Managing medicines in schools and early years settings




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Guidance
All Local Authorities and all

schools and early years settings

and their employers
Date of Issue: March 2005
Reference: 1448-2005DCL-EN
Status: Recommended

MANAGING MEDICINES IN SCHOOLS

AND EARLY YEARS SETTINGS

Department for Education and Skills | Department of Health



FOREWORD
As part of the government’s agenda to improve the lives of children and young people, we are pleased to be able to introduce this updated guidance on managing medicines in school and early years settings, which replaces the earlier Department for Education and Employment and Department of Health Supporting Pupils with Medical Needs: a good practice guide and Circular 14/96 Supporting Pupils with Medical Needs in School, which were published in 1996.

This updated guidance sets a clear framework within which Local Authorities, NHS Primary Care Trusts, schools, early years settings and families are able to work together to develop policies to ensure that children requiring medicines receive the support they need. The guidance, which has been produced by the Department for Education and Skills in collaboration with the Department of Health, takes full account of the recommendations included in the Department of Health and Department for Education and Skills National Service Framework for Children, Young People and Maternity Services and is consistent with our Every Child Matters: Change for Children programme.

In updating this guidance we were very fortunate to be able to work closely with a number of voluntary bodies, including those that specialise in supporting children with particular medical needs, and with the Royal College of Paediatrics and Child Health, the Royal College of Nursing, school staff unions, Confed and the Local Government Association. We are grateful for their input in seeking to make this guidance as clear and helpful as possible.
We trust that this updated guidance will encourage and help early years settings, schools, Local Authorities and NHS Primary Care Trusts to


  • review their current policies and procedures involving children with medical needs in order to make sure that everyone, including parents, is clear about their respective roles

  • put in place effective management systems to help support individual children with medical needs

  • make sure that within early years and school settings medicines are handled responsibly

  • help ensure that all school staff are clear about what to do in the event of a medical emergency

All of us want all children to have successful and fulfilling lives. By implementing this guidance you will be helping to achieve our shared vision that all children and young people should be healthy, stay safe, enjoy and achieve, and be able to make a positive contribution. The measures outlined in this guidance are one more step towards ensuring that vision becomes a reality.

Department of Health



Department of Health


CONTENTS




Paragraph




Introduction







Children with Medical Needs

4




Access to Education and Associated Services

8




Support for Children with Medical Needs

13













Chapter 1: Developing Medicines Policies







Introducing a Policy

20




Prescribed Medicines

25




Controlled Drugs

29




Non-Prescription Medicines

35




Short-Term Medical Needs

37




Long-Term Medical Needs

38




Administering Medicines

42




Self-Management

45




Refusing Medicine

49




Record Keeping

50




Educational Visits

56




Sporting Activities

60




Home to School Transport

62













Chapter 2: Roles and Responsibilities







Introduction

66




Parents and Carers

67




The Employer

73




The Governing Body

79




The Head Teacher or Head of Setting

81




Teachers and Other Staff

86




The Local Authority

92




Primary Care and NHS Trusts

95




Health Services

97




Ofsted

103













Chapter 3: Dealing With Medicines Safely







Safety Management

106




Storing Medicines

107




Access to Medicines

111




Disposal of Medicines

112




Hygiene and Infection Control

114




Emergency Procedures

115













Chapter 4: Drawing up a Health Care Plan







Purpose of a Health Care Plan

118




Co-ordinating Information

124




Information for Staff and Others

125




Staff Training

129




Confidentiality

130
















Chapter 5: Common Conditions – Practical Advice on Asthma, Epilepsy, Diabetes and Anaphylaxis







Introduction

131




What is Asthma?

134




Medicine and Control

137




What is Epilepsy?

150




Medicine and Control

156




What is Diabetes?

164




Medicine and Control

167




What is Anaphylaxis?

178




Medicine and Control

182













Annex A: Legal Framework
















Annex B: Forms







Form 1: Contacting Emergency Services







Form 2: Healthcare Plan







Form 3A: Parental agreement for school/setting to administer medicine







Form 3B: Parental agreement for school/setting to administer medicine







Form 4: Head’s agreement to administer medicine







Form 5: Record of medicine administered to an individual







Form 6: Record of medicines administered to all children







Form 7: Request for child to carry his/her own medicine







Form 8: Staff training record - administration of medicines







Form 9: Authorisation for the administration of rectal diazepam
















Annex C: Related Documents
















Annex D: Useful Contacts




INTRODUCTION


  1. This guidance is designed to help all schools and all early years settings and their employers develop policies on managing medicines, and to put in place effective management systems to support individual children with medical needs. Positive responses by schools and settings to a child’s medical needs will not only benefit the child directly, but can also positively influence the attitude of their peers. This guidance replaces Supporting Pupils with Medical Needs: a good practice guide and Circular 14/96 Supporting Pupils with Medical Needs in School (DfEE/DH 1996).




  1. It is for Local Authorities, schools and governing bodies, settings and management groups to work out their own policies in the light of statutory responsibilities and their own assessment of local needs and resources, but it is hoped that when doing so they will find this guidance useful. To help in this process, forms are provided at Annex B that can be photocopied or adapted for use.




  1. This guidance is not a definitive interpretation of the law. Interpreting the law is a matter for the courts alone.


Children with Medical Needs


  1. Children with medical needs have the same rights of admission to a school or setting as other children. Most children will at some time have short-term medical needs, perhaps entailing finishing a course of medicine such as antibiotics. Some children however have longer term medical needs and may require medicines on a long-term basis to keep them well, for example children with well-controlled epilepsy or cystic fibrosis.




  1. Others may require medicines in particular circumstances, such as children with severe allergies who may need an adrenaline injection. Children with severe asthma may have a need for daily inhalers and additional doses during an attack.




  1. Most children with medical needs are able to attend school regularly and can take part in normal activities, sometimes with some support. However, staff may need to take extra care in supervising some activities to make sure that these children, and others, are not put at risk.




  1. An individual health care plan can help staff identify the necessary safety measures to support children with medical needs and ensure that they and others are not put at risk. Detailed advice on how to develop an individual health care plan is set out in Chapter 4.


Access to Education and Associated Services


  1. Some children with medical needs are protected from discrimination under the Disability Discrimination Act (DDA) 1995. The DDA defines a person as having a disability if he has a physical or mental impairment which has a substantial and long-term adverse effect on his abilities to carry out normal day to day activities.




  1. Under Part 4 of the DDA, responsible bodies for schools (including nursery schools) must not discriminate against disabled pupils in relation to their access to education and associated services – a broad term that covers all aspects of school life including school trips and school clubs and activities.1 Schools should be making reasonable adjustments for disabled children including those with medical needs at different levels of school life; and for the individual disabled child in their practices and procedures and in their policies.




  1. Schools are also under a duty to plan strategically to increase access, over time to schools. This should include planning in anticipation of the admission of a disabled pupil with medical needs so that they can access the school premises, the curriculum and the provision of written materials in alternative formats to ensure accessibility.




  1. Early years settings not constituted as schools, including childminders and other private, voluntary and statutory provision are covered by Part 3 of the DDA. Part 3 duties cover the refusal to provide a service, offering a lower standard of service or offering a service on worse terms to a disabled child2. This includes disabled children with medical needs. Like schools, early years settings should be making reasonable adjustments for disabled children including those with medical needs. However, unlike schools, the reasonable adjustments by early years settings will include alterations to the physical environment as they are not covered by the Part 4 planning duties.




  1. The National Curriculum Inclusion Statement 2000 emphasises the importance of providing effective learning opportunities for all pupils and offers three key principles for inclusion:



Support for Children with Medical Needs


  1. Parents3 have the prime responsibility for their child’s health and should provide schools and settings with information about their child’s medical condition. Parents, and the child if appropriate, should obtain details from their child’s General Practitioner (GP) or paediatrician, if needed. The school doctor or nurse or a health visitor and specialist voluntary bodies may also be able to provide additional background information for staff.




  1. The school health service can provide advice on health issues to children, parents, education and early years staff, education officers and Local Authorities. NHS Primary Care Trusts (PCTs) and NHS Trusts, Local Authorities, Early Years Development and Childcare Partnerships and governing bodies should work together to make sure that children with medical needs and school and setting staff have effective support.




  1. Local Authorities and other employers, schools (including community nursery schools) should consider the issue of managing administration of medicines and supporting children with more complex health needs as part of their accessibility planning duties. It will greatly assist the smooth integration of children into the life of the school or setting.




  1. There is no legal duty that requires school or setting staff to administer medicines. A number of schools are developing roles for support staff that build the administration of medicines into their core job description. Some support staff may have such a role in their contract of employment. Schools should ensure that they have sufficient members of support staff who are appropriately trained to manage medicines as part of their duties.




  1. Conditions of employment are individual to each non-maintained early years setting. The registered person has to arrange who should administer medicines within a setting, either on a voluntary basis or as part of a contract of employment.




  1. Staff managing the administration of medicines and those who administer medicines should receive appropriate training and support from health professionals. Where employers’ policies are that schools and settings should manage medicines, there should be robust systems in place to ensure that medicines are managed safely. There must be an assessment of the risks to the health and safety of staff and others and measures put in place to manage any identified risks.




  1. Some children and young people with medical needs have complex health needs that require more support than regular medicine. It is important to seek medical advice about each child or young person’s individual needs.4

CHAPTER 1: DEVELOPING MEDICINES POLICIES
Introducing a Policy


  1. A clear policy understood and accepted by staff, parents and children provides a sound basis for ensuring that children with medical needs receive proper care and support in a school or setting.




  1. The employer has the responsibility for devising the policy. However schools and settings, acting on behalf of the employer, should develop policies and procedures that draw on the employer’s overall policy but are amended for their particular provision. Policies should, as far as possible, be developed in consultation with heads, and with governing bodies or management groups where they are not the employer. All policies should be reviewed and updated on a regular basis.




  1. Policies should aim to enable regular attendance. Formal systems and procedures in respect of administering medicines, developed in partnership with parents and staff should back up the policy.




  1. A policy needs to be clear to all staff, parents and children. It could be included in the prospectus, or in other information for parents. A policy should cover:




  • procedures for managing prescription medicines which need to be taken during the school or setting ‘day’

  • procedures for managing prescription medicines on trips and outings

  • a clear statement on the roles and responsibility of staff managing administration of medicines, and for administering or supervising the administration of medicines

  • a clear statement on parental responsibilities in respect of their child’s medical needs

  • the need for prior written agreement from parents5 for any medicines to be given to a child

  • the circumstances in which children may take any non-prescription medicines

  • the school or setting policy on assisting children with long- term or complex medical needs

  • policy on children carrying and taking their medicines themselves

  • staff training in managing medicines safely and supporting an identified individual child

  • record keeping

  • safe storage of medicines

  • access to the school’s emergency procedures

  • risk assessment and management procedures



  1. Parents should provide full information about their child’s medical needs, including details on medicines their child needs.

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