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MEDICATION POLICY AND MANAGEMENT PROCEDURES

MEDICATION POLICY

AND MANAGEMENT PROCEDURES

Our school is:

a safe, supportive stimulating learning environment;

a team of respectful, tolerant, open minded citizens;

a community where everyone aspires to be the very best they can be;

a community of resilient lifelong learners;

a centre of excellence where all achieve success.

 

PURPOSE

 

This policy sets out how Arboretum Primary School will ensure that pupils are fully supported with their medical conditions.

 

 

Review Date

January 2020

Reviewed By

Clare Fryer, SENDCo, Welfare Assistant

Next Review

January 2022

Summary of changes

 

Updated in line with DDAT policy

 

Approved By:

 

Head Teacher …………………………………………….……………… Date …………………………….

 

 

Chair of Governors …………………………………………….……….. Date …………………………….
CONTENTS

 

1.      INTRODUCTION.. - 3 -

2.      MEDICATION POLICY STATEMENT. - 4 -

3.      MEDICATION MANAGEMENT PROCEDURES. - 5 -

3.1.      Roles and Responsibilities. - 5 -

3.1.1.       The Governing Body: - 5 -

3.1.2.       Head Teacher: - 5 -

3.1.3.       School Staff: - 5 -

3.1.4.       School Nurse: - 6 -

3.1.5.       Other healthcare professionals: - 6 -

3.1.6.       Pupils: - 6 -

3.1.7.       Parents/Carers: - 6 -

3.2.      Training / Qualifications for Supporting Pupils with a Medical Condition. - 7 -

3.3.      Managing Medicines on School Premises. - 8 -

3.3.1.       Liability and Idemnity. - 8 -

3.3.2.       Individual Health Care Plan (IHCP) - 8 -

3.3.3.       Administering Medication. - 9 -

3.3.4.       Self Management - 13 -

3.3.5.       Refusal to Take Medicine. - 13 -

3.3.6.       Storage and Access. - 13 -

3.3.7.       Record Keeping. - 14 -

3.3.8.       Disposal of Medicines. - 14 -

3.3.9.       Controlled Drugs (CDs) - 14 -

3.3.10.         Unacceptable Practice. - 16 -

3.3.11.         Complaints Procedure. - 16 -

3.4.      Managing Medication on an Outing/Residential Visit - 17 -

3.5.      Emergency Procedures. - 19 -

3.6.      Further Guidance / References. - 20 -

Appendices. - 21 -

Appendix 1: Model IHCP Flowchart - 22 -

Appendix 2 – Consent form: Use of Emergency Salbutamol Inhaler - 23 -

Appendix 3 – Notification to Parent / Carer of Use of Emergency Salbutamol Inhaler - 24 -

Appendix 4 – Consent form: Use of Emergency Adrenaline Auto Injector - 25 -

Appendix 5 – Consent form: Application of Creams/Ointments for Medical Reasons. - 26 -

Appendix 6 - Individual Healthcare Plan (IHCP) Template. - 28 -

Appendix 7 - Administration of Medication Permission and Record. - 31 -

Appendix 8 - Administration of Medication Continuation Sheet - 31 -

Appendix 9: Model Letter inviting parents to contribute to Individual Healthcare Plan Development - 33 -

 

  1. INTRODUCTION

 

This policy has been developed for Derby Diocesan Academy Trust (DDAT) schools to ensure pupils are fully supported with their medical conditions.  It has been developed in line with the Department for Education statutory guidance on Supporting Pupils with Medical Conditions (2014) For Governing Bodies of Maintained Schools and Proprietors of Academies in England December 2015

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/484418/supporting-pupils-at-school-with-medical-conditions.pdf

This policy has not been developed by a specific medical professional or organisation / body.

The policy it based on the DDAT model policy provided by YMD Boon and has been customised to reflect management, training, administering and medication storage procedures of Arboretum Primary School.

 

2.MEDICATION POLICY STATEMENT

                   

Section 100 of the Children and Families Act 2014 places a duty on governing bodies of maintained schools, proprietors of academies and management committees of pupil referral units (PRUs) to make arrangements for supporting pupils at their school with medical conditions. 

 

The aim of this policy is to ensure that Arboretum Primary School carries out their statutory duty to make arrangements to support pupils at school with medical conditions.

 

Arboretum Primary School will:

 

  • ensure that the arrangements detailed within this policy are implemented effectively, by the Head Teacher, who has overall responsibility for policy implementation.

 

  • administer prescribed, and non-prescribed medications, to support a pupil’s continuous attendance at school, when written consent has been provided by a parent/carer (see Appendix 7).

 

  • have clear roles and responsibilities to be able to support pupils so that they have full access to education, including school trips and physical education.

 

  • ensure full co-operation with all relevant parties; healthcare professions, local authority and clinical commissioning groups (CCGs) as required

 

  • provide support and training to enable staff to support pupils with medical conditions

 

  • ensure that clear arrangements are in place to manage the administration and storage of all medicines on the premises

 

  • ensure that the appropriate level of insurance is in place to appropriately reflect the level of risk

 

  • ensure that written records are kept of all medicines administered to pupils

 

  • ensure that emergency procedures are in place and shared with all staff

 

  • ensure that all staff are aware of what practice is not acceptable

 

  • ensure that a complaints procedure is in place regarding the support provided to a pupil with a medical condition

 

 

Signed                                                           Date  

Olivia Dean - Chair of Governors

 

3.MEDICATION MANAGEMENT PROCEDURES

 

The following sections in the Management Procedures outline how Arboretum Primary School (the Academy) will ensure that the Medication Policy Statement is implemented.

 

Further reference documentation and guidance is detailed at the end of the policy.

 

3.1:Roles and Responsibilities

 

3.1.1:The Governing Body:

  • must make arrangements to support pupils with medical conditions in school, including making sure that this policy is implemented. 
  • should ensure that pupils with medical conditions are supported to enable the fullest participation possible in all aspects of school life. 
  • should ensure that sufficient staff have received suitable training and are competent before they take on responsibility to support children with medical conditions. 
  • should ensure that any members of school staff who provide support to pupils with medical conditions are able to access information and other teaching support materials as needed.

3.1.2.Head Teacher:

  • should ensure that the school’s policy is developed and effectively implemented with all partners. This includes ensuring that all staff are aware of the policy for supporting pupils with medical conditions and understand their role in its implementation.  
  • should ensure that all relevant staff, including external providers, i.e. Before/After School and activity clubs, are aware of pupil’s conditions. 
  • should ensure that sufficient trained numbers of staff are available to implement the policy and deliver against all individual healthcare plans, including in contingency and emergency situations.   
  • should make sure that school staff are appropriately insured, and are aware that they are insured to support pupils in this way.
  • should be aware that they have overall responsibility for the development of individual healthcare plans
  • should contact the school nursing service in the case of any child who has a medical condition that may require support at school, but who has not yet been brought to the attention of the school nurse.

3.1.3.School Staff:

  • should be aware that they may be asked to provide support to pupils with medical conditions, including the administering of medicines, although they cannot be directed to do so unless it is within the staff member’s contract.
  • should take into account the needs of pupils with medical conditions that they teach, although administering medicines is not part of teachers’ professional duties.
  • should receive sufficient and suitable training and achieve the necessary level of competency before they take on responsibility to support children with medical conditions
  • should know what to do and respond accordingly when they become aware that a pupil with a medical condition needs help.

3.1.4.School Nurse:

  • should be aware of their responsibilities for notifying the school when a pupil has been identified as having a medical condition which will require support in school
  • can support staff on implementing a pupil’s individual healthcare plan and provide advice and liaison, for example, on training
  • can liaise with lead clinicians locally on appropriate support for the pupil and associated staff training needs

 

3.1.5.Other healthcare professionals:

(including GPs, paediatricians, nurse specialists/ community paediatric nurses)

  • should notify the school nurse and work jointly when a pupil has been identified as having a medical condition that will require support at school. 
  • may provide advice on developing healthcare plans
  • specialist local health teams may be able to provide support in schools for pupils with particular conditions (e.g. asthmas, diabetes, epilepsy)
  • should ensure any prescribed medications, including dosages, are appropriately monitored and reviewed.

3.1.6.Pupils:

  • should be fully involved in discussions about their medical support needs and contribute as much as possible to the development of, and comply with, their individual healthcare plan.

3.1.7.Parents/Carers:

  • should provide the school with sufficient and up to date information about their son/daughter’s medical needs
  • should be involved in the development and review of their son/daughter’s individual healthcare plan
  • should carry out any action they have agreed to as part of its implementation (e.g. provide medicines and equipment and ensure that they or another nominated adult are contactable at all times)

 

3.2.Training / Qualifications for Supporting Pupils with a Medical Condition

 

Specific support and training needs will be identified through the Individual Health Care Plans (IHCP), together with who will provide the training.  This will enable staff who support a pupil with a medical condition to understand the specific conditions, their implications, preventative and emergency procedures.

Arboretum Primary School will ensure that adequate first aid cover is available at all times.  The first aider role is key in emergency procedures – see section 3.5.  However, a first aid certificate does not constitute appropriate training in the general day to day support of a pupil with a medical condition. 

Training on administering medications/injections for specific medical conditions at the Academy will be carried out by appropriately qualified professionals, for example the KITE team at Derby Hospital.

Named staff will be responsible for administering a pupil’s medication.   When a controlled drug has been prescribed for a pupil’s medical condition, at least two members of staff should be trained on how to manage this medication.

Arrangements should be in place to cover staff absence, or staff turnover, so that someone is always available.

All training should be recorded, together with a clear plan for refresher sessions, or updates if the pupil’s condition changes.

The Academy will ensure that whole school awareness training will take place every 3 years, in conjunction with the whole school first aid training.  This should include the contents of this policy, and awareness of common conditions such as asthma allergies, epilepsy and diabetes. This training will be carried out by an appropriately qualified trainer.

It is recognised that it is not a requirement to have specific training to administer non-prescribed medications such as pain relief or antihistamines, but in line with good practice, the Welfare Assistant and members of the Office Staff are trained in Administration of Medicines.

 

Medication will be kept in the Medical Room, except for controlled drugs, which will be kept in the Office safe.  All staff who work in this area must be aware of:-

  • what medication is in the Medical Room
  • who it belongs to
  • who will administer this medication

The Administration of Medication Permission and Record (see Appendix 7) will also be kept in the Medical Room, giving details of the dose and frequency of administration to the pupils concerned.

 

 

3.3. Managing Medicines on School Premises

 

3.3.1.Liability and Idemnity

Arboretum Primary School will ensure that a level of insurance is in place that appropriately reflects the level of risk for managing medication on the premises.  The Department for Education’s guidance for “Supporting Pupils at School with Medical Conditions 2015” refers to the appropriate level of insurance being in place, or that the Academy is a member of the Department for Education’s Risk Protection Arrangements (RPA).  RPA is a scheme provided specifically for academies.

https://www.gov.uk/guidance/academies-risk-protection-arrangement-rpa

 

Currently, Arboretum Primary school is a member of the RPA.  This will cover staff providing support to pupils with medication conditions.  Insurance policies should be accessible to staff providing such support.

 

The level and ambit of insurance cover required must be ascertained directly from the insurers.  Any requirements of the insurance, such as the need for staff training, should be complied with.  Insurers should be updated when a pupil is newly diagnosed, if a pupil’s condition changes resulting in extra support needs, or if a pupil with a medical condition leaves the Academy.

 

3.3.2:Individual Health Care Plan (IHCP)

An Individual Healthcare Plan – see Appendix 6 - Individual Healthcare Plan (IHCP) Template - will be used to record the support of an individual pupil for their medical condition.  The IHCP is developed with the pupil (where appropriate), parent/carer, designed named member of school staff, specialist nurse (where appropriate) and relevant healthcare services.  Appendix 1 is a Department for Education model flowchart for an IHCP.

 

Where a child has SEN but does not have a statement of EHC plan, their special educational needs are mentioned in their IHCP.

 

The IHCP will cover the following:-

  • the medical condition, its triggers, signs, symptoms and treatments
  • the pupil’s resulting needs, including medication (dose, whether it is a controlled drug, side effects and storage) and other treatments, time, facilities, equipment, testing, access to food and drink where this is used to manage their condition, dietary requirements and any environmental issues (crowded corridors, travel time between lessons)
  • specific support for the pupil’s educational, social and emotional needs – for example how absences will be managed, requirements for extra time to complete exams, rest periods or additional support in catching up with lessons
  • the level of support needed, including emergencies.  If a pupil is self-managing their medication, this should be clearly stated with appropriate arrangements for monitoring
  • who will provide this support, their training needs, expectations of their role and confirmation of proficiency to provide support for the pupil’s medical condition from a healthcare professional; and cover arrangements for when they are unavailable
  • who in the school needs to be aware of the pupil’s condition and the support required
  • arrangements for written permission from parents and the headt eacher for medication to be administered by a member of staff, or self-administered by the pupil during school hours
  • where confidentiality issues are raised by the parent/child, the designated individuals to be entrusted with information about the pupil’s conditions
  • emergency plans, including whom to contact and contingency arrangements. 

Arboretum Primary School will keep a centralised register of IHCPs, which is the responsibility of the SENDCo. 

IHCPs will be reviewed regularly, at least every year, or whenever the pupil’s needs changes.

The parents/carers, specialist nurse (where appropriate) and relevant healthcare services should hold a copy of the IHCP.  Other school staff will be made aware of, and have access to the IHCP for the pupils directly in their care.

 

3.3.3.Administering Medication

Medication will only be administered when it would be detrimental to a pupil’s health or school attendance not to do so.

Arboretum Primary School will not give any medication (prescribed or non-prescribed) to a child under 16 without a parent’s written consent except in exceptional circumstances under direction of a medical professional. 

Arboretum Primary School only accept prescribed medicines if these are in-date, labelled, provided in the original container as dispensed by a pharmacist and include instructions for administration, dosage and storage. The exception to this is insulin, which must still be in date, but will generally be available to schools inside an insulin pen or a pump, rather than in its original container.

Arboretum Primary School only accept non-prescribed medicines if these are in-date, labelled, provided in the original container as purchased, and include instructions for administration, dosage and storage.

In all cases it is necessary to check:

•         Name of child

•         Name of medicine

•         Dosage

•         Written instructions provided by prescriber

•         Expiry date

An Administration of Medicine Permission & Record form (Appendix 7) must be completed and signed by the parent / carer.

When a member of staff administers medicine, they will check the child’s Administration of Medication Permission and Record form (Appendix 7) against the medication, to ensure that the dose and timing are correct.  They will then administer the medicine as required, and record this on the form.  For long-term medication, an Administration of Medication Continuation Sheet (Appendix 8) will be used as necessary.

 

Pain relief, anti-histamine and cough relief mixtures 

When administering pain relief, anti-histamine or cough relief medication, the member of staff will check the maximum dosage and when a previous dose was given.  Parents/carers will be informed of all doses given at school. 

The Academy will only give non-prescription medicines to pupils for a maximum of 3 days, even where parents give permission.  The only exemption to this is if pain relief is required during the healing period of an injury such as a sprained joint, or broken/fractured limb.

A child under 16 years of age should never be given medicine containing Aspirin unless prescribed by a healthcare professional. 

Some medicines need to be given at specific times, for example

  • before, with or after food – the absence/presence of food in the stomach can affect how the medicine works and may cause unwanted effects
  • some illness can only be controlled with very precise dose timings, for example, seizures may only be controlled if the medication is taken at set times

Schools must have robust communication procedures in place to ensure that any information relating to the administration of medications, whilst in their care, is shared with external providers.  For example, extra curriculum activity, including Before and After School clubs, whether led by the school or an external provider.

 

Oral Mixtures

A measuring spoon/syringe/vessel must be provided by the parent/carer, and the dose of medicine is measured using this.  Instructions on the medication label must be followed.  Wherever possible, the spoon/syringe/vessel should be handed to the pupil for them to administer the dose themselves.  Each individual pupil’s spoon/syringe/vessel should be cleaned and kept with their own medication.

 

Tablets/capsules

Pupils who need tablets usually take them before or after their meal according to their GP’s instructions.  They may however be needed at other times of the day.

Pupils should go to the Welfare Assistant or Office and ask for their tablets from the appropriate member of staff.

 

Inhalers

Inhalers will be kept in individual classrooms in a grab bag, unless there is a specific reason why this is not appropriate, which must be documented in the IHCPWhen the pupil needs to take their inhaler, e.g. before a PE lesson, or at break time/lunchtime, the teacher/admin staff should record this on a daily record.  Where a child increases the number of times they need their inhaler, staff will be alerted to this by the record, and they are able to pass this information onto the parents, so that the ‘preventer’ inhaler dose can be checked by their GP.

Pupils are trained how to access and use their inhaler, and the importance of adult supervision.  Pupils should be supervised when they take their inhaler.  If they have any difficulty, the First Aider should be called to assist.

If parents request that their child keeps their inhaler with them during the day, the pupil must be reminded by the class teacher to record when a dose has been taken.

 

Emergency Salbutamol Inhalers

Arboretum Primary School has chosen to hold an emergency inhaler for use by pupils who have been diagnosed with asthma and prescribed a reliever inhaler, OR who have been prescribed a reliever inhaler.

Written parental consent for its use will be obtained using the Consent form: Use of Emergency Salbutamol Inhaler (Appendix 2), and a copy of this is kept with the emergency inhalers to establish which pupils have this in place.  The Welfare Assistant is responsible for ensuring that this register is reviewed and kept up to date.   This information will also be included on the pupil’s IHCP.

If there is an emergency situation whereby consent has not been received, either for a pupil with diagnosed asthma, or for a pupil with no previous history or knowledge of asthma and symptoms suggest an asthma attack is occurring, the emergency services will be called. If advised to do so by the emergency services, the emergency inhaler will be used even where consent has not been received and full details of the advice given and dosage administered will be recorded.

An emergency kit is in place, kept in the Medical Room, which includes:-

  • a salbutamol metered dose inhaler
  • at least two plastic spacers
  • instructions on using the inhaler and spacer, together with cleaning/storage instructions

 

To avoid possible risk of cross-infection, the plastic spacer should not be reused.  It can be given to the pupil to take home for future personal use.  The inhaler can be cleaned and reused.

If a pupil has used the emergency inhaler, their parent/carer will be informed as soon as possible, using the Notification to Parent / Carer of Use of Emergency Salbutamol Inhaler (Appendix 3).  This will be completed by the Welfare Assistant.

 

Further information can be found in the Department of Health’s “Guidance on the user of emergency salbutamol inhalers in school – March 2015”

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/416468/emergency_inhalers_in_schools.pdf

 

Emergency Medication for Anaphylactic Shock

Pupils with a known allergy, for example, to wasp stings, food allergies and medications, should have an Individual Health Care Plan (IHCP), with an emergency action plan, completed by their healthcare professional. 

Where an adrenaline auto-injector has been prescribed, the pupil’s parent/carer should ensure that two in date adrenaline auto injectors (e.g. an Epi Pen) are kept in the school.  If appropriate, the pupil may keep an auto injector on their person – refer to the section on Self-Management.  If this is not appropriate, the auto injector should be kept safely in the pupil’s classroom.  The second auto-injector should be kept in the medicine cupboard in the Medical Room and be available for administering if the pupil goes into anaphylactic shock.  Both auto-injectors should be kept in a container clearly labelled with the child’s name, class and photograph..

If a pupil is going into anaphylactic shock, the emergency services will be called immediately – see Emergency Procedures 3.4.

If there is an emergency situation where a pupil has no previous history or knowledge of having an allergy but symptoms suggest anaphylactic shock is occurring, the emergency services will be called. If advised to do so by the emergency services, another pupil’s auto-injector will be used even where consent has not been received and full details of the advice given and dosage administered will be recorded.  The Academy should inform the emergency services that an emergency adrenaline auto-injector is in the school.

 

Emergency Adrenaline Auto-Injector

Arboretum Primary School has chosen to hold an emergency Adrenaline Auto-Injector to be administered to pupils in an emergency if the pupil’s own prescribed auto-injector cannot be administered correctly without delay. 

Written parental consent for its use has been obtained, and a record of this is kept with the emergency injector to establish which pupils have this in place.  The Welfare Assistant is responsible for ensuring that this register is reviewed and kept up to date.   This information will also be included on the pupil’s IHCP.

 

Injections

School staff will not give a pupil an injection unless staff have agreed and specific training to do so has been delivered.  This training will be delivered by a Healthcare professional.

 

Ointments/creams

Arboretum Primary School will only administer ointments/creams prescribed by healthcare professionals.  All efforts should be made for the pupil’s ointment/cream to be applied at home by parent/carers.  If it is necessary to apply a prescribed dose during school hours, this should be recorded on Appendix 7 - Administration of Medication Permission and Record.

If it is a long-term prescription (i.e. more than 4 weeks), a Healthcare Plan should be provided by the pupil’s healthcare professionals.

The pupil will be encouraged to apply the cream/ointment themselves, under supervision from a member of staff.  Where this is not possible due to competency or location area on the body then the Consent form: Application of Creams/Ointments for Medical Reasons (Appendix 5) should be completed.  A body map should be completed for the area where the cream/ointment is to be applied – See Appendix 5.

 

Eye, Nose and Ear Drops

Arboretum Primary School will only administer ear, nose or eye drops prescribed by healthcare professionals.  All efforts should be made for the pupil’s ear, nose or eye drops to be applied at home by parent/carers.  If it is necessary to apply a prescribed dose during school hours, this should be recorded on Appendix 7 - Administration of Medication Permission and Record.  The drops should be administered, following the label’s instructions by a member of staff.  Good infection prevention practice should be adhered to, i.e. using a clean environment, with handwashing facilities immediately available.

 

Defibrillator

Arboretum Primary School has a defibrillator, which is kept in the Medical Room.  Sudden cardiac arrest is when the heart stops beating and can happen to people of any age and without warning. If this does happen, quick action (in the form of early CPR and defibrillation) can help save lives. A defibrillator is a machine used to give an electric shock to restart a patient’s heart when they are in cardiac arrest. Modern defibrillators are easy to use, inexpensive and safe.  Staff members are trained in the use of CPR and defibrillators as part of their first aid training.

 

 

3.3.4.Self Management

It is good practice to support and encourage pupils, who are able, to take responsibility to manage their own medicines from a relatively early age, and Arboretum Primary School will encourage pupils to manage the use of their inhalers and adrenaline auto injectors (Epi-Pens) accordingly.  The school acknowledges that the age at which pupils are ready to take care of and be responsible for, their own medication varies.  Health professionals need to assess, with parents and pupil, the appropriate time to make this transition.

 

3.3.5.Refusal to Take Medicine

If a pupil refuses to take their medication, staff should not force them to do so.  If a prescribed condition critical medication/injection is refused, the Academy must take prompt action by informing the parent/carer and healthcare professional as soon as possible, as outlined in their IHCP.

If a pupil refuses to take a non-prescribed medication, this should be recorded in the pupil’s records.  Parent/carers should be informed of the refusal on the same day. 

If a refusal to take medication results in an emergency, the academy’s emergency procedures should be followed – see Section 3.4.

 

3.3.6.Storage and Access

All medications should be stored safely.  Pupils with medical conditions should know where they are at all times and have access to them immediately.

A refrigerator is provided in the Medical Room to provide cold storage for medications once opened, if required, as directed by prescription/written instructions from a healthcare professional.

Medications should not be stored in any first aid boxes on the premises.

Arboretum Primary School will only accept medication that is in date, labelled and in its original container including prescribing instructions for administration.

Medicine (with the exception of individual inhalers) should be stored in the Medical Room cupboard or refrigerator, with each pupil’s medicine clearly marked with the pupil’s name and the dose to be taken.

Adrenaline auto-injectors will be stored in a box clearly labelled with the child’s name and photograph for clear identification

It is essential that a pupils’ emergency medication is immediately accessible for that pupil, if participating in an extra curriculum activity, including Before and After School clubs, whether led by the school or an external provider.

Parents/carers should be asked to collect all medications/equipment at the end of the school term, and to provide new and in date medication at the start of each term.

 

3.3.7.Record Keeping

As part of the Academy’s admissions process and annual data collection exercise parents/carers are asked if their son/daughter has any medical conditions.  These procedures also cover transitional arrangements between schools.

 

General Record Keeping

The pupil’s confidentiality should be protected and the Academy should seek permission from parents/carers before sharing any medical information with any other party.

Arboretum Primary School will keep an accurate record of all medication administered, including the dose, time, date and supervising staff by using Appendix 7 - Administration of Medication Permission and Record.

 

3.3.8.Disposal of Medicines

The Welfare Assistant will check all medicines kept in school each term to ensure that they have not exceeded their expiry date.  Parents/carers will be notified of any that need to be replaced.  Parents/carers are responsible for ensuring that date-expired medicines are returned to a pharmacy for safe disposal. If parents do not collect all medicines, they should be taken to a local pharmacy for safe disposal.

Sharps boxes should always be used for the disposal of needles. There is a sharps box in the Medical Room.  If any child requires regular injections (eg. Insulin), they will have their own sharps box which can be taken offsite with them on trips etc.  The parents will be notified when the box is almost full so that they can bring in a new box and take the full box for disposal.

 

3.3.9.Controlled Drugs (CDs)

Some pupils may require routine, or emergency prescribed controlled drugs administering whilst at school.  Controlled Drugs require additional safety controls for storage, administration and disposal, under the Misuse of Drugs Regulations 2001.  Arboretum Primary School will follow these to ensure that all legal requirements and best practice are adhered to. 

A list of commonly encountered controlled drugs can be found at the following link:-

https://www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation

Guidance on how a controlled drug is classified can be found at the following link:

https://www.gov.uk/government/publications/2010-to-2015-government-policy-drug-misuse-and-dependency/2010-to-2015-government-policy-drug-misuse-and-dependency#appendix-1-classifying-and-controlling-drugs

An example of a medical condition that may require a controlled drug is ADHD, for which methylphenidate (Ritalin tm) may be prescribed. 

Midazolam Buccal, which is a medication used for controlling seizures, is a Schedule 3 controlled drug, and does not require the same controls as other Schedule 1 and 2 controlled drugs under the legislation.  However it is best practice to store and control this medication in the same way as other controlled drugs.

A controlled drug can only be admitted on the school premises if it is recorded in the pupil’s individual healthcare plan – see Appendix 6 - Individual Healthcare Plan (IHCP) Template.  When a controlled drug is prescribed, and has to be administered during school hours, it should be highlighted on the IHCP.  Extra training requirements should be highlighted and undertaken for staff administering a controlled drug.  Advice should be sought from healthcare professionals, or the School Nurse, together with consultation with the parent/carers.

The following requirements should be met, in line with the above legislation:-

  • storage:
    • the medication should be double locked, i.e. in an appropriate storage container, in a locked room.  The medication may need to be kept refrigerated once opened, and this should be made clear on the IHCP.
    • named staff only should be allowed access to the medication.  A plan for obtaining the medication for a medical emergency, or school evacuation, should be put into place.
  • administering:
    • two members of staff should be present when the drug is to be administered, to double check the dose is correct.  One person will administer the dose, and the second person will witness its administration. 
  • record keeping:
    • a separate Controlled Drug register should be kept, to record each dose that is administered, and should be signed by the two members of staff who administer the medication.  This register is to be kept for two years from the date of the last entry in the register.
    • if misuse of a controlled drug is suspected, all records should be checked by Senior Management and the Head Teacher, and reported to the Police/Local Intelligence Network (LIN).  Guidance on this should be sought from healthcare professionals.
  • destroying
    • unused controlled drugs should be destroyed of under specific controlled conditions.  This should be referred to on the IHCP, and advice taken from healthcare professionals.

