Medical

PART ONE – MANAGING MEDICINES AT ST CLARES SCHOOL

Policy and Procedures

 

  1. It is important to have a clear policy that is understood and accepted by staff, parents and children so that this provides a sound basis for ensuring that children with medical needs receive proper care and support at St Clares School.

 

  1. The Governing body have responsibility for the development of a policy and procedure that meets the needs of the children at St Clares School. As far as was possible this policy has been developed in consultation with school staff and with governors. It will be reviewed and updated on a regular basis every two years or sooner if necessary.

 

  1. This policy has been formulated to help improve regular attendance for young people with medical needs. The formal systems and procedures in place to administer medicines, developed in partnership with parents and staff will ensure the effectiveness of the policy.

 

  1. To be most effective this policy needs to be clear to all staff, parents and children. Aspects of the policy are included in the prospectus and all new parents are given information about how medicines are administered in the welcome pack for parents when children start the school.

 

  1. This  policy covers:

 

  • 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 parents[1] 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  • safe storage of medicines and disposal of unused and out of date medicines.
  • access to the school’s emergency procedures
  • risk assessment and management procedures

 

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

 

Prescribed Medicines

 

  1. Medicines should only be taken to school or settings when essential; that is where it would be detrimental to a child’s health if the medicine were not administered during the school or setting ‘day’. We only accept medicines that have been prescribed by a doctor, dentist, nurse prescriber or pharmacist prescriber. Medicines must always be provided in the original container as dispensed by a pharmacist and include the prescriber’s instructions for administration and dosage.

 

  1. We never accept medicines that have been taken out of the container as originally dispensed nor do we dispense medicines if the dosages instructions have been changed.

 

  1. If possible and where clinically appropriate, medicines may be prescribed in dose frequencies which enable it to be taken outside school hours. We will encourage Parents to ask the prescriber about this. If medicines need to be taken three times a day it may be possible for it to be taken in the morning, after school hours and at bedtime.

 

N.B.  The Medicines Standard of the National Service Framework (NSF) for Children[2] recommends that a range of options are explored including:

 

  • Prescribers consider the use of medicines which need to be administered only once or twice a day (where appropriate) for children and young people so that they can be taken outside school hours
  • Prescribers consider providing two prescriptions, where appropriate and practicable, for a child’s medicines: one for home and one for use in the school or setting, avoiding the need for repackaging or re-labelling of medicines by parents

Controlled Drugs

 

  1. The supply, possession and administration of some medicines are controlled by the Misuse of Drugs Act and its associated regulations (see Annex A). Some may be prescribed as medicine for use by children, e.g. methylphenidate.

 

  1. At St Clares First Aid trained staff may administer a controlled drug to the child for whom it has been prescribed. This medicine is to be administered in accordance with the prescriber’s instructions.

 

  1. At St Clares all controlled drugs will be looked after by the trained First Aider who will administer the medicine to the child for whom it has been prescribed.

 

  1. Controlled drugs will be kept in a locked non-portable container and only named First Aider staff should have access. A record is kept for audit and safety purposes.

 

  1. All medicines including controlled drugs will be returned to the parent when they are no longer required so that they may arrange for safe disposal (by returning the unwanted supply to the local pharmacy). If this is not possible the medicine will be returned to the dispensing pharmacist (details should be on the label).

 

  1. Passing any drug to another child for use is an offence. The schools drug policy identifies how drug misuse is dealt with.[3]

 

Non-Prescription Medicines

 

  1. Prior written permission from the parents is required before a qualified First Aider can administer any non-prescribed medicine to a child. Where the head agrees to administer a non-prescribed medicine it must be in accordance with the employer’s policy. Written permission slips from parents must be kept on file.

Staff must also check that the medicine has not been administered earlier in the day by making telephone contact with home.

When the non-prescribed medicine is administered to a child it must be recorded on the “Record of Medicines Administered to all children” proforma and the parents must be informed. When a child suffers regularly from frequent or acute pain the parents should be encouraged to refer the matter to the child’s GP.

 

  1. We do not administer aspirin-containing medicine unless it is prescribed by a doctor.

 

Short-Term Medical Needs

 

  1. We recognise that many children will need to take medicines during the day at some time during their time in a school or setting. This will usually be for a short period only, perhaps to finish a course of antibiotics or to apply a lotion. To allow children to do this will minimise the time that they need to be absent. However, such medicines should only be brought to school where it would be detrimental to a child’s health if it were not administered during the day.

 

Long-Term Medical Needs

 

  1. We believe it is important to have information about the medical condition of any child with long-term medical needs. If their medical needs are inadequately supported this may have a significant and positive impact on a child’s experiences and the way they function in or out of school or a setting. The impact may be direct in that the condition may affect cognitive or physical abilities, behaviour or emotional state. Some medicines may also affect learning leading to poor concentration or difficulties in remembering. The impact could also be indirect; perhaps disrupting access to education through unwanted effects of treatments or through the psychological effects that serious or chronic illness or disability may have on a child and their family.

 

  1. The Special Educational Needs (SEN) Code of Practice 2001 advises that a medical diagnosis or a disability does not necessarily imply SEN. It is the child’s educational needs rather than a medical diagnosis that must be considered. [4]

 

  1. At St Clares we gather information about any particular child’s medical needs before they are admitted to the school, or when they first develop a medical need. If children attend hospital appointments on a regular basis we make special arrangements to support the child if necessary. A written health care plan for such children, involving the school nurse, the parents and other relevant health professionals is essential in supporting the child. It is not possible for the school to write health care plans without this input.

 

  1. At St Clares the health care plan includes the following:

 

  • details of a child’s condition
  • special requirement e.g. dietary needs, pre-activity precautions
  • and any side effects of the medicines
  • what constitutes an emergency
  • what action to take in an emergency
  • what not to do in the event of an emergency
  • who to contact in an emergency
  • the role the staff can play

 

Administering Medicines

 

  1. No child will be given medicines without their parent’s written consent. First Aid staff giving medicines to a child should always check:
  • the child’s name
  • prescribed dose
  • expiry date
  • written instructions provided by the prescriber on the label or container[5]

 

If there is doubt about any procedure staff should not administer the medicines but check with the parents or a health professional before taking further action. If staff have any other concerns related to administering medicine to a particular child, the issue should be discussed with the parent, if appropriate, or with a health professional attached to the school or setting

 

  1. In order to demonstrate that staff have exercised a duty of care First Aid staff will complete and sign a record each time they give medicine to a child. In some circumstances where a controlled drug is being administered it is good practice to have the dosage and administration witnessed by a second adult.

 

Self-Management

 

  1. Although we recognise that it is good practice to support and encourage children, who are able, to take responsibility to manage their own medicines. We will not encourage this practise at St Clares due to the nature of special educational needs of the pupils.

 

Refusing Medicines

 

  1. If a child refuses to take medicine, staff should not force them to do so, but should note this in the records and follow agreed procedures. The procedures will be to contact parents. If this refusal to take medicines may result in an emergency parents will be contacted to come into the school.

 

Record Keeping

 

  1. Parents should tell the school about the medicines that their child needs to take and provide details of any changes to the prescription or the support required. However staff should make sure that this information is the same as that provided by the prescriber.

 

  1. Medicines should always be provided in the original container as dispensed by a pharmacist and include the prescriber’s instructions.

 

  1. In all cases it is necessary to check that written details include:

 

  • name of child
  • name of medicine
  • dose
  • method of administration
  • time/frequency of administration
  • any side effects
  • expiry date

 

  1. Parents are given a proforma to record details of medicines in a standard format. Staff should check that any details provided by parents, or in particular cases by a paediatrician or specialist nurse, are consistent with the instructions on the container.

 

  1. A proforma to confirm with the parents, that a member of staff will administer medicine to their child, will be sent home to parents.

 

 

  1. Although there is no similar legal requirement for schools to keep records of medicines given to pupils, staff who administer medicines at St Clares will do so to offer protection and to prove that they have followed agreed procedures.

 

  1. The administration of Paracetamol will only take place if parents have given written permission and after parents have been contacted to ascertain if they have already had any tablets before coming into school. A record of this will be kept in the Diary that acts as a log book for both administration of paracetamol and as a record of treatment given for minor accidents that occur during the school day.

