Supporting Pupils with Medical Needs Policy

Policy details

• Date created - 29/08/2024
• Date reviewed - 01/09/2024
• Date approved - 17/09/2024
• Date implemented - 17/09/2024
• Next review date - August 2025
• Policy owner - Property and Health and Safety Manager

• This policy sets out specific guidance on the principles that should apply to the management of medical conditions, including the administration of medications.
• Special schools can add supplementary documentation and amendments to make this policy bespoke to their specialist settings. 
• The policy applies to all staff employed at Co-op Academies Trust.

Supporting Pupils with Medical Needs Trust Policy        1

Aims        3

Legislation and Statutory Responsibilities        3

Links to other policies        3

Roles and Responsibilities        4

The Trust Board        4

The Principal/Headteacher        4

SENCos        4

School colleagues        5

Parents and Carers Responsibilities        6

Pupils        7

School nurses and other healthcare professionals        7

Managing Medicines/Medical Interventions at the Academy        7

Child’s Role in Managing Their Own Medical Needs        8

Refusing Medication/Medical Intervention        9

Storage of Medicines/Medical Intervention Equipment and Resources        9

Controlled Drugs        9

Records        10

Individual Health Care Plans (IHCP) and Risk Assessments (IPRA)        11

Managing Emergencies and Emergency Procedures        12

Confidentiality and Sharing of Information within academy        12

Liability and Indemnity        12

Complaints Procedure        13

Unacceptable Practice        13

Forms        13

Aims

• Pupils, staff and parents/carers understand how our school will support pupils with medical conditions
• Pupils with medical conditions are properly supported to allow them to access the same education as other pupils, including school trips and sporting activities
• The outcome should be that pupils can play a full and active role in all aspects of academy life including trips, educational visits and residential and extended academy activities, such that they remain healthy and achieve their academic potential. 

Legislation and Statutory Responsibilities

This policy meets the requirements under Section 100 of the Children and Families Act 2014, which places a duty on governing boards to make arrangements for supporting pupils at their school with medical conditions.

It is also based on the Department for Education (DfE)’s statutory guidance on supporting pupils with medical conditions at school.

This policy also complies with our funding agreement and articles of association.

Links to other policies

This policy links to the following policies:

•   Accessibility plan
•   Complaints
•   Equality information and objectives
•   First aid policy
•   Health and safety policy
•   Safeguarding and Child Protection Policy
•   Special educational needs information report and policy

Roles and Responsibilities

The Trust Board

The trust board has ultimate responsibility to make arrangements to support pupils with medical conditions. The trust board may delegate their responsibilities to the CEO and/or their representatives. They will ensure that this policy is implemented effectively, including through the biennial Safeguarding and Culture Review and annual Health and Safety audit scheduled for each school.

The Principal/Headteacher

The Principal/Headteacher or Head of School will ensure that:

• All staff are aware of this policy on supporting pupils with medical conditions, understand their role in its implementation and follow the correct procedures.
• The policy is available for staff in the shared area of the academy system or as a hard copy.
• The responsibilities of the SENCo (see below) are carried out effectively, including:

• There is a sufficient number of trained staff available to implement this policy and deliver against all individual healthcare plans (IHCPs), including in contingency and emergency situations
• All staff who need to know are aware of a child’s condition
• IHCPs are effectively developed and implemented
• School staff are appropriately insured and aware that they are insured to support pupils in this way
• The school nursing service is contacted in the case of any pupil 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
• Systems are in place for obtaining information about a child’s medical needs and that this information is kept up to date
• Medicines are stored appropriately and are in-date

• All documentation (including risk assessments and IHCPs) are appropriate and signed off all by the Headteacher.

SENCos

The SENDCo are responsible for effective implementation of this policy. Parts of the responsibilities listed below may be delegated to a designated member(s) of staff (e.g. a member of the admin or support team). The SENCo is responsible for regularly checking on the systems and procedures to ensure that they are being carried out effectively and inline with this policy.

