Medication in Schools

Who Is Responsible?

Introduction

1. It is important that responsibility for pupils’ safety is clearly defined and that each person involved with pupils with medical needs is aware of what is expected of them.  Close co-operation between schools, parents, health professionals and other agencies will help provide a suitably supportive environment for pupils with medical needs.

Parents and Guardians

2. Parents, as defined in the Education (Scotland) Act, 1980 are a child’s main carers.  They are responsible for making sure that their child is well enough to attend school.

3. Parents should provide the Head Teacher with sufficient information about their child’s medical condition and treatment or special care needed at school.  They should, jointly with the Head Teacher, reach agreement on the school’s role in helping with their child’s medical needs.  Parents’ cultural and religious views should be respected.  Ideally, the Head Teacher should seek parents’ agreement before passing on information about their child’s health to other school staff.  Sharing information is important if staff and parents are to ensure the best care for a pupil.

4. Some parents may have difficulty understanding or supporting their child’s medical condition themselves.  The School Health Service can often provide additional assistance in these circumstances.

The UN Convention on the rights of the child

BASIC PRINCIPLES:

Best interests

Article 3.1 “In all actions concerning children, whether taken by public or private social welfare institutions, courts of law, administrative authorities or legislative bodies, the best interests of the child shall be a primary consideration”

The Child’s opinion

Article 2.1 “parties shall assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child, the views of the child being given due weight in accordance with the age and maturity of the child”

The Employer

5. The Moray Council, as Education Authority, is responsible, under the Health and Safety at Work etc Act 1974, for making sure that a school has a health and safety policy.  This should include procedures for supporting pupils with medical needs, including managing medication.

6. In the event of legal action over an allegation of negligence, the employer rather than the employee is likely to be held responsible.  It is the employer’s responsibility to make sure that correct procedures are followed.  Keeping accurate records in the school is therefore vital.  Teachers and other staff are expected to use their best endeavours at all times, particularly in emergencies.  In general, the consequences of taking no action are likely to be more serious than those of trying to assist in an emergency.

7. The employer is also responsible for making sure that willing staff have appropriate training to support pupils with medical needs.  This should be arranged in conjunction with the Grampian Universities Hospital Trust and/or Grampian Health Board, or other health professionals.  The Health Authorities have the discretion to make resources available for any necessary training.  In many instances they will be able to provide the training themselves.  The employer must be satisfied that any training has given staff sufficient understanding, confidence and expertise.  A  health care professional will confirm proficiency in medical procedures in certain defined areas. ( Form Med 3 )

The Head Teacher

8. The Head Teacher is responsible for implementing the Authority’s policy in practice and for developing detailed procedures.  When teachers/auxiliaries volunteer to give pupils help with their medical needs the Head Teacher should agree to their doing this, and must ensure that teachers receive proper support and training where necessary.  Day to day decisions about administering medication will normally fall to the Head Teacher.

9. The Head Teacher should make sure that all parents are aware of the school’s policy and procedures for dealing with medical needs.  The school’s policy should make it clear that parents should keep children at home when they are acutely unwell.  The policy should also cover the school’s approach to taking medication at school.

10. The local Consultant in Communicable Disease Control (CCDC) can advise on the circumstances in which pupils with infectious diseases should not be in school, and the action to be taken following an outbreak of an infectious disease.

11. For a child with medical needs, the Head Teacher will need to agree with the parents exactly what support the school can provide.  Where there is concern about whether the school can meet a pupil’s needs, or where the parents’ expectations appear unreasonable, the Head Teacher can seek advice from the school nurse or doctor, the child’s GP or other medical advisers and if appropriate, the Inclusion Development Manager (ASN) or the Head of Integrated Children’s Services.  Complex medical assistance is likely to mean that the staff who volunteer will need special training.

12. Where no voluntary provision for the administration of medicines is available, the Head Teacher, or in his/her absence, the delegated person, shall organise measures in conjunction with appropriate Health Board personnel.  Procedures for ensuring the administration of medicines must be in place at all times to ensure a safe and supportive environment for pupils with medical needs.

13. If staff follow the school’s documented procedures, they will be fully covered by The Moray Council’s public liability insurance (i.e. Zurich Municipal) should a parent make a complaint.  The Head Teacher should provide proof/confirmation of training of staff to the Education and Social Care department of The Moray Council who will seek confirmation of the insurance cover for those members of staff who provide specific medical support.  (Refer Introduction)

14. If for any reason agreed arrangements cannot be maintained (e.g. on account of staff absence etc) then alternative emergency protocols will operate (see 12 above).

