Supporting Pupils with Medical Needs Policy November 23 / 24

Supporting Pupils with Medical Conditions:

This policy has been written with reference to the following DfE statutory guidance;

‘Supporting pupils at school with medical conditions. Statutory guidance for governing bodies of maintained schools and proprietors of academies in England’ December 2015

Coop Academy Bebington’s Primary aims in supporting children with medical needs are to ensure:

• Pupils at school with medical conditions should be properly supported so that they have full access to education, including school trips and physical education.
• The governing body is aware of its responsibility in ensuring that arrangements are in place in schools to support pupils at school with medical conditions.
• The governing body ensures that school leaders consult health and social care professionals, pupils and parents to ensure that the needs of children with medical conditions are properly understood and effectively supported.

Definition:

Pupils’ medical needs may be broadly summarised as being of two types:

1. Short-term, affecting their participation in school activities whilst on medication or recovering from injury.
2. Long-term, potentially limiting their access to education and requiring extra care and support

Coop Academy Bebington Ethos:

Schools have a responsibility for the health and safety of pupils in their care. The Health and Safety at Work Act 1974 makes employers responsible for the health and safety of employees and anyone else on the premises. In the case of pupils with special medical needs, the responsibility of the employer is to make sure that safety measures cover the needs of all pupils at the school. This may mean making special arrangements for particular pupils so that they can access their full and equal entitlement to all aspects of the curriculum. In this case, individual procedures may be required. Coop Academy Bebington is responsible for making sure that relevant staff know about and are, if necessary, trained to provide any additional support that pupils with medical conditions (long or short term) may need.

The Children and Families Act 2014 places a duty on schools to make arrangements for children with medical conditions. Pupils with medical conditions have the same right of admission to school as other children and cannot be refused admission or excluded from school on medical grounds alone. However, teachers and other school staff in charge of pupils have a common law duty to act ‘in loco parentis’ and must ensure the safety of all pupils in their care. To this end, we reserve the right to refuse admittance to a child with an infectious disease, where there may be a risk posed to others or to the health of the child involved. This duty also extends to teachers leading activities taking place off the school site

The prime responsibility for a child's health lies with the parent, who is responsible for the child's medication and must supply the school with all relevant information needed in order for proficient care to be given to the child. The school takes advice and guidance from a range of sources, including the School Nurse, Health professionals and the child’s GP in addition to the information provided by parents in the first instance. This enables us to ensure we assess and manage risk and minimise disruption to the learning of the child and others who may be affected.

Coop Academy Bebington Aims:

• To support pupils with medical conditions, so that they have full access to education, including physical education and educational visits.
• To ensure that school staff involved in the care of children with medical needs are fully informed and adequately trained by a professional in order to administer support or prescribed medication.
• To comply fully with the Equality Act 2010 for pupils who may have disabilities or special educational needs.
• To write, in association with healthcare professionals, Individual Healthcare Plans where necessary.
• To respond sensitively, discreetly and quickly to situations where a child with a medical condition requires support.
• To keep, monitor and review appropriate records.

Pupil Entitlement:

Coop Academy Bebington provides full access to the curriculum for every child wherever possible. We believe that pupils with medical needs have equal entitlement and must receive necessary care and support so that they can take advantage of the opportunities available to all in school.

However, we also recognise that employees have rights in relation to supporting pupils with medical needs, as follows:

Employees may:

• Ask to receive appropriate training
• Work to clear guidelines
• Bring to the attention of Senior Leadership Team any concern or matter relating to the support of pupils with medical conditions

Expectations:

It is expected that:

• Parents will inform school of any medical condition that affects their child.
• Parents will supply school with appropriately prescribed medication, where the dosage information and regime is clearly printed by a pharmacy on the container
• Parents will ensure that medicines to be given in school are in date and clearly labelled
• Parents will co-operate in training their children to self-administer medicine if this is appropriate, and that staff members will only be involved if this is not possible
• Medical professionals involved in the care of children with medical needs will fully inform staff beforehand of the child’s condition, its management and implications for the school life of that individual
• Coop Academy Bebington will ensure that, where appropriate, children are involved in discussing the management and administration of their medicines and are able to access and administer their medicine if this is part of their Individual Healthcare plan (for example, an inhaler)
• School staff will liaise as necessary with Healthcare professionals and services in order to access the most up-to-date advice about a pupil’s medical needs and will seek support and training in the interests of the pupil
• Transitional arrangements between schools will be completed in such a way that Coop Academy Bebington will ensure full disclosure of relevant medical information, Healthcare plans and support needed in good time for the child’s receiving school to adequately prepare.
• Individual Healthcare plans will be written, monitored and reviewed regularly and will include the views and wishes of the child and parent in addition to the advice of relevant medical professionals

Procedure:

The Governing Body of Coop Academy Bebington and the Coop Academies Trust ensures that an appropriate level of insurance is in place and reflects the level of risk presented by children with medical conditions. When school is notified that that student on roll has medical conditions requiring support the governing body also ensures that procedures are in place to cover any transitional arrangements between schools, the process to be followed upon reintegration or when pupils’ needs change, and arrangements for any staff training or support.

For children starting at a new school, arrangements should be in place in time for the start of the relevant school term. In other cases, such as a new diagnosis or children moving to a new school mid-term, every effort should be made to ensure that arrangements are put in place within two weeks. Schools does not have to wait for a formal diagnosis before providing support to pupils. In cases where a pupil’s medical condition is unclear, or where there is a difference of opinion, judgements will be needed about what support to provide based on the available evidence.

Information:

Children with serious medical conditions will be identified in SIMS and tagged in class charts. An Individual Health Care Plan will be written in cooperation with parents and medical professionals and the plan will be linked to Class Chart. Form Teacher, Curriculum Staff and support staff (according to child’s timetable) will be sent copies of the IHCP when reviewed annually.

When writing the IHCP school will consider the following:

• the medical condition, its triggers, signs, symptoms and treatments
• the pupil’s resulting needs, including medication (dose, side effects and storage) and other treatments, time, facilities, equipment, testing, dietary requirements and environmental issues, e.g. crowded corridors, travel time between lessons
• specific support for the pupil’s educational, social and emotional needs – for example, how absences will be managed, requirements for extra time to complete exams, use of rest periods or additional support in catching up with lessons, counselling sessions
• the level of support needed (some children will be able to take responsibility for their own health needs) including in emergencies. If a child is self-managing their medication, this should be clearly stated with appropriate arrangements for monitoring
• who will provide this support, their training needs, expectations of their role and confirmation of proficiency to provide support for the child’s medical condition from a healthcare professional; and cover arrangements for when they are unavailable
• who in the school needs to be aware of the child’s condition and the support required
• arrangements for written permission from parents and the headteacher for medication to be administered by a member of staff, or self-administered by the pupil during school hours
• separate arrangements or procedures required for school trips or other school activities outside of the normal school timetable that will ensure the child can participate, e.g. risk assessments
• where confidentiality issues are raised by the parent/child, the designated individuals to be entrusted with information about the child’s condition; and
• what to do in an emergency, including whom to contact, and contingency arrangements. Some children may have an emergency healthcare plan prepared by their lead clinician that could be used to inform development of their individual healthcare plan.

Roles and Responsibilites:

Supporting a child with a medical condition during school hours is not the sole responsibility of one person. Coop Academy Bebington will work in partnership with school staff, healthcare professionals, social care professionals, parents and pupils. The following roles are key to ensuring all proefessional work effectively:

Governing bodies should ensure that pupils with medical conditions are supported to enable the fullest participation possible in all aspects of school life. They should also ensure that any members of school staff who provide support to pupils with medical conditions are able to access information and other teaching support materials as needed.

Headteachers should ensure that their school’s policy is developed and effectively implemented with partners. This includes ensuring that all staff are aware of the policy for supporting pupils with medical conditions and understand their role in its implementation. Headteachers should ensure that all staff who need to know are aware of the child’s condition. They should also ensure that sufficient trained numbers of staff are available to implement the policy and deliver against all individual healthcare plans, including in contingency and emergency situations. This may involve recruiting a member of staff for this purpose. Headteachers have overall responsibility for the development of individual healthcare plans. They should also make sure that school staff are appropriately insured and are aware that they are insured to support pupils in this way. They should contact the school nursing service in the case of any child 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.

Parents should provide the school with sufficient and up-to-date information about their child’s medical needs. They may in some cases be the first to notify the school that their child has a medical condition. Parents are key partners and should be involved in the development and review of their child’s individual healthcare plan, and may be involved in its drafting. They should carry out any action they have agreed to as part of its implementation, e.g. provide medicines and equipment and ensure they or another nominated adult are contactable at all times.

Pupils with medical conditions will often be best placed to provide information about how their condition affects them. They should be fully involved in discussions about their medical support needs and contribute as much as possible to the development of, and comply with, their individual healthcare plan. Other pupils will often be sensitive to the needs of those with medical conditions.

Teaching and Support Staff may be asked to provide support to pupils with medical conditions, including the administering of medicines, although they cannot be required to do so. Although administering medicines is not part of teachers’ professional duties, they should take into account the needs of pupils with medical conditions that they teach.

School staff should receive sufficient and suitable training and achieve the necessary level of competency before they take on responsibility to support children with medical conditions. Any member of school staff should know what to do and respond accordingly when they become aware that a pupil with a medical condition needs help.

School nurses: Every school has access to school nursing services. They are responsible for notifying the school when a child has been identified as having a medical condition which will require support in school. Wherever possible, they should do this before the child starts at the school. They would not usually have an extensive role in ensuring that schools are taking appropriate steps to support children with medical conditions, but may support staff on implementing a child’s individual healthcare plan and provide advice and liaison, for example on training. School nurses can liaise with lead clinicians locally on appropriate support for the child and associated staff training needs; for example, there are good models of local specialist nursing teams offering training to local school staff, hosted by a local school. Community nursing teams will also be a valuable potential resource for a school seeking advice and support in relation to children with a medical condition.

Other healthcare professionals, including GPs and paediatricians, should notify the school nurse when a child has been identified as having a medical condition that will require support at school. They may provide advice on developing individual healthcare plans. Specialist local health teams may be able to provide support in schools for children with particular conditions (e.g. asthma, diabetes, epilepsy).

Local authorities are commissioners of school nurses for maintained schools and academies. Under Section 10 of the Children Act 2004, they have a duty to promote co-operation between relevant partners – such as governing bodies of maintained schools, proprietors of academies, clinical commissioning groups and NHS England – with a view to improving the wellbeing of children with regard to their physical and mental health, and their education, training and recreation. Local authorities and clinical commissioning groups (CCGs) must make joint commissioning arrangements for education, health and care provision for children and young people with SEN or disabilities (Section 26 of the Children and Families Act 2014). Local authorities should provide support, advice and guidance, including suitable training for school staff, to ensure that the support specified within individual healthcare plans can be delivered effectively. Local authorities should work with schools to support pupils with medical conditions to attend full-time. Where pupils would not receive a suitable education in a mainstream school because of their health needs, the local authority has a duty to make other arrangements. Statutory guidance for local authorities sets out that they should be ready to make arrangements under this duty when it is clear that a child will be away from school for 15 days or more because of health needs.

In An Emergency:

In a medical emergency, the school’s First Aiders will be asked to attend.

If an ambulance is required, then the office staff are responsible for calling it. They will need to:

• Outline the full condition and how it occurred
•         Give details regarding the child’s date of birth, address, parents’ names and any known medical conditions.
• Children will be accompanied to hospital by a member of staff if this is deemed appropriate. Staff cars should not be used for this purpose. Parents must always be called in a medical emergency, but do not need to be present for a child to be taken to hospital.

They are expected to meet the child at the hospital.

First Aid trained staff will remain with the child until the ambulance arrives. This will allow teaching staff to return to their class and to supervise the children accordingly.