The SENDCo must ensure that:

• School holds relevant, up-to-date information on pupils’ medical needs from parents and medical professionals
• Maintain a register of pupils’ medical needs (including expiry dates of medication)
• All relevant staff are aware of an individual child’s medical condition and needs
• Sufficient numbers of staff receive appropriate training to fulfil the roles and responsibilities of supporting children with medical conditions so that the academy is able to deliver against all Individual Healthcare Plans (IHCPs) and implement policy, including for example in contingency or emergency situations and management of staff absence.
• A system is in place which outlines procedures to be followed on receipt of notification of a pupil’s medical needs; procedures should cover any transitional arrangements or when pupis’l needs change. They will design this with the Designated Safeguarding Lead and Headteacher, and will evaluate its effectiveness at regular intervals.
• Cover arrangements are always available in the event of staff absence or staffing changes, including briefing for volunteers, supply teachers and appropriate induction for new members of staff. 
• IHCPs are in place, where appropriate, and developed in consultation with parents/carers, healthcare professionals, relevant staff and (if appropriate) the child or young person.
• IHCPs are monitored and are subject to review, at least annually, or sooner if needs change. 
• IHCPs will be linked to, or become part of, any education, health and care (EHCP) plan. If a pupil has special educational needs (SEN) but does not have an EHC plan, the SEN will be mentioned in the IHCP.

• Risk assessments relating to the academy environment are in place, as appropriate, including consideration for actions to take in the event of emergency situations.
• All pupils with medical needs have a risk assessment for offsite activities (in liaison with  the Educational Visits Co-ordinator-EVC).
• Risk assessments relating to off-site visits, residential trips and extended academy opportunities offered outside the normal timetable are in place, as appropriate, including consideration for actions to take in the event of emergency situations. The EVC will need to be consulted on these.
• The notification procedure is followed when information about a child’s medical needs are received. 
• Parents/carers provide full and up to date information about their child’s medical needs by completion of ‘Parent/Carer Information about a Child’s Medical Condition’ form (Template A). 
• On receipt of a ‘Parent/Carer Request and Agreement for academy to Administer Medicines / Medical Interventions’ form (Template B), on a case by case basis, will decide whether any medication or medical intervention will be administered, following consultation with staff. They will keep the Headteacher informed of any requests.
• For Secondary academies, on receipt of a ‘Parent/Carer Request for the Child’s Self–administration of Medication/Medical Intervention (Template B), on a case by case basis, will consult with the Headteacher as to whether or not any medication will be carried by the child, will be self-administered by the child or any medical intervention will be self-administered by the child, following consultation with staff, if appropriate. In the case of Primary academy sites, this should always be administered by an adult staff member with the exception of asthma and allergy medication that should be managed in the appropriate government guidance on inhalers.
• Medicines held in school are stored appropriately and are in-date

School colleagues

• School colleagues must follow school’s procedures, including ensuring medicines are stored appropriately
• Any member of staff may be asked to provide support for a child with a medical condition, including the administration of medicine(s) and medical intervention(s).
• Academy staff will receive sufficient and suitable training and achieve competency before they take on responsibility for supporting children with medical conditions.
• Where children have an IHCP, the roles and responsibilities of staff will be clearly recorded and agreed.
• Staff administering medication must follow the procedures outlined in the IHCP
• Staff administering medication or carrying out a medical procedure must record this on template C (IHCP)

Parents and Carers Responsibilities 

• Parents and carers must provide the academy with sufficient and up to date information about their child’s medical needs and to update it at the start of each academy year, as a minimum or if needs change, by completion of a ‘Parent/Carer Information about a Child’s Medical Condition’ form (Template A). 
• Complete, if appropriate, a ‘Parent/Carer Request and Agreement for academy to Administer Medicines / Medical interventions’ form (Template B) to gain consent for medicines / medical interventions to be administered at academy.
• Complete, if appropriate, a ‘Parent/Carer Request for the Child’s Self–administration of Medication/Medical Intervention’ form (Template B) to gain consent for medicines / medical interventions to be administered by the child.
• Provide up-to-date contact information so that parents/carers or other nominated adults are contactable at all times. 
• Carry out any action they have agreed to as part of the implementation of an IHCP. 
• Provide any medication in its original packaging, with the pharmacy label stating the following: 

• Child’s name 
• Child’s date of birth 
• Name of medicine 
• Frequency / time medication administered 
• Dosage and method of administration 
• Special storage arrangements 

