues and any concerns, and professionals should not rely on the parents to convey messages.

For further information and advice on what do you do next, visit Safeguarding Network here:

MEDIA WATCH: A round-up of the latest news stories involving pastoral care in education

At NAPCE we work very hard to stay across the national and international news media to store and share the latest stories involving pastoral care in education on our own platforms.

In this new feature for NAPCE News, we are sharing with you a selection of the biggest stories hitting the headlines this month with the aim that some of these reported developments may provide useful context within your work as a strategist or practitioner of pastoral support.

Here is a summary for January 2020.

“A school looking after its children – and their families” from BBC News

Read here:

“Teenage girls self-harm three times as much as boys ‘because they tend to internalise problems and blame themselves more often'” from Mail Online

Read here:

“‘I was angry I couldn’t even say the word’: UK teens refuse to be silent about periods” from The Guardian

Read here:

“Putting pupils in isolation ‘drives poor behaviour'” from BBC News

Read here:

“Schools in deprived areas become ‘dumping grounds’ for struggling children, Ofsted report suggests” from The Independent

Read here:

“Social media data needed for ‘harm’ research, say doctors” from BBC News

Read here:

“Period poverty: Schools urged to order free menstrual products”” from BBC News

Read here:

“Exclusions for racism in primary schools in England up more than 40%” from BBC News

Read here:

We use cookies to improve your website experience. To learn about our use of cookies and how you can manage your cookie settings, please see our Cookie Policy. By closing this message, you are consenting to our use of cookies.