www.wiltshire.gov.uk
Medication for Pupils
General Principles
- The County Council is committed to pursuing a policy of inclusive education. In other words, no child should be unnecessarily excluded from school or other educational activities simply by virtue of having a medical condition.
- Risk assessments, individual health care plans and school nursing health care plans compiled by trained and competent persons, in conjunction with parents/carers, should determine the procedures which schools will need to adopt to comply with the LEA’s policy of inclusive education. These assessments and plans should also identify any exceptions to normal participation in school activities.
- Teachers and support staff have a responsibility to act as any reasonably prudent parent would to maintain the health and safety of the pupils under their control, whether this is at school or during any other school event or activity. In exceptional circumstances, this might extend to administering medicine or taking other medical action in an emergency.
- Subject to point 3 above, it is entirely the decision of the school management whether to allow a member of staff to administer medication to pupils which has been prescribed by a GP. If a school chooses not to take on this responsibility then parents must be informed. Any school that chooses to accept the responsibility must carry out the duty with reasonable care and follow the advice contained in this section.
- Subject to point 3 above, it is the entirely the decision of each individual employee, within any school that chooses to accept the responsibility for the administration of prescribed medication, as to whether he/she is prepared to personally administer medication. No sanction must be taken against any employee who declines to undertake this task.
- No medication must be given to any pupil or child without the specific written consent of the parent/carer concerned. Even then consideration should be given to the need for the medicine to be taken during school hours - most courses of medication can be taken satisfactorily before and after school and at night. Some older children may also be deemed capable of administering their own medication.
- Non-prescribed medicines containing analgesics (including mild painkillers such as aspirin, paracetamol in tablet form or in cough mixtures) should not be given even with the consent of parents/carers.
- The concern of employees administering medication in respect of personal liability is unfounded. The LEA takes vicarious liability for the actions of its staff provided those actions are taken in good faith and in accordance with LEA policy and practices.
- In the event of the administration of medication proving to be an impediment to the LEA’s policy of inclusive education beyond the local management of the school then the matter should be immediately referred to the Assistant Director for Resources and Improvement at County Hall.
Children Taking a Course of Prescribed Medication
- Very few medicines need to be taken during normal school hours and in most cases the appropriate dosage of medicine when prescribed to be taken “three times a day” can be given “before school, after school and at night”. The same principle can also be applied to medication such as creams/drops for conjunctivitis etc. However, the school should not assume that this will always be the case as some prescribed medication will have times or conditions stipulated by the doctor.
- Where pupils are recovering from a short term illness which requires medication (such as tablets, creams, eye drops, mixtures), any request for school staff to administer medicine by a parent/carer must be in writing and include evidence that the child needs to take medicine during school hours, e.g. instructions on the container or advice from the pharmacist. Standard forms have been drawn up to assist in this process. Copies of these can be found in the Schools Health and Safety Manual or by contacting the Health and Safety Liaison Officer at County Hall. They are Form 1 (Parental Consent form) and Form 1A (Medical Practitioner’s form). If parents are unwilling or unable to provide written consent using Form 1 or schools have some reason to doubt the information provided on Form 1, seek confirmation directly from the medical practitioner using Form 1A.
- The medicine, together with the completed and signed consent form, should be delivered to school, where possible by a parent, and should be handed personally to the headteacher or a designated member of staff. The school policy should make it clear that in no circumstances should staff administer prescribed medication on their own initiative or without the written consent of parents/carers.
- A written record should be kept of the administration of all prescribed medication to pupils, using Form 2. Such a record should be kept together with the instructions, and be checked on every occasion and completed by the designated member of staff. The record should give the date and time of administration, the name of the medicine, the dose given, the name of the child and the name of the staff member administering the medication. Form 2 should be retained on the school premises with the school’s and child’s records respectively.
- Medicines must be stored safely in the pharmacist’s original container and be clearly labelled with the contents, the child’s name, and the dosage and/or other instructions. The receiving member of staff should check the accuracy of the name and date. Some medication such as liquid antibiotics or insulin may need to be kept in a refrigerator but must not be frozen. These medicines must be placed in a suitable additional sealed container, e.g. tupperware box and clearly marked “medicines”. Under no circumstances should medicines be kept in first aid boxes.
- Any medication which has passed its expiry date should be collected from school by parents within 5 days of the expiry date or it should be disposed of safely (e.g. by returning it to the local pharmacist). Medicines should not be disposed of in the sink or toilet.
Special Circumstances
- Some pupils/children have unusual or special specific medical needs which may require treatment in an emergency. Examples would be extreme allergic reaction (anaphylactic shock) to wasp stings or food such as peanuts; epileptic seizure, which may involve invasive medical procedures such as giving an injection or inserting rectal diazepam. Other instances where children require special personal care involving intimate or invasive treatment include assistance with catheters, or the use of equipment for children with tracheotomies.
- The number of such cases will be very small and early identification and careful planning by the relevant Health Service should result in detailed discussion with a receiving school and the formulation of a carefully designed individual health care plan (see Form 3 at the end of this Section) or school nursing health care plan, to meet the needs and circumstances of a particular child.
- Schools should be prepared for such eventualities and Headteachers should therefore seek staff who are willing to undertake the necessary training to enable them to act in emergencies or administer treatment in potentially life threatening situations where there is no alternative. In many cases, the treatment will involve a simple procedure, such as using an “Epi-pen” to administer emergency intramuscular medication, or inserting a suppository.
- For the protection of both staff and children, a second member of staff should be present while the more intimate procedures are being followed, and appropriate personal protection must be worn. Staff should protect the dignity of the child as far as possible, even in emergencies.
- For those children who require treatment including invasive medical procedure, only those who are both willing and appropriately trained should administer such treatment. Training in invasive procedures should be conducted by qualified medical personnel. The school nurse may be able to provide this training.
- Subject to parents/carers consent all staff should be made aware of the pupil’s condition and where to locate the trained staff in the case of an emergency. There should be sufficient trained staff to cover for any absences. All staff should be made aware of the importance of respecting the confidentiality of medical information.
- It may be appropriate for pupils to keep items such as an Epi-pen with them in the school. Where this is not appropriate, sufficient care should be taken to handle and store medicines and medical aids for use in emergencies at the school. Items such as syringes, Epi-pens and suppositories, must be placed in a suitable additional sealed container eg tupperware box, and clearly marked Emergency Medication” and with the pupil’s name. Under no circumstances should medicines be kept in first aid boxes. It is essential, that wherever items are stored, the trained member of staff has immediate access to it.
Risk Assessment
For a number of pupils with medical needs it may be appropriate for risk assessments to be conducted on certain activities, e.g., physical activities, external visits, residential visits. The risk assessment would consider such issues as the pupil’s medical needs, medication requirements,
physical abilities, emergency treatment etc.
Sources of Advice or Expertise
Within the Council’s organisation, advice on policy in respect of the administration of medicines in schools should be sought, in the first instance, from those listed at the end of this section.
If you require general advice about the administration of a particular medicine within the school the headteacher should seek advice via the school nurse or designated medical officer or the Consultant Community Paediatrician.
The School Nursing Service has developed comprehensive strategies for working with schools to ensure that appropriate training and support is offered to staff where a pupil has special health needs.
The service has developed separate training and information packs for such medical needs as rectal diazepam, epilepsy and severe allergy as well as medication such as ritalin and epi-pens.
The service has developed separate training and information packs for such medical needs as rectal diazepam, epilepsy and severe allergy as well as medication such as ritalin and epi-pens. The service has also developed procedures which bring together the parents, school and, where appropriate, GPs/Consultants in the development of the Individual Health Care Plan.
The documentation for the Individual Health Care Plans will initially be held by the School
Nursing Service, but once an IHCP has been agreed for a pupil, a copy will be held by the
school and all relevant staff must be aware of its content.
In the event of queries arising in relation to staff responsibilities, remuneration for undertaking training or difficulties in obtaining volunteers to undertake training to enable a child to attend school, headteachers should seek advice from the Asst Director (Resources and Improvement Branch) or Education HR.
LEA Contacts
LEA Policy Adviser: 01225 713851 or 01380 733808
Assistant Director (Resources & Improvement Branch): 01225 713754
LEA Health & Safety Liaison Officer at County Hall: 01225 713268
Education HR Manager at County Hall: 01225 713896
School Nursing Service
Salisbury Area: 01722 425154
Kennet, West Wiltshire and North Wiltshire Areas: 01249 812821
