A number of different brands of AAIs are available in different doses, depending on the manufacturer.

Advice as to which brand to purchase, and which dose, can be found here. Schools may wish to purchase the brand most commonly prescribed to its pupils.

No. Schools should decide themselves whether they would like to purchase “spare” AAI(s) for emergency use.

AAIs are prescription-only medicines, which means that you cannot use one person’s AAI in another person unless you are a medical professional, nor were schools allowed to keep “spare” AAI(s) for emergencies.

Following a recommendation from the Commission on Human Medicines and a UK-wide public consultation, the Human Medicines Regulations 2012 was changed on 5 July 2017 to allow schools to hold spare AAIs, without a prescription, for use in emergencies. These regulations came into effect on 1 October 2017.

The change in the law does not affect a school’s responsibility with regards to a pupil at risk of anaphylaxis. Schools already had a duty to be able to care for an allergic child (and, if a child is having anaphylaxis, provide emergency management) under The Children and Families Act 2014, supported by the statutory guidance with Supporting pupils at school with medical conditions.

The Medicines & Healthcare products Regulatory Agency (MHRA) recommends that those prescribed AAIs should have TWO devices available, at all times.

Ideally, pupils – particularly those in secondary schools – should be encouraged to be independent and keep their own prescribed AAIs with them at all times. This can also be done with most primary school-aged children, although for the youngest children, AAIs should either be kept in the cIassroom or in a safe and suitably central and accessible location nearby. AAIs should not be located more than 5 minutes away from where they may be needed.

Schools will often request AAIs are kept on site during term time, as pupils/families can forget to bring their own AAI(s) into school. However, children at risk of anaphylaxis should always have access to AAI(s), so you’ll need to ensure AAI(s) are available on the journey to/from school.

Healthcare professionals may need to prescribe more than 2 AAIs to school-aged children: one or two AAIs to be kept near/with the pupil at all times, and a further AAI held centrally on the school premises where this is requested by the school.

Government guidance advises that adrenaline auto-injectors must:

  • Be accessible at all times, in a safe and suitably central location e.g. school office or staffroom
  • NOT be locked away in a cupboard or kept in an office where access is restricted.

AAIs should not be located more than 5 minutes away from where they may be needed. So larger schools may need to have an Emergency Anaphylaxis kit near the central dining area, and another near the playground.

In general, children – particularly in secondary schools – should keep their own AAI(s) on their person, and may be asked to bring the AAI(s) with them during sport activities etc. These issues should be covered by the school’s policy relating to the management of medicines.

Schools should conduct a risk-assessment for any pupil at risk of anaphylaxis taking part in a school trip off school premises, in much the same way as is required with regards to safeguarding etc. Pupils at risk of anaphylaxis should have their AAI(s) with them, and staff trained to help administer AAIs in an emergency should be available. Under some circumstances, it may be appropriate for any “spare” AAI(s) obtained for emergency use to be taken on some trips.

The school has to ensure that catering and other staff have sufficient training in food allergen management. However, parents are responsible for giving the school staff and caterers sufficient information about their child’s allergy, so the school can help keep the child safe.

Under legislation, the school has a duty of care to safeguard children with special medical needs, including those with food allergies. Any food-allergic child should have an individualised healthcare plan agreed between the parent/guardian and school, which might include measures for managing specific classroom scenarios.

Schools are obligated to safeguard children, so any special measures need to be appropriate and proportionate, otherwise the school might seek to exclude children from certain activities in order to keep that child safe.

Children with food allergies are not always prescribed an AAI, but may still be at risk of anaphylaxis. These children can be given the spare AAI in an emergency, so long as:

  • the school has a care plan confirming that the child is at risk of anaphylaxis
  • a healthcare professional has authorised use of a spare AAI in an emergency in that child
  • the child’s parent/guardian has provided consent for a spare AAI to be administered.

The British Society for Allergy and Clinical Immunology (BSACI) has produced a range of Allergy Plans which can be used for this purpose, and can be downloaded here.

Talk to the school staff early if you think this may be happening. Help empower your child to talk about their allergy and ask questions if they are unsure. Many schools encourage food-allergic pupils to help raise awareness of food allergies and educate the entire school about allergies – this has been shown to promote a safe environment for your child and others with allergies.

“Spare” AAIs can be obtained, without prescription, from a pharmacy in small quantities on an occasional, and not-for-profit basis. The school will need to give the pharmacy a written request signed by the principal or head teacher stating:

  • the name of the school for which the product is required;
  • the purpose for which that product is required, and
  • the total quantity required.

A template letter which can be used for this purpose can be accessed here. A healthcare professional does not need to sign this letter.

Pharmacies are not required to provide AAIs free of charge, the school must pay for them as a retail item. Unfortunately, there are no funds held centrally or by local authorities to cover the cost.

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