• Ensure medicines or resources associated with delivery of a medical intervention have not passed the expiry date.
• Collect and dispose of any medicines held in the academy at the end of each term, or as agreed.
• Provide any equipment required to carry out a medical intervention e.g. catheter tubes, auto injector (EpiPen), inhalers and spacers including spares for emergency and equipment failure.
• Collect and dispose of any equipment used to carry out a medical intervention e.g. asthma spacers/EpiPens. 
• Pupil Information - Parents/carers are required to give the following information about their child’s medical condition and to update it at the start of each academy year, or sooner if needs change, by completion of ‘Parent/Carer Information about a Child’s Medical Condition’ form (see Template A): 

• Details of pupil’s medical conditions and associated support needed at academy 
• Medicine(s), including any side effects 
• Medical intervention(s) 
• Name of GP / Hospital and Community Consultants/Other Healthcare Professionals 
• Special requirements e.g. dietary needs 
• Who to contact in an emergency 
• Cultural and religious views regarding medical care 

This must be updated on all pupil records where appropriate to ensure the most up to date information is available to staff.

Pupils

Pupils with medical conditions will often be best placed to provide information about how their condition affects them. Pupils should be fully involved in discussions about their medical support needs and contribute as much as possible to the development of their IHCPs. They are also expected to comply with their IHCPs.

School nurses and other healthcare professionals

Our school nursing service will notify the school when a pupil has been identified as having a medical condition that will require support in school. This will be before the pupil starts school, wherever possible. They may also support staff to implement a child’s IHCP.

Healthcare professionals, such as GPs and paediatricians, will liaise with the school’s nurses and notify them of any pupils identified as having a medical condition. They may also provide advice on developing IHPs.

Managing Medicines/Medical Interventions at the Academy

• Medicine / medical interventions will only be administered at academy when it would be detrimental to a pupil’s health or attendance not to do so.
• It is expected that parents/carers will normally administer medication / medical interventions to their children during their time at home, where at all possible.
• No medication / medical intervention will be administered without prior written permission from the parents/carers (with the exception of a medical emergency). ‘Parent/Carer Request and Agreement for academy to Administer Medicines / Medical Interventions’ (Template B). The Headteacher makes the final decision whether and by whom any medication or medical intervention will be administered in the academy, following receipt of the above form and after consultation with staff. 
• Not all pupils with a medical condition will require an IHCP. It will be agreed with a healthcare professional and the parents/carers when an IHCP would be inappropriate or disproportionate. This will be based on evidence. If there is no consensus, the headteacher will make the final decision.
• No changes to administration method or dosage of medication or changes in procedures relating to medical interventions will be carried out without written authority from parents/carers and recorded amendment to the ‘Parent/Carer Request and Agreement for academy to Administer Medicines / Medical interventions’ form (Template B).
• The Headteacher makes the decision on whether a child is able to carry and self-administer any medication or self-administer any medical intervention, following consultation with staff as appropriate ‘Parent/Carer Request for the Child’s Self–Administration of Medication/Medical Intervention’ (Template B).
• All medicines / medical interventions will normally be administered during academy breaks and/or lunchtime. 
• If, for medical reasons, medicine has to be taken at other times during the day or a medical intervention delivered at a different time, arrangements will be made for the medicine / medical intervention to be administered at other prescribed times. 
• Pupils will be told where their medication / medical intervention equipment and resources are kept and who will administer them. 
• Any member of staff, on each occasion, giving medicine / medical intervention to a pupil should check: 

• Name of pupil 
• Written instructions provided by the parents/carers or healthcare professional or as agreed in an IHCP 
• Prescribed dose, if appropriate 
• Expiry date, if appropriate 
• Any member of staff, on each occasion, will make a written record of medication / medical interventions administered on the ‘Record of Administration of Medicines/Medical Intervention to an Individual Child’ (Template C)

• No child under 16 will be given medicine containing aspirin unless prescribed by a doctor.
• Anyone giving a pupil any medication (for example, for pain relief) will first check maximum dosages and when the previous dosage was taken. Parents/carers will always be informed.  
• The school will only accept prescribed medicines that are: In-date, labelled and provided in the original container, as dispensed by the pharmacist, and include instructions for administration, dosage and storage. Insulin in a Pen and Pump can be used if original packaging is not available but it must be checked and in date at appropriate intervals.