Teachers and Other School Staff

15. Some staff are naturally wary about their ability to support a pupil with a medical condition, particularly if it is potentially life threatening.  Teachers who have pupils with medical needs in their class should understand the nature of the condition, and when and where the pupil may need extra attention.  The pupil’s parents and health professionals should provide this information.  Staff should be aware of the likelihood of an emergency arising and what action to take if one occurs.  Back up cover should be arranged for when the member of staff responsible is absent or unavailable.  At different times of the school day other staff may be responsible for pupils (e.g. auxiliary staff).  It is important that they are also provided with training and advice.   Form Med 3 provides an example of confirmation that any necessary training has been completed.  Contact Inclusion Development Manager (ASN), Moray Council Headquarters for further information if required.

16. Many voluntary organisations specialising in particular medical conditions provide advice or produce school packs advising teachers on how to support pupils.   Appendix F lists contact names and address.  Schools are encouraged to build up a current bank of appropriate resource materials.

School Staff Giving Medication

17. Teachers’ conditions of employment do not include giving medication or supervising a pupil taking it, although staff may volunteer to do this and many are happy to do so.  Any member of staff who agrees to accept responsibility of administering prescribed medication to a pupil should have proper training and guidance.  He or she should also be aware of possible short-term side effects of the medication and what to do if they occur.  The type of training necessary will depend on the individual case.  Education Authority/school should be satisfied that any training has given staff sufficient understanding, confidence and expertise.  In the case of those staff willing to administer medication an appropriate health care professional should confirm theoretical and practical knowledge in medical procedures.  It will also be necessary to develop a programme of refresher courses to ensure that competencies remain current.

The Education Authority

18. The Moray Council, as employer, is responsible for all health and safety matters affecting schools, one aspect of which will be to arrange for staff in-service training in conjunction with health professionals.

Grampian Health Board

19. Grampian Health Board has a statutory duty to purchase services to meet local needs in Moray.  The Grampian Universities Hospital Trust provides these services.  GHB, GUHT and the Education Authority will work in co-operation to determine need and to plan and co-ordinate effective local provision within the resources available.

20. There is a designated medical officer with specific responsibility for children with special educational needs (SEN).  Some of these children may have medical needs.  The Grampian Universities Hospital Trust through the School Health Service, will provide advice and training for school staff in providing for a pupil’s medical needs.  (See Appendix E – The School Health Service).

The School Health Service

21. The School Health Service is part of Grampian Universities Hospital Trust.  It provides advice on health issues to children, parents and the education officers and authority.  The main contact for schools is the School Health Department.  (See Appendix E )

22. The School Health Department will also provide guidance on medical conditions and specialist support for a child with medical needs.

The School Nurse / Doctor

23. All schools will have contact with the health service through a school nurse or doctor.

24. The school nurse or doctor may help schools draw up IPP’s ( Form Med 3 ) for pupils with medical needs, and may be able to supplement information already provided by parents and the child’s GP.  The nurse or doctor will also be able to advise on training for school staff willing to administer medication, or take responsibility for other aspects of support.  The school nurse or doctor will attend school open days or parents’ evening to give advice to parents and staff by invitation.

The General Practitioner

25. GPs are part of primary health care teams.  All parents will register their child with a GP.  A GP has a duty of confidentiality to patients.  Any exchange of information between GPs and schools about a child’s medical condition should be with the consent of the child (if he/she has the capacity), or otherwise that of the parent or guardian.  In some cases parents may agree for GPs to advise teachers directly about a child’s condition, in others GPs may do so by liaising with the School Health Service.

Other Health Professionals

26. Other health professionals may also be involved in the care of pupils with medical needs in schools.  The Community Paediatrician is a specialist doctor with an interest in disability, chronic illness and the impact of ill health on children.  He/she may give advice to the school on individual pupils or on health problems generally.

27. Most NHS Trusts with School Health Services have specialist trained pharmacists, often referred to as Community Pharmacists.  Community Pharmacists provide pharmaceutical advice to the School Health Service through Grampian Universities Hospital Trust.  The School Health Service works closely with the Education and Social Care department and gives advice on the management of medicines within schools.  This can involve helping to prepare policies related to medicines in schools and training school staff.  In particular, they can advise on the storage, handling and disposal of medicines.  Advice on the preparation of this document has been received from the Pharmacy Service Manager, MHS Trust.

28. Some pupils with medical needs will receive dedicated support from specialist nurses, who work as part of the GUHT and who work closely with the primary health care team.  They can provide advice on the medical needs of an individual pupil, particularly when a medical condition has just been diagnosed and the pupil is adjusting to new routines.