Advice from paediatric allergy nurse specialist, Rebecca Elder

I am a paediatric allergy clinical nurse specialist based at King’s College Hospital in London. I liaise a great deal with schools, and find that the attitude towards allergies differs a great deal depending on the ethos of the school and their previous experience dealing with allergic children.

Nearly one-fifth of anaphylactic reactions happen at school. There is confusion and inconsistency about where to store emergency medication in schools, who should administer the treatment and how school staff are trained. Documents such as Managing Medicines in Schools and Early Years Settings set out a clear framework, ensuring that children requiring medicines receive the support they need. However, the decision on how many EpiPens® the school should hold and where to store them is decided on an individual basis between the head teacher, the child’s parents/ carer and medical staff involved.

The Anaphylaxis Campaign currently provide training sessions for school nurses empowering them to train all school staff in the avoidance of allergens, the management of an acute allergic reaction and the safe and appropriate use of an EpiPen®. These free, one-day voluntary courses are run throughout the year across the country. These are excellent courses and highly recommended but it is up to the school nurse to go on them. The nurses then get a resource pack to take back to the school.

Teachers’ conditions of employment do not include giving or supervising a pupil taking medicines. Schools must ensure that they have sufficient members of support staff who are employed and appropriately trained to manage medicines. Legally, schools have to ensure the safety of pupils and enable them to have access to mainstream education and school activities. This applies to children with asthma, allergies and other conditions such as epilepsy and diabetes.

Schools must have someone on site who can administer medicine but this is not legally a teacher’s duty. This is a purely voluntary role and is recognised as such by the Department for Children, Schools and Families. While teachers have a general legal duty of care to their pupils, this does not extend to a requirement to routinely administer medicines. The unions take the view that teachers should be wary of administering medications or supervising a child taking a medication.

The parents cannot be criticised for wanting to send their child to a school that is geared up to dealing with allergies. My best advice is for the parents to speak to the head of the school and the designated school nurse and ask whether provisions can be made for the school nurse to attend a day course and therefore train the rest of the staff.

If there is no joy, they may have to consider changing schools. If this child is under a paediatric team, they should get in touch with their allergy nurse who can help the process along and even attend the school and train the staff if there is no chance of the school nurse doing it. I do this fairly often!

If they are not under a paediatric allergy team, they should ask their GP for a referral to one as issues such as management plans will be resolved.

First published in August 2009

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