Reviewed by: Sarah Cokayne and Shakera Rahman, Resources Committee 28th February 2022

Next Review: Spring 2024

Section 100 of the Children & Families Act places a duty on Kelvin Grove Primary School to make arrangements for supporting children with medical conditions, and in doing so must have regard for the Department for Education’s Supporting Children at School with Medical Conditions (DfE, 2014) statutory guidance: this policy outlines Kelvin Grove Primary School’s approach to meeting the requirements of this guidance.  

This policy should be read in conjunction with:

Kelvin Grove SEND policy   

Key Principles 

There are four key principles underpinning our policy, in line with the DfE guidance:  

• Children with medical conditions should be properly supported so that they can have full access to education, including school trips and physical education
• Our focus is on each child as an individual, and how their medical needs and unique situation  affect their access, participation and enjoyment of school life
• Arrangements must be in place in school to support children with medical conditions, including the appropriate use of risk assessments and the development and implementation of healthcare plans
• Meeting the needs of children with medical conditions can only be done to the highest standards when the child him/herself, the parent/carer and the relevant health and social care practitioners are fully included in supporting children with medical needs. 

As such, children with medical needs 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, in line with safeguarding duties, the governing body ensures that children’s health is not put at risk (e.g. from infectious diseases). We do not therefore permit entry to school where it is detrimental to the health of that child or others to do so.  

The prime responsibility for a child’s health always lies with the parent/carer who is responsible for   the child’s medication, and should supply the school with information regarding the management of  the child’s condition such that the school fully meets the child’s needs. As part of our commitment to the child’s inclusion in supporting themselves, we also encourage self-administration of medicine wherever possible. 

Procedure Once Notification is received  

Once a member of staff is aware that a child with medical needs will begin attending Kelvin Grove School e.g. Foundation Stage staff during entry profiling, Reception/Office staff when processing application, etc.) the Special Educational Needs & Disabilities [SEND] Co-ordinator [SENCO] Claire Ackford should be informed. She then ensures that all of the relevant staff are notified and begin the process of planning for the child’s safe admission to school. Arrangements to support children are ideally in place before the child starts, or no later than two weeks after their admission (dependent on new diagnoses emerging or starting at Kelvin Grove midyear). 

When a formal diagnosis has not yet been made, or where there is a difference of opinion, the school makes a judgement about what support to provide based on the available evidence – usually some form of medical evidence and consultation with parent/carers. If evidence conflicts, the school challenges appropriately to ensