The schoolrooms at the Chelsea and Westminster Hospital could be part of any good school: lots of activities, brightly coloured paintings and sculptures around the room, a lot of stimulating reading material, attentive teachers. But, of course, this is far from being an ordinary school. A hospital school attached to a children's ward, it makes extraordinary demands on the energy and talents of the teachers employed.
First, of course, most of the 30 or so children are ill, some very ill. Then there is a huge age range: from three up to l8; and a great variation in ability: many have special needs and may have statements.
As Pat Aggarwal, the deputy head, says, hospital teachers require special skills and traits. "You need to be very flexible, as well as level-headed and well balanced. You have to have the skills to work with a wide age range and you must be able to cope with change and like a challenge. Pupils and their needs may change from day to day."
Hospital teachers have to work as part of a multi-disciplinary team. Pupils' needs are often bound up with their injuries and illnesses, and meetings with doctors, nurses, social workers, psychiatrists and others are necessary to assess them. Also important is contact with mainstream schools.
And then there is the open-door policy. Parents come and go, as do siblings, volunteers, students teachers and doctors, physiotherapists, nurses and others.
"You have to have the skills to deal with distraught parents sensitively. It can be harrowing, especially the death of a child," says Ms Aggarwal.
Classroom space can be inadequate, for this is often an underfunded area of education - "the Cinderella of the service", is how one hospital teacher describes it. Sometimes teachers have to share classrooms and storage with other competing claimants. In small hospitals, or where the children are too ill to be moved, teaching goes on at the bedside.
"Our job satisfaction comes in different ways from those of a mainstream teacher," says Ms Aggarwal. The satisfactions are many though, for hospital schools have a lot to offer children. Apart from the benefits of keeping up, as far as they are able, with their education, research shows that children get better much quicker if they are stimulated and happy. School adds a degree of normality to lives which, often, have been tragically disrupted.
"Many children feel anxious on arriving and dread the thought of being parted from their parents," says Ms Aggarwal. "We want to turn what can be a very frightening experience into something positive."
By law, local education authorities must make arrangements for the education of children who for reasons including illness may not for any period receive suitable education.
Chelsea Children's Hospital School covers three hospitals in a London borough with large numbers of school-age admissions; 85 per cent of the children come from outside the area. There are about eight full-time teachers.
The Chelsea and Westminster (where about 30 children are taught every day) has a lot of specialised cases, such as leg lengthening, children with congenital conditions like spina bifida, and children with injuries from traffic accidents. The Royal Brompton (where about 20 children are taught every day) has a greater proportion of very sick children with, for example, cystic fibrosis and heart and lung problems. The third hospital, Collingham Gardens Child and Adolescent Service, is a psychiatric residential unit for about 12 pupils, who stay on average about four months. Here most of the teachers have special qualification over and above several years' experience in mainstream.
True to the school's philosophy of providing lots of stimulation and fun, the headteacher Janette Steel organises a multitude of projects for pupils. Examples of photography, weaving and collage enliven the classrooms and corridors. A storyteller works with children who are so ill they cannot move or even communicate. A drama therapist and a musician also come in to work with groups of children.
But this does not mean that academic studies are neglected. In this, the introduction of the national curriculum with its clear standards has certainly helped, says Janette Steel.
"It's the best thing that ever happened to us. It means that we can fit in with any schools. We now have research and materials on all the most used topics and can slot them in."
A large hospital school such as Chelsea can make sure that it has teachers who can cover a whole range of subjects, and the school is able to cater for most subjects up to GCSE. At A-level, outside tutors can be brought in, and, if this is not possible, schools may send in work.
But what about those hospital schools where only one or two teachers are employed? Joan Smith is teacher in charge of the paediatric school at Leeds General Infirmary which caters on average for eight or nine children (though it can be as many as 15) aged between three and 16 in a two-room school. The majority are long-stay patients with broken limbs or head injuries. There is only one other full-time member of staff.
Teaching all the subject areas is not easy, she admits. "If I have any great difficulty, I take it home and ask someone I know to help me. But anyone would realise that one person is not going to be so wonderfully talented as to provide properly for the age range we cater for."
She emphasises the importance of being available to parents, who often need to talk to someone other than medical staff, but admits that supporting people who have to cope with dramatic and irreversible changes in their children's personalities is a difficult and sometimes distressing part of the job. But still she finds this contact rewarding.
Like many hospital teachers, Joan Smith had worked many years in the mainstream before she came to Leeds - most hospitals expect teachers to be experienced and many recruit from mainstream schools; some, however, do take newly qualified teachers.
National Association for the Education of Sick Children, 18 Victoria Park Square, Bethnal Green, London E2 9PF. Tel: 0181-980 8523. The NAESC also publishes Education for Sick Children (Pounds 21 from the above address)