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can be used if the pupil’s own prescribed AAI(s) are not immediately available (for example, because they are broken, out-of-date, have misfired or been wrongly administered).
“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, and the child’s parent/guardian has provided written authorisation.
Not all children with food allergies and at risk of anaphylaxis are prescribed AAIs. These children can be given a 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.
Schools are not required to hold spare AAI(s) – this is a discretionary change enabling schools to do this, if they wish. This applies to all primary and secondary schools (including independent schools) in the UK. Only those institutions described in regulation 22 of the Human Medicines (No.2) Regulations 2014 may legally hold “spare” AAIs.
To support schools, the Department of Health together with key stakeholders has developed non-statutory guidance, to be read in conjunction with Supporting Pupils. Schools may wish to use this as the basis for any protocol or policy relating to food allergies and the use of AAIs to treat allergic reactions.
The change in law does not affect a school’s responsibility to be able to look after a pupil at risk of anaphylaxis. Schools already had a duty to be able to care for pupils with allergies (and provide emergency care for a child having anaphylaxis) under The Children and Families Act 2014, supported by the statutory guidance with Supporting pupils at school with medical conditions.
Liability and indemnity
Schools should have appropriate levels of insurance in place to cover staff when supporting pupils with medical conditions; this includes liability cover relating to the administration of medication such as AAIs. This is a legal requirement under Supporting Pupils. The only exception to this are acts of serious and wilful misconduct. Carelessness or a simple mistake does not amount to serious and wilful misconduct.
Local Authorities may provide schools with appropriate indemnity cover; however schools need to agree any such cover directly with the relevant authority. Academies should ensure that either the appropriate level of insurance is in place, or that the academy is a member of the Department for Education’s Risk Protection Arrangement (RPA).