 

Educational Visits

 

  1. We encourage children with medical needs to participate in safely managed visits. We should consider what reasonable adjustments can be made to enable children with medical needs to participate fully and safely on visits. This will include risk assessments for such children.

 

  1. Sometimes additional safety measures may need to be taken for outside visits. It may be that an additional supervisor, a parent or another volunteer might be needed to accompany a particular child. Arrangements for taking any necessary medicines will also need to be taken into consideration. Staff supervising excursions should always be aware of any medical needs, and relevant emergency procedures. A copy of any health care plans should be taken on visits in the event of the information being needed in an emergency.

 

Sporting Activities

 

  1. We believe that all children with medical conditions can participate in physical activities and extra-curricular sport. There must be sufficient flexibility for all children to follow in ways appropriate to their own abilities. Physical activity can benefit a pupil’s overall social, mental and physical health and well-being. If there are any restrictions on a child’s ability to participate in PE it will be recorded in their individual health care plan. Staff are aware of issues of privacy and dignity for children with particular medical needs.

 

  1. It may be necessary to take precautionary measures for some children before or during exercise such as access to their medicines such as asthma inhalers. Staff supervising sporting activities should be fully conversant with details about specific health conditions and they should
  • consider whether risk assessments are necessary for some children,
  • be aware of relevant medical conditions and
  • any preventative medicine that may need to be taken and emergency procedures.

 

Home to School Transport

 

  1. Local Authorities arrange home to school transport where legally required to do so. They must make sure that pupils are safe during the journey. Most pupils with medical needs do not require supervision on school transport, but Local Authorities should provide appropriate trained escorts if they consider them necessary[6]. Guidance should be sought from the child’s GP or paediatrician.

 

  1. Drivers and escorts should know what to do in the case of a medical emergency. They should not generally administer medicines but where it is agreed that a driver or escort will administer medicines (i.e. in an emergency) they must receive training and support and fully understand what procedures and protocols to follow. They should be clear about roles, responsibilities and liabilities.

 

  1. Where pupils have life threatening conditions, specific health care plans should be carried on vehicles. Schools will be well placed to advise the Local Authority and its transport contractors of particular issues for individual children. Individual transport health care plans will need input from parents and the responsible medical practitioner for the pupil concerned. The care plans should specify the steps to be taken to support the normal care of the pupil as well as the appropriate responses to emergency situations. All drivers and escorts should have basic first aid training. Additionally trained escorts may be required to support some pupils with complex medical needs. These can be healthcare professionals or escorts trained by them.

 

  1. Some pupils are at risk of severe allergic reactions (see Chapter 5). Risks can be minimised by not allowing anyone to eat on vehicles. As noted above, all escorts should have basic first aid training and should be trained in the use of an adrenaline pen for emergencies where appropriate.

 


PART TWO – DEALING WITH MEDICINES SAFELY

 

Safety Management

 

  1. As all medicines may be harmful to anyone for whom they are not appropriate we ensure that the risks to the health of others are properly controlled. This duty is set out in the Control of Substances Hazardous to Health Regulations 2002 (COSHH).

 

Storing Medicines

 

  1. Large volumes of medicines should not be stored. Staff should only store, supervise and administer medicine that has been prescribed for an individual child. Medicines should be stored strictly in accordance with product instructions (paying particular note to temperature) and in the original container in which dispensed. Staff should ensure that the supplied container is clearly labelled with the name of the child, the name and dose of the medicine and the frequency of administration. This should be easy if medicines are only accepted in the original container as dispensed by a pharmacist in accordance with the prescriber’s instructions. Where a child needs two or more prescribed medicines, each should be in a separate container.  Non-healthcare staff should never transfer medicines from their original containers.

 

  1. Children should know where their own medicines are stored and who holds the key. The head is responsible for making sure that medicines are stored safely. All emergency medicines, such as asthma inhalers and adrenaline pens, should be readily available to children and should not be locked away. At St Clares we allow children to carry their own inhalers. Other non-emergency medicines should generally be kept in a secure place not accessible to children.