Day trips, residential visits and sporting activities:

Arrangements will be made to ensure that pupils with medical conditions can participate in school trips and visits, or in sporting activities. Through the IHCP teachers will be made aware of how a child’s medical condition will impact on their participation, but there should be enough flexibility for all children to participate according to their own abilities and reasonable adjustments will be made.

Pupils will only be prevented form participation in such activities if evidence from a clinician such as a GP states that this is not possible.

Decision re participation will be made in consultation with parents and pupils and advice from the relevant healthcare professional to ensure that pupils can participate safely

Administration of Medicines:

Only essential medicines will be administered during the school day. These will be only those prescribed by a doctor. Parents must submit a written permission slip before any medicine is administered. Medicines to be given during the school day must be in their original container. An Administration of Medication Record Book will be completed after each administration of medicine.

Essential medicines will be administered on Educational Visits, subject to the conditions above. A risk assessment may be needed before the visit takes place. Staff supervising the visit will be responsible for safe storage and administration of the medicine during the visit.

Named staff members will give medicines. Before administering any medicine staff must check that the medicine belongs to the child, must check that the dosage they are giving is correct, and that written permission has been given. Any child refusing to take medicine in school will not be made to do so, and parents will be informed about the dose being missed.

All medicines will be stored safely. Medicines needing refrigeration will be stored in the first aid room fridge. Some medicines (inhalers, etc) will be carried with the children, for ease of access during outside activities. All medicines must be clearly labelled.

Controlled drugs, including Epi-pens or prescribed medicines will be kept in the medical room. Access to these medicines is restricted to the named persons.

Spare inhalers are kept in the school office. Children have access to these inhalers at all times, though must inform a member of staff that they are taking a dose. All inhalers are marked with the child’s name. All children with an inhaler must take them on educational visits, however short in duration.

Epi-pens:

Any member of staff can administer an Epi-pen in an emergency.

The pen (cap off) should be pushed against the child’s thigh, through clothing if necessary. The pen should be held for a count of 10 seconds before being withdrawn. Ambulances must be called for a child who may require an Epi-pen. Cetrizine may be given if slight tingling of the lips occurs following ingestion of possible irritants for nut allergy sufferers. This is a liquid medicine stored with the Epi- pen. If symptoms are more severe, the Epi-pen should be given immediately. An ambulance must be called immediately. Parents should be contacted after this call has been made.

 The Human Medicines Regulations Act 2017 allows school to hold spare Epipens. These are kept in the school office and can be administered to a pupil in the event that their own device is unavailable or not working (broken or out of date) providing the school has received the parents permission.

Unacceptable Practice:

School staff will use their discretion and judge each case on its merits with reference to the child’s individual healthcare plan, however it is not generally acceptable practice to:

• prevent children from easily accessing their inhalers and medication and administering their medication when and where necessary
• assume that every child with the same condition requires the same treatment
• ignore the views of the child or their parents; or ignore medical evidence or opinion (although this may be challenged)
• send children with medical conditions home frequently for reasons associated with their medical condition or prevent them from staying for normal school activities, including lunch, unless this is specified in their individual healthcare plans
• if the child becomes ill, send them to the school office or medical room unaccompanied or with someone unsuitable
• penalise children for their attendance record if their absences are related to their medical condition, e.g. hospital appointments
• prevent pupils from drinking, eating or taking toilet or other breaks whenever they need to in order to manage their medical condition effectively
• require parents, or otherwise make them feel obliged, to attend school to administer medication or provide medical support to their child, including with toileting issues. No parent should have to give up working because the school is failing to support their child’s medical needs;
• prevent children from participating, or create unnecessary barriers to children participating in any aspect of school life, including school trips, e.g. by requiring parents to accompany the child.

Complaints:

Should parents be unhappy with any aspect of their child’s care at Coop Academy Bebington, they must discuss their concerns with the school. This will be with the child’s pastoral leader in the first instance, with whom any issues should be managed. If this does not resolve the problem or allay concern, the problem should be brought to a member of the leadership team, who will, when necessary, bring concerns to the attention of the Head teacher. Formal complaints must be made using the procedure outlined in the ‘Complaints Policy’ on the academy website.

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