Legislation and school policies
Schools have a legal duty to make arrangements for pupils with medical conditions (including those with food allergies) under the Children and Families Act 2014. This requirement is supported by the statutory guidance Supporting pupils at school with medical conditions. All pupils with medical conditions – including food allergies – should have an Individual Healthcare Plan agreed between the parents and the school. This is particularly important where an adrenaline auto-injector (AAI) has been prescribed for use in emergencies.
Teachers and other non-healthcare professionals are permitted – but not obligated – to administer an AAI under existing legislation, but only to the person the AAI device has been prescribed. They cannot use an AAI prescribed to child ‘A’ to treat anaphylaxis occurring in child ‘B’.
In 2017, the law was changed: the Human Medicines (Amendment) Regulations 2017 now allows schools to obtain, without a prescription, “spare” AAI devices for use in emergencies, if they so wish. “Spare” AAIs are in addition to any AAI devices a pupil might be prescribed and bring to school. The “spare” AAI(s) can be used if the pupil’s own prescribed AAI(s) are not immediately available (for example, because they are broken, out-of-date, have misfired or been wrongly administered). To support schools, the Department of Health together with key stakeholders has developed non-statutory guidance.
“Spare” AAI devices can be used in any pupil known to be at risk of anaphylaxis, so long as the school have medical approval for the “spare” AAI to be used in a specific pupil (e.g. from a GP or Paediatrician), and the child’s parent/guardian has provided written authorisation. Unless medical authorisation and parent/guardian consent have been provided, schools cannot administer the “spare” AAI to a pupil having anaphylaxis.
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. All children with a diagnosis of food allergy and at risk of anaphylaxis should have a written Allergy Management Plan. The BSACI plans can be used as the pupil’s individualised healthcare plan to meet the school’s duty under Supporting Pupils, where the pupil has no other healthcare needs. Most Children’s Allergy Clinics in the UK will now issue the BSACI plans to their patients.
Schools don’t have to use the BSACI plans, but then they need to have an alternative in place which includes information on:
- Known allergens and risk factors for anaphylaxis in the pupil.
- Whether the pupil has been prescribed AAI(s) (and if so what type and dose).
- Where a pupil has been prescribed an AAI: if parental consent has been given for use of the spare AAI.
- A photograph of the pupil to allow a visual check to be made (this will require parental consent).
Schools are not required to hold spare AAI(s) – this is a discretionary change enabling schools to do this, if they wish. Unfortunately, “spare” AAI(s) are not provided free of charge – schools must pay for them as a retail item. This applies even in those devolved nations where no prescription charge is currently levied.
The Royal Pharmaceutical Society has produced a quick reference guide for Pharmacists receiving requests from schools to supply AAIs.