 

  1. A few medicines need to be refrigerated. They are kept in a refrigerator in an airtight container and clearly labelled. There is restricted access to the refrigerator holding medicines in the First Aid room.

 

  1. If required the school will seek advice from local pharmacists about storing medicines.

 

Access to Medicines

 

  1. A named First Aider will ensure that children have immediate access to their medicines when required. All drugs are locked away in fixed medicine cabinets in the Medical room. All First Aiders have access to medicine cabinet keys that are kept in the school office.

 

Disposal of Medicines

 

  1. Staff should not dispose of medicines. Parents are responsible for ensuring that date-expired medicines are returned to a pharmacy for safe disposal. They should also collect medicines held at the end of each term. When parents do not collect medicines, these will be taken by two members of staff to a local pharmacy for safe disposal.

 

  1. Sharps boxes are always used for the disposal of needles. The boxes are locked away in the filing cabinet in the Medical room. Sharps boxes can be obtained by parents on prescription from the child’s GP or paediatrician. Collection and disposal of the boxes is arranged with another school in the LA.

 

Hygiene and Infection Control

 

  1. Staff are all familiar with normal precautions for avoiding infection and they follow basic hygiene procedures[7]. Staff have access to protective disposable gloves and they take care when dealing with spillages of blood or other body fluids and disposing of dressings or equipment.

 

Emergency Procedures

 

  1. There are arrangements in place at St Clares for dealing with emergency situations. Children know what to do in the event of an emergency, such as getting help from a member of staff. All staff know how to call the emergency services.

Guidance on calling an ambulance is next to the telephone in the school office.

All staff know that it is the Head Teacher or Deputy Head Teachers who are responsible for carrying out emergency procedures in the event of need.

 

  1. A member of staff from St Clares will always accompany a child if they are taken to hospital by ambulance, and they will stay until the parent arrives. Health professionals are responsible for any decisions on medical treatment when parents are not available. Staff will not take children to hospital in their own car; it is safer to call an ambulance. In remote areas a school might wish to make arrangements with a local health professional for emergency cover.

 

  1. Individual health care plans should include instructions as to how to manage a child in an emergency, and identify who has the responsibility in an emergency, for example if there is an incident in the playground a lunchtime supervisor would need to be very clear of their role.

 

PART THREE – ROLES AND RESPONSIBILITIES

 

INTRODUCTION

 

  1. It is important that responsibility for child safety is clearly defined and that each person involved with children with medical needs is aware of what is expected of them. Close co-operation between schools, settings, parents, health professionals and other agencies will help provide a suitably supportive environment for children with medical needs. An overview of the relevant legislation can be found in Annex A of the DfES and HA “Managing Medicines in Schools and Early Years Settings” a copy of which is in the Managing Medicines Policy file.

 

Parents and Carers

  1. Parents, as defined in section 576 of the Education Act 1996, include any person who is not a parent of a child but has parental responsibility for or care of a child. In this context, the phrase ‘care of the child’ includes any person who is involved in the full-time care of a child on a settled basis, such as a foster parent, but excludes baby sitters, child minders, nannies and school staff.

 

  1. It only requires one parent to agree to or request that medicines are administered. As a matter of practicality, it is likely that this will be the parent with whom the school or setting has day-to-day contact. Where parents disagree over medical support, the disagreement must be resolved by the Courts. The school or setting should continue to administer the medicine in line with the consent given and in accordance with the prescriber’s instructions, unless and until a Court decides otherwise.

 

  1. It is important that professionals understand who has parental responsibility for a child. The Children Act 1989 introduced the concept of parental responsibility. The Act uses the phrase “parental responsibility” to sum up the collection of rights, duties, powers, responsibilities and authority that a parent has by law in respect of a child. In the event of family breakdown, such as separation or divorce, both parents will normally retain parental responsibility for the child and the duty on both parents to continue to play a full part in the child’s upbringing will not diminish. In relation to unmarried parents, only the mother will have parental responsibility unless the father has acquired it in accordance with the Children Act 1989. Where a court makes a residence order in favour of a person who is not a parent of the child, for example a grandparent, that person will have parental responsibility for the child for the duration of the Order.