Emergency supply of Allergy Medication/Asthma Medication

• All schools will have an appropriate number of adrenaline auto injectors and inhalers in case of emergencies
• Schools will follow government guidance on the use and supply of adrenaline auto injectors
• All educational visits and trips have an emergency adrenaline auto injector within the first aid box for emergency use only Government guidance and letter template
• Schools will follow the government guidance on the use and supply of Salbutamol inhalers in school Government guidance on inhalers
• These are the only two medications schools should have onsite which don’t relate to individual pupils (it is not permitted for schools to have their own supply of medication, such as Calpol or paracetamol to administer to pupils).

Child’s Role in Managing Their Own Medical Needs

• After discussion with parents/carers, children who are competent will be encouraged to take responsibility for managing their own medicines and medical interventions. 
• Written permission from the parents/carers will be required for pupils to self-administer medicine(s) / medical intervention(s). The academy’s ‘Parent/Carer Request for the Child’s self–administration of Medication/Medical Intervention (Template B)  This template must also be used to document pupil self administration of medication to ensure parents understand to give permission for the child to self medicate this must be completed by parents/carers.
• Written permission from the parents/carers will be required for pupils to carry medicine(s) or resources associated with a medical intervention(s). The academy’s ‘Parent/Carer Request for the Child’s self–administration of Medication/Medical Intervention (Template B) must be completed by parents/carers.
• Children who can take medicines or manage medical interventions independently may still require a level of adult support e.g. in the event of an emergency. In this situation agreed procedures will be documented in an IHCP.

Refusing Medication/Medical Intervention

• If a child refuses to take their medication / medical intervention, staff will not force them to do so. Refusal to take medication will be recorded and dated on the child’s record sheet. Reasons for refusal to take medications / medical intervention must also be recorded as well as the action then taken by the member of staff and parents/carers informed.
• Parents/Carers will be required to bring and oversee the taking of medication where not doing so would put the child or others at risk.
• Parents/carers will be informed as soon as possible. Where the child is potentially placing themselves at risk by refusal, parents/carers will be informed immediately.

Storage of Medicines/Medical Intervention Equipment and Resources

• All children will know where their medicines / medical intervention equipment/resources are, at all times and will be readily available as required.
• All prescribed medicines will be stored securely in a lockable fridge/store cupboard (if medication is to be kept at an ambient temperature).
• All medication must be stored out of reach of pupils at all times
• Signage must be displayed to identify where emergency medication is stored.

Controlled Drugs

• Controlled drugs are prescription medicines that are controlled under the Misuse of Drugs Regulations 2001 and subsequent amendments, such as morphine or methadone.
• A child who is prescribed a controlled drug may legally have it in their possession if they are competent to do so but passing it to another child for use is an offence. 
• Where controlled drugs are not an individual child’s responsibility, they will be kept in a non-portable locked cabinet in a secure environment e.g. admin office, medical room. Only named staff will have access.
• Controlled drugs will be easily accessible in an emergency as agreed with parents/carers or described in the child’s IHCP.
• Where controlled drugs are not an individual child’s responsibility, records will be kept of any doses used and the amount kept on the premises.

Non-Controlled Drugs and Medical Resources

• All medicines and medical equipment / resources will be stored safely as agreed with parents/carers or described in the child’s IHCP.
• Parents can request administration of non-prescribed drugs (e.g. Calpol, paracetamol). Such medication should be labelled with the child’s name and DOB. The written procedure for requesting administration of medicines should be followed.
• Schools are not permitted to have their own supplies of non-prescribed medicines (such as Calpol or paracetamol) for administration to pupils

Records

• The academy will keep a record of all medicines / medical interventions administered to individual children on each occasion, including the following: 
• Name of pupil 
• Date and time of administration 
• Who supervised the administration 
• Name of medication 
• Dosage
• A note of any side effects / reactions observed 
• If authority to change protocol has been received and agreed. 
• Record of Administration to an Individual Child (Template D) and Record of Medicine Administered to All Children (Template E). 

Training

• Staff must not give prescription/non prescription medicines or undertake healthcare procedures without appropriate training. A First Aid Certificate does NOT constitute appropriate training in supporting children with medical conditions. Staff must not give advice or a medical view on a child’s health or a member of staff.
• All staff will be made aware of the academy’s Policy for supporting pupils with medical conditions and their role in implementing this policy through, for example, whole academy awareness training, involvement in development of IHCPs, staff briefing sessions etc.
• Specialist training and advice will be provided by appropriate healthcare professionals, e.g. specialist epilepsy nurse, asthma training by academy nurse etc, for staff involved in supporting pupils with medical conditions including the administration of relevant medicines / medical interventions.
• Training for all staff will be provided on a range of medical needs, including any resultant learning needs, as and when appropriate. 
• Supporting a child with a medical condition during academy hours should never be the sole responsibility of one person. 
• Training will ensure that sufficient numbers of staff are competent and have confidence in their ability to support pupils with medical conditions, and to fulfil the requirements as set out in IHCPs. Induction training will raise awareness of the academy’s Policy and practice on supporting pupils with medical condition(s).
• Training will be sufficient to ensure staff are competent and have confidence in their ability. The academy will make every effort to ensure that specialist training will be completed as quickly as possible to ensure that the child is able to attend academy safely.
• A record of staff training carried out will be kept, identifying the date review or refresher training will be required where appropriate. ‘Record of Staff Training’ (Template F).

Individual Health Care Plans (IHCP) and Risk Assessments (IPRA)

Where appropriate, an IHCP will be drawn up in consultation with the academy, parents/carers, health professionals and any other relevant professionals. Where a medical professional assesses that a medical condition is unstable, an Individual Pupil Risk Assessment (IPRA template ) should also be completed to sit alongside the IHCP.

The content of an individual child’s IHCP (Template A ) will be dependent on the complexity of their needs and may include the following:

• The level of support required in academy, who will provide this support, their training needs and cover arrangements for when they are unavailable.
• How, if agreed, the child is taking responsibility for their own health needs. 
• A reference to staff confidentiality. 
• Flow Chart (Appendix 3) to guide through deciding which elements of the IHCP are relevant to an individual child.
• Individual Health Care Plans will be reviewed annually or sooner if needs change

Off-Site and Extended academy Activities

• Pupils with medical conditions will be actively supported in accessing all activities on offer including academy trips, sporting activities, clubs and residential / holidays.
• Preparation and forward planning for all off-site and extended academy activities will take place in good time to ensure that arrangements can be put in place to support a child with a medical condition to participate fully.
• The academy will consider what reasonable adjustments need to be put in place to enable children with medical conditions to participate safely and fully.
• The academy will carry out and record a thorough risk assessment to ensure the safety of all pupils and staff. In the case of pupils with medical needs the risk assessment process will involve consultation with child, parents/carers and relevant healthcare professionals to ensure the pupil can participate safely. Please refer to Health and Safety Executive (HSE) Guidance on academy Trips. This will be signed off by a member of SLT.
• In some circumstances evidence from a clinician, such as a hospital consultant, may state that participation in some aspects offered is not possible. Where this happens, the academy will make alternative arrangements for the child.
• Arrangements will be in place to ensure that an IHCP can be implemented fully and safely when out of academy. Risk assessments utilising the IPRA documentation will identify how IHCPs will be implemented effectively off-site and where additional supervision or resources are required.
• The IPRA for each child must be completed when taking children with IHCPs off site.
• The allergens policy should be read in conjunction with this. (Allergens policy template) Download and make a copy.

Managing Emergencies and Emergency Procedures

• The Headteacher will ensure that all staff are aware of the academy’s general risk management processes and planned emergency procedures.
• Where a child has an IHCP this will clearly define what constitutes an emergency and describes what to do. This may include:

• An Emergency Medical Protocol that details the actions to be taken by staff and supported by specialist training where relevant e.g. seizure management and administration of rescue medication. 
• A Personal Emergency Evacuation Plan (PEEP) that details the actions to be taken by staff to support the child’s evacuation from the building, supported by specialist training where relevant e.g. use of an Evac chair; the PEEP should also detail the actions to be taken by staff to support how staff will manage the child’s medical needs during the evacuation e.g. ensuring appropriate medication is taken outside and is available whilst at the assembly point. 

• The academy must have a procedure for contacting emergency services (Template G) which is displayed in the appropriate places e.g. office, staff room etc and is in the staff operational handbook.

Confidentiality and Sharing of Information within academy

• The academy is aware of the need to manage confidential information sensitively and respectfully, maintaining the dignity of the child and family at all times, in line with GDPR.
• The academy will disseminate information to key members of staff involved in the child’s care on a needs-to-know basis, as agreed with parents/carers.
• Where the child has an IHCP this will be shared with key staff with regular, scheduled re-briefings, organised by the SENDCo.
• The academy will ensure that arrangements are in place to inform new members of staff of the child’s medical needs.
• The academy will ensure that arrangements are in place to transfer information on a child’s medical needs to staff during any transition.
• Medical documents (including letters from medical professionals, IHCPs, IPRAs) and records of conversations with parents/carers and medical professionals will all be stored in the ‘Medical’ section of each child’s Arbor record.

Liability and Indemnity

• The academy insurance policies provide liability cover relating to the administration of medicines. A full and comprehensive set of documentation must be available to ensure academy insurance policies can be validated for all pupils who are administered medication on academy sites. Failure to demonstrate the correct documentation may invalidate insurance cover.
• In the case of medical interventions, individual cover may be arranged for any specific healthcare procedures, including information about appropriate staff training and other defined requirements of the insurance policy. 
• The expectation is that only appropriately trained and insured staff will be involved in supporting medical interventions.

Complaints Procedure

• In the first instance parents/carers dissatisfied with the support provided for their child’s medical condition should discuss their concerns directly with the SENDCo.
• If, for whatever reason, this does not resolve the issue then the Complaints Policy can be followed.

Unacceptable Practice

The academy works to prevent the following: 

• Requiring parent/carers to attend the academy to administer medicines / medical interventions or provide medical support to their child, including around toileting issues.
• Preventing children from participating, or creating unnecessary barriers to children participating in any aspect of school life, including trips, including by requiring parents/carers to accompany the child. 
• Preventing children from easily accessing and administering their medicines as and where appropriate. 
• Assuming every child with the same condition requires the same treatment. 
• Ignoring the views of the child and/or their parents/carers (although these may be professionally challenged). 
• Ignoring medical evidence or opinion (although this may be professionally challenged). 
• Sending children with medical conditions home frequently. 
• Preventing children with medical conditions from staying at the academy for normal academy activities, including lunch, unless this is specified in their IHCP. 
• If the child becomes ill, sending them to the academy office or medical room unaccompanied or with someone unsuitable. 
• Penalising children for their attendance record if their absences are related to their medical condition e.g. hospital appointments. 
• Preventing children from eating, drinking or taking toilet / other breaks whenever they need to in order to manage their identified medical condition effectively. 

Forms

DfE Website link to Keeping Children Safe in Education

DfE Booklet Keeping Children Safe in Education

Link to DfE Templates A - G

Appendix 1 (Record of medication administered to a pupil)

Name of academy Setting

Appendix 2

Contacting the Emergency Services

N.B. If you are dialling 999 or a mobile number from an internal academy phone you must first dial 9 to get an outside line.

Request for an ambulance

Dial 999 or 112(from a mobile) and ask for an ambulance.  You will be asked which service you require – police, fire or ambulance. Be ready with the following information.

1. Your telephone number
2. academy:

Give your location as follows

Co-op Academy

1. Give exact location in the academy/setting

Make sure you state on the phone where the main entrance is situated

Make sure the receptionist knows where you are within the academy. 

1. Give your name

1. Give the name of the pupil and a brief description of their symptoms

1. Inform ambulance crew of the best entrance and state again that the crew will be met and taken to the correct location

(See above)

Speak clearly and slowly and be ready to repeat information if asked.

Once the ambulance has been contacted then contact reception and we contact the parents of the pupil.

IF AN AMBULANCE IS CALLED THE PRINCIPAL AND responsible SLT member MUST BE INFORMED. 

If an ambulance is called during the lunch break / breaktime, then avoid taking the ambulance straight through the play area, unless you have to, in order to avoid attention being drawn to the situation.

Appendix 3

Flow Chart