 

3.3.10.Unacceptable Practice

Although school staff should use their discretion and judge each case on its merits with reference to the pupil’s individual healthcare plan, the following is generally not acceptable practice.

Arboretum Primary School will not:

  • prevent pupils from easily accessing their inhalers and medication and administering their medication when and where necessary
  • penalise pupils for their attendance record if their absences are related to their medication condition, e.g. hospital appointments.
  • require parents, or make them feel obliged, to attend school to administer medications, or provide medical support to their child. 
  • assume that every pupil with the same condition requires the same treatment
  • ignore the views of the pupil or their parents; ignore medical evidence or opinion
  • send pupils with medical conditions home frequently for reasons associated with their medical condition or prevent them from staying for normal school activities, including lunch, unless this is specified in their individual healthcare plans
  • send a pupil to the school office/medical room if they become ill unaccompanied, or with an unsuitable person
  • prevent pupils from drinking, eating or taking toilet or other breaks whenever they need to in order to manage their medical condition effectively
  • prevent pupils from participating, or create unnecessary barriers to children participating in any aspect of school life, including school trips, e.g. by requiring parents to accompany the pupil.

If a pupil misuses their medication, or anyone else’s, their parent/carer is informed as soon as possible and the Academy’s disciplinary procedures are followed.

Arboretum Primary School will ensure that all staff responsible for administering medications understand that they must strictly adhere to the prescription dosage, and the implications for not doing so.  This will be done at the time of agreeing to undertake this role.

Staff should be aware that they must not alter/amend any medications, i.e. by crushing tablets or increasing a dose if requested by the pupil.  Specific written instructions will be given by a healthcare professional if there are any changes to a dose or methods of administration.

Arboretum Primary School will make it clear to staff responsible for administering medicines of the implications for covertly taking medications and that the Academy will immediately undertake disciplinary action/police investigations as needed.

 

3.3.11.Complaints Procedure

Arboretum Primary School will ensure that any complaints concerning the support provided to pupils with medical conditions will be investigated appropriately.

Should parent/carers be dissatisfied with the support provided, they should discuss their concerns directly with the Academy.  If, for whatever reason this does not resolve the issue, they may make a formal complaint via the Academy’s complaints procedure. 

Making a formal complaint to the Department for Education should only occur if it comes within scope of section 496/497 of the Education Act 1996, and after other attempts at resolution have been exhausted.  

It will be relevant to consider whether the Academy has breached the terms of its Funding Agreement, or failed to comply with any other legal obligation placed on it.  Ultimately, parents (and pupils) will be able to take independent legal advice and bring formal proceedings if they consider they have legitimate grounds to do so.

 

3.4. Managing Medication on an Outing/Residential Visit

 

It is good practice for schools to encourage pupils with medical needs to participate in offsite visits. All staff supervising visits should be aware of any medical needs and relevant emergency procedures.  Risk assessments are completed before each school trip and outing.  Risks for pupils with known medical conditions are considered, as well as any potential risk to others.  A member of staff who is trained to administer any specific medication will accompany the pupil and ensure that the appropriate medication is taken on the visit.  Inhalers must be taken for all children who suffer from asthma.

 

Pupils who require short term medication for the duration of the trip/residential

 

Parent/carers complete medical forms at least three weeks before the visit at which point the Academy will establish, from parents/carers, the medication, circumstances in which it can be administered, the precise time the dose is given and the exact dose.

 

All medication must be provided in the original packaging as supplied from the pharmacy. 

 

Travel Sickness

 

Tablets can be given with written consent from a parent but the child’s name, dosage, time of dose and any possible side effects (the child must have had the travel sickness preventative at home before the trip in case of side effects) should be clearly marked on the container, which must be the original packaging. Parents will need to complete an Administration of Medication Permission and Record form.

 

Pain Relief

 

Pupil’s/students who require regular/prescribed pain relief that needs to be taken whilst on an outing/residential visit must bring in their own supply of the medication and parents must complete a separate medication consent form. All pupil/student medication will be held in by the Visit Leader.

 

The Academy may take a central store of medication such as Calpol/paracetamol on a residential visit. Parental consent must still have been given for administration. This will be achieved as part of the parental consent to act in loco parentis in emergency situations. Prior to administering medication that has not been directly provided by the parent/carer, the Visit Leader will always attempt to contact the parent/carer to explain why the medication is being given.

 

Pupils with an Individual Healthcare Plan in place

 

For pupils with known medical conditions, staff will make contact with the parent/carer in advance of the trip.  This will ensure that they are fully briefed to ensure that there are adequate quantities of medication available, that the pupil’s condition is stable, and which emergency details are required should the pupil need to have additional support.  This is documented for the Group Leader.

 

For Early Years/Foundation Stage pupils, where it is assessed that the pupil cannot self-manage their inhaler, Group Leaders will ensure that staff keep the inhalers for pupils allocated to them.   All doses administered need to be recorded.

 

Controlled drugs

 

The Academy will make every effort to accommodate pupils with a medical condition who require controlled drugs to be administered when in the school’s care, but off the school premises.    For a residential visit, consultation with the venue will need to take place, to ensure safe storage facilities will be in place.

 

3.5.Emergency Procedures

 

The flowchart follows Template F of the Department for Education statutory guidance. 

 

Staff should not take pupils to hospital in their own vehicle.

 

Where an Ambulance needs to be called in school, there are several roles which need to be fulfilled.  The responsibility for these roles is fluid, to cover staff absence/cover.  All staff should be aware of the procedures. (Please refer to the pdf for further details)

 

3.6.Further Guidance / References

 

GUIDANCE

Department for Education – “Supporting Pupils at School with Medical Conditions - December 2015”

Royal Pharmaceutical Society of Great Britain (RPSGB) - The Handling of Medicines in Social Care 

Department of Health - “Guidance on the use of emergency salbutamol inhalers in school – March 2015”

https://www.gov.uk/government/publications/2010-to-2015-government-policy-drug-misuse-and-dependency/2010-to-2015-government-policy-drug-misuse-and-dependency#appendix-1-classifying-and-controlling-drugs

https://www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/645476/Adrenaline_auto_injectors_in_schools.pdf

 

LEGISLATION:

Section 2 of the Health and Safety at Work Act 1974 and the associated regulations, provides that it is the duty of the employer (the governing body and academy trust) to take reasonable steps to ensure that staff and pupils are not exposed to risks to their health and safety.

Misuse of Drugs Regulations 2001 and associated regulations the supply, administration, possession and storage of certain drugs are controlled.  Schools may have a pupil who has been prescribed a controlled drug.

The Medicines Act 1968 specifies the way that medicines are prescribed, supplied and administered within the UK and places restrictions on dealings with medicinal products, including their administration.

Regulation 5 of the School Premises (England) Regulations 2012 (as amended) provides that maintained schools must have accommodation appropriate and readily available for use for medical examination and treatment and for the caring of sick or injured pupils.  It must contain a washing facility and be reasonably near to a toilet.  It must not be teaching accommodation.  Paragraph 24 of the Schedule to the Education (Independent School Standards) Regulations 2014 replicates this provision for independent schools (including academy schools and alternative provision academies).

Section 100 of the Children and Families Act 2014 places a duty on governing bodies of maintained schools, proprietors of academies and management committees of pupil referral units (PRUs) to make arrangements for supporting pupils at their school with medical conditions.

Appendices

 

Appendix 1:  Model IHCP flowchart

 

Appendix 2:  Consent form from parent/carer for use of emergency inhaler

 

Appendix 3:  Form to inform parent/carer of use of emergency inhaler

 

Appendix 4:  Consent form from parent/carer for use of emergency adrenaline auto-injector

 

Appendix 5:  Consent form for application of creams / ointments

 

Appendix 6: Template for Individual Healthcare Plan (IHCP)

 

Appendix 7:  Administration of Medication Permission and Record

 

Appendix 8:  Administration of Medication Continuation Sheet

 

Appendix 9: Model Letter inviting parents to contribute to Individual Healthcare Plan Development

 

Appendix 1: Model IHCP Flowchart​​​​​​​(Please refer to the pdf)

Appendix 2 – Consent form: Use of Emergency Salbutamol Inhaler

CONSENT FORM:

USE OF EMERGENCY SALBUTAMOL INHALER

 

 

Child showing symptoms of asthma / having asthma attack

 

1.   I can confirm that my child has been diagnosed with asthma / has been prescribed an inhaler

      [delete as appropriate].

 

2.   My child has a working, in-date inhaler, clearly labelled with their name, which they keep in school.

 

3.   In the event of my child displaying symptoms of asthma, and if their inhaler is not available or is unusable,

      I  consent for my child to receive salbutamol from emergency inhaler held by the school for such

      emergencies.

 

 

Signed:…………………………………….     .     .                                                                           Date:………………………………………………

 

 

Name (print):………………………………………………………………………………………………………….

 

 

Child’s name:………………………………………………………………………………………………………….

 

Class:………………………………………………………………………………………………………………….

 

 

Parent’s address and contact details:

 

…………………………………………………………………………………………………………………………

 

…………………………………………………………………………………………………………………………

 

…………………………………………………………………………………………………………………………

 

Telephone:……………………………………………………………………………………………………………

 

E-mail:…………………………………………………………………………………………………………………

 

 

Appendix 3 – Notification to Parent / Carer of Use of Emergency Salbutamol Inhaler 

 

 

Notification of Use of Emergency Salbutamol Inhaler

 

 

Name of pupil: ………………………………………Date of Birth:………………………………

 

Class:.………………………………………………………………………………………………

 

 

Dear Parent / Carer,

 

This letter is to formally notify you that your child has had problems with their breathing today.

Details …………………………………………………..……………………………………………….

 

……………………………………………………………………………………………………………

 

They did not have their own asthma inhaler with them / Their own asthma inhaler was not working

[Delete as appropriate]

 

A member of staff helped them to use the emergency asthma inhaler containing salbutamol.

 

They were given ……… puffs.

 

 

We would strongly advise that you have your seen by your own doctor as soon as possible and arrange for a new salbutamol inhaler to be provided and kept in school.

 

 

 

Name ………………………………………………………………………………………………

 

Signed …………………………………………………………  Date ……………………………

 

Appendix 4 – Consent form: Use of Emergency Adrenaline Auto Injector

 

 

Consent form: Use of Emergency Adrenaline Auto Injector

 

This form is to give consent for use of the school’s emergency adrenaline auto injector for pupils who have been diagnosed with severe allergies and have a prescribed personal adrenaline auto injector.

 

Name of pupil: ………………………………………Date of Birth:………………………………

 

Class:.………………………………………………………………………………………………

 

 

  1. I can confirm that my child has been diagnosed with a food / wasp/bee sting / latex allergy / other allergy   [delete as appropriate]

For food or other allergy, please give details ………………………………………………..

 

  1. My child has been prescribed an adrenaline auto injector.         

 

  1. I will provide the school with two in-date adrenaline auto injectors, clearly labelled with their name, which will be kept at school.

 

  1. In the event of my child displaying symptoms of anaphylaxis shock, and if their own adrenaline auto injector is not available or is unusable, I consent for my child to receive an injection from an emergency adrenaline auto injector held by the school for such emergencies.

 

 

Parent/carer signature………………………………………………… Date: ……………………

 

Parent/carer name ….………………………………………………………………………………

 

 

 

Appendix 5 – Consent form: Application of Creams/Ointments for Medical Reasons

 

 

Consent form: Application of Creams/Ointments for Medical Reasons

 

For use for pupils who require assistance with the application of creams/ointments for medical reasons

(The body map must be completed by the parent/carer before any cream or ointment is applied at school)

Name of pupil:………………………………………Date of Birth:  ……………………………..

Class: ………………………………………………………………………………………………..

Name of medication: ……………………………………………………………………………….

Reason for, and frequency of application:

……………………………………………………………………………………………………………….....

Name(s) of staff to apply prescribed cream/ointment:………………………………………….

………………………………………………………………………………………………………..

Indicate below the affected areas where cream/ointment may require applying.

 

 

 

Parent/carer signature …………………………………………………….. Date ………………..

Parent/carer name …………………………………………………………………………………..

Record of application

 

Pupil Name: ………………………………………………… Class ………………………

 

Medication: ………………………………………………………………………………….

 

Date

Time

Affected areas applied

Staff name and signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix 6 - Individual Healthcare Plan (IHCP) Template

 

If no healthcare professional input has been received, choose one of the following statements:  Delete one or both as appropriate

 

Mild ill health (seasonal/childhood asthma or allergies of a mild nature)

The ill health condition of the pupil does not require direct input from a healthcare professional.  Parents/carers are confident that they are able to provide sufficient information to enable the pupil to be safety supported at school.

​​​​​​​

More serious medical conditions

(insert pupil name) healthcare professional (insert name) has been requested to provide information/assist in the development of the Individual Healthcare Plan

The healthcare professional (insert name) has declined to provide information/assist (attach response or date/time if a phone call).

The information and management controls within this plan have been developed from the information provided by parents/carers only, to the best of their ability without the requested healthcare professional assistance.

 

Name of Academy/setting

 

Child’s name

 

Group/class/form

 

Date of birth

 

 

 

 

Child’s address

 

Medical diagnosis or condition

 

Date

 

 

 

 

Review date

 

 

 

 

 

Family Contact Information

 

Name

 

Phone no. (work)

 

(home)

 

(mobile)

 

Name

 

Relationship to child

 

Phone no. (work)

 

(home)

 

(mobile)

 

 

 

 

Clinic/Hospital Contact

 

Name

 

Phone no.

 

 

G.P.

 

Name

 

Phone no.

 

 

 

Who is responsible for providing support in Academy

 

 

 

Describe medical needs and give details of child’s symptoms, triggers, signs, treatments, facilities, equipment or devices, environmental issues etc.

 

 

 

 

Name of medication – dose, method of administration, when to be taken, side effects, contra-indications, administered by/self-administered with/without supervision. 

If this is a controlled drug – detail the arrangements required for storage, administering and disposal

 

 

 

Daily care requirements

 

 

 

 

 

 

Specific support for the pupil’s educational, social and emotional needs

 

 

 

 

Arrangements for Academy visits/trips etc

 

 

 

 

 

 

Other information

 

 

 

 

 

Describe what constitutes an emergency, and the action to take if this occurs

 

 

 

 

 

Who is responsible in an emergency (state if different for off-site activities)

 

 

 

 

 

 

Plan developed with

 

 

 

 

 

 

Staff training needed/undertaken – who, what, when

 

 

 

 

 

Form copied to

 

 

 

 

 

 

 

Appendix 7 - Administration of Medication Permission and Record

 

 

Appendix 8 - Administration of Medication Continuation Sheet

 

Appendix 9: Model Letter inviting parents to contribute to Individual Healthcare Plan Development

 

Dear Parent

DEVELOPING AN INDIVIDUAL HEALTHCARE PLAN FOR YOUR CHILD

Thank you for informing us of your child’s medical condition. I enclose a copy of the Academy’s policy for supporting pupils at Academy with medical conditions for your information.

A central requirement of the policy is for an individual healthcare plan to be prepared, setting out what support each pupil needs and how this will be provided. Individual healthcare plans are developed in partnership between the Academy, parents, pupils, and the relevant healthcare professional who can advise on your child’s case.  The aim is to ensure that we know how to support your child effectively and to provide clarity about what needs to be done, when and by whom.  Although individual healthcare plans are likely to be helpful in the majority of cases, it is possible that not all children will require one.  We will need to make judgements about how your child’s medical condition impacts on their ability to participate fully in Academy life, and the level of detail within plans will depend on the complexity of their condition and the degree of support needed.

A meeting to start the process of developing your child’s individual health care plan has been scheduled for xx/xx/xx.  I hope that this is convenient for you and would be grateful if you could confirm whether you are able to attend.  The meeting will involve [the following people]. Please let us know if you would like us to invite another medical practitioner, healthcare professional or specialist and provide any other evidence you would like us to consider at the meeting as soon as possible.

If you are unable to attend, it would be helpful if you could complete the attached individual healthcare plan template and return it, together with any relevant evidence, for consideration at the meeting.  I [or another member of staff involved in plan development or pupil support] would be happy for you contact me [them] by email or to speak by phone if this would be helpful.

 

Yours sincerely

 

 

 

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