 

  1. If a child is ‘looked after’ by a local authority, the child may either be on a care order or be voluntarily accommodated. A Care Order places a child in the care of a local authority and gives the Local Authority parental responsibility for the child. The local authority will have the power to determine the extent to which this responsibility will continue to be shared with the parents. A local authority may also accommodate a child under voluntary arrangements with the child’s parents. In these circumstances the parents will retain parental responsibility acting so far as possible as partners of the local authority. Where a child is looked after by a local authority day-to-day responsibility may be with foster parents, residential care workers or guardians.

 

  1. Parents should be given the opportunity to provide the head with sufficient information about their child’s medical needs if treatment or special care needed. They should, jointly with the head, reach agreement on the school’s role in supporting their child’s medical needs, in accordance with the employer’s policy. Ideally, the head should always seek parental agreement before passing on information about their child’s health to other staff. Sharing information is important if staff and parents are to ensure the best care for a child.

 

  1. Some parents may have difficulty understanding or supporting their child’s medical condition themselves. Local health services can often provide additional assistance in these circumstances.

 

The Employer

 

  1. Under the Health and Safety at Work etc Act 1974, employers, including Local Authorities and school governing bodies, must have a health and safety policy[8]. This should incorporate managing the administration of medicines and supporting children with complex health needs, which will support schools and settings in developing their own operational policies and procedures.

 

  1. With the exception of Local Authorities, employers must take out Employers Liability Insurance[9] to provide cover for injury to staff acting within the scope of their employment. Local Authorities may choose instead to “self-insure” although in practice most take out Employers Liability Insurance.

 

  1. In the event of legal action over an allegation of negligence the employer, rather than the employee, is likely to be held responsible. Employers should therefore make sure that their insurance arrangements provide full cover in respect of actions which could be taken by staff in the course of their employment. It is the employer’s responsibility to make sure that proper procedures are in place; and that staff are aware of the procedures and fully trained. Keeping accurate records is helpful in such cases. Employers should support staff to use their best endeavours at all times, particularly in emergencies.  In general, the consequences of taking no action are likely to be more serious than those of trying to assist in an emergency.

 

  1. In most instances, the Local Authority, a school or an early years setting will directly employ staff. However, some care or health staff may be employed by a local health trust or Social Services department, or possibly through the voluntary sector. In such circumstances, appropriate shared Governance arrangements should be agreed between the relevant agencies.

 

  1. The employer is responsible for making sure that staff have appropriate training to support children with medical needs. Employers should also ensure that there are appropriate systems for sharing information about children’s medical needs in each school or setting for which they are responsible. Employers should satisfy themselves that training has given staff sufficient understanding, confidence and expertise and that arrangements are in place to up-date training on a regular basis.  A health care professional should provide written confirmation of proficiency in any medical procedure.

 

  1. NHS Primary Care Trusts (PCTs) have the discretion to make resources available for any necessary training. Employers should also consider arranging training for staff in the management of medicines and policies about administration of medicines. Complex medical assistance is likely to mean that the staff will need specialised training. This should be arranged in conjunction with local health services or other health professionals. Managing medicines training could be provided by Local Authorities, Regional Consortia, Pharmacists and other training providers.

 

The Governing Body

 

  1. Individual schools should develop policies to cover the needs of their own school. The policies should reflect those of their employer. The governing body has general responsibility for all of the school’s policies even when it is not the employer. The governing body will generally want to take account of the views of the head teacher, staff and parents in developing a policy on assisting pupils with medical needs. Where the Local Authority is the employer, the school’s governing body should follow the health and safety policies and procedures produced by the Local Authority.

 

  1. Criteria under the national standards for under 8s day care make it clear that day care providers should have a clearly understood policy on the administration of medicines. If the administration of prescription medicines requires technical or medical knowledge then individual training should be provided to staff from a qualified health professional. Training is specific to the individual child concerned. Ofsted’s guidance on this standard sets out the issues that providers need to think through in determining the policy.

 

The Head Teacher

 

  1. The Head teacher is responsible for putting the employer’s policy into practice, for developing detailed procedures and for making day to day decisions.

 

  1. The employer must ensure that staff receive proper support and training where necessary. Equally, there is a contractual duty on head teachers to ensure that their staff receive the training. As the manager of staff it is likely to be the head teacher who will agree when and how such training takes place.

 

  1. The head should make sure that all parents and all staff are aware of the policy and procedures for dealing with medical needs. The head should also make sure that the appropriate systems for information sharing are followed. The policy should make it clear that parents should keep children at home when they are acutely unwell. The policy should also cover the approach to taking medicines at school or in a setting. Head teachers and governors of schools may want to ensure that the policy and procedures are compatible and consistent with any registered day care operated either by them or an external provider on school premises.

 

  1. For a child with medical needs, the head will need to agree with the parents exactly what support can be provided. Where parents’ expectations appear unreasonable, the head should seek advice from the school nurse or doctor, the child’s GP or other medical advisers and, if appropriate, the employer. In early years settings advice is more likely to be provided by a health visitor.

 

  1. If staff follow documented procedures, they should be fully covered by their employer’s public liability insurance should a parent make a complaint. The head should ask the employer to provide written confirmation of the insurance cover for staff who provide specific medical support. Registered persons are required to carry public liability insurance for day care provision.

 

Teachers, LSAs and Other Staff

 

  1. Some staff may be naturally concerned for the health and safety of a child with a medical condition, particularly if it is potentially life threatening. Staff with children with medical needs in their class or group should be informed about the nature of the condition, and when and where the children may need extra attention. The child’s parents and health professionals should provide this information.

 

  1. All staff should be aware of the likelihood of an emergency arising and what action to take if one occurs. Back up cover should be arranged for when the member of staff responsible is absent or unavailable. At different times of the day other staff may be responsible for children, such as lunchtime supervisors.  It is important that they are also provided with training and advice.  Form 8 provides an example of confirmation that any necessary training has been completed.

 

  1. Many voluntary organisations specialising in particular medical conditions provide advice or produce packs advising staff on how to support children. Annex D lists contact details.

 

First Aid Staff Giving Medicines

 

  1. Teachers’ conditions of employment do not include giving or supervising a pupil taking medicines. Schools should ensure that they have sufficient members of support staff who are employed and appropriately trained to manage medicines as part of their duties.

 

  1. Any member of staff who agrees to accept responsibility for administering prescribed medicines to a child should have appropriate training and guidance. They should also be aware of possible side affects of the medicines and what to do if they occur. The type of training necessary will depend on the individual case.

 

The Local Authority

 

  1. In community, community special and voluntary controlled schools and community nursery schools, the Local Authority, as the employer, is responsible for all health and safety matters. For local authority day nurseries, out of school clubs (including open access schemes), holiday clubs and play schemes the registered person, which may be the authority itself, is responsible for all health and safety matters.

 

  1. The Local Authority should provide a general policy framework to guide schools in developing their own policies on supporting pupils with medical needs. Many Local Authorities find it useful to work closely with their Primary Care Trusts (PCTs) when drawing up a policy. The Local Authority may also arrange training for staff in conjunction with health professionals.

 

  1. Local Authorities have a duty under the Children Act 1989 to provide advice and training for day care providers. However providers should seek appropriate training from qualified professionals to deal with the needs of specific children.

 

Primary Care and NHS Trusts

 

  1. PCTs have a statutory duty to purchase services to meet local needs. PCTs and NHS Trusts may provide these services. PCTs, Local Authorities and school governing bodies should work in cooperation to determine need, plan and co-ordinate effective local provision within the resources available.

 

  1. PCTs must ensure that there is a medical officer with specific responsibility for children with special educational needs (SEN)[10]. Some of these children may have medical needs. PCTs and NHS Trusts, usually through the school health service, may provide advice and training for staff in providing for a child’s medical needs.

 

Health Services

 

  1. The nature and scope of local health services to schools and settings varies between Health Trusts. They can provide advice on health issues to children, parents, teachers, education welfare officers and Local Authorities. The main health contact for schools is likely to be a school nurse, whilst early years settings usually link with a health visitor. The school health service may also provide guidance on medical conditions and, in some cases, specialist support for a child with medical needs.

 

  1. Most schools will have contact with the health service through a school nurse or doctor. The school nurse or doctor should help schools draw up individual health care plans for pupils with medical needs, and may be able to supplement information already provided by parents and the child’s GP. The nurse or doctor may also be able to advise on training for school staff on administering medicines, or take responsibility for other aspects of support.

 

  1. Every child should be registered with a GP. GPs work as part of a primary health care team. Parents usually register their child with a local GP practice. A GP owes a duty of confidentiality to patients, and so any exchange of information between a GP and a school or setting should normally be with the consent of the child if appropriate or the parent. Usually consent will be given, as it is in the best interests of children for their medical needs to be understood by school staff. The GP may share this information directly or via the school health service.

 

  1. Many other health professionals may take part in the care of children with medical needs. Often a community paediatrician will be involved. These doctors are specialists in children’s health, with special expertise in childhood disability, chronic illness and its impact in the school setting. They may be directly involved in the care of the child, or provide advice to schools and settings in liaison with the other health professionals looking after the child.

 

  1. Most NHS Trusts with school health services have pharmacists. They can provide pharmaceutical advice to school health services. Some work closely with local authority education departments and give advice on the management of medicines within schools and settings. This could involve helping to prepare policies related to medicines in schools and training school staff. In particular, they can advise on the storage, handling and disposal of medicines.

 

  1. Some children with medical needs receive dedicated support from specialist nurses or community children’s nurses, for instance a children’s oncology nurse. These nurses often work as part of a NHS Trust or PCT and work closely with the primary health care team. They can provide advice on the medical needs of an individual child, particularly when a medical condition has just been diagnosed and the child is adjusting to new routines.

 

Ofsted

 

  1. During an inspection Ofsted will check that day care providers have adequate policies and procedures in place regarding the administration and storage of medicines. Regulations require that parents give their consent to medicines being given to their child and that the provider keeps written records.

 

  1. During school inspections Ofsted inspectors must evaluate and report on how well schools ensure pupils’ care, welfare, health and safety. Ofsted will look to see whether ‘administration of medicines follows clear procedures’.[11] The Commission for Social Care Inspection (CSCI) already has a regular programme of inspections for care homes and other types of residential establishment such as special residential and boarding schools. Specialist pharmacy inspectors are available for follow-up visits if the generic inspection reveals any cause for concern.

 

  1. During LEA inspections Ofsted will look at support for health and safety, welfare and child protection. Ofsted will look to see that ‘Schools are well supported in developing their health and safety policies and receive comprehensive guidance on dealing with medical needs.’[12] From September 2005, LEAs’ services will be inspected within multi-inspectorate joint area reviews of children’s services. Inspectors propose to assess that steps are taken to provide children and young people with a safe environment, including that the safe storage and use of medicines is promoted.

[2]           National Service Framework for Children and Young People and Maternity Services: Medicines for Children and Young People (Department of Health/DfES, 2004)

[3]           ‘Drugs: Guidance for Schools (DfE/0092/ 2004)

[4]           ‘SEN Code of Practice’ (DfE/0581/ 2001) paragraphs 7.64 – 7.67

[5]           It is to be noted that adrenaline pens include manufacturer’s instructions

[6]           See  Home to school travel for pupils requiring special arrangements (DfE/0261/2004)

[7]           See Guidance on infection control in schools and nurseries (Department of Health/Department for Education and Employment/Public Health Laboratory Service, 1999)

[8]           Health and Safety: Responsibilities and Powers (DfE/0803/2001) includes information on responsibilities for health and safety in schools

[9]           Insurance – A guide for schools (DfE/0256/2003)

[10]          SEN Code of Practice (DfE/0581/2001) paragraphs 10:24 – 10:26

[11]          Ofsted ‘Inspecting schools – Handbook for inspecting nursery and primary schools; Inspecting schools – Handbook for inspecting secondary schools;’ Inspecting schools – Handbook for inspecting special schools and pupil referral units (all Ofsted 2003). These include “‘Judgements about the care, welfare, health and safety of pupils.”’

[12]          Ofsted Inspection Guidance Document LEA Framework 2004 – Support for health and safety, welfare and child protection (Ofsted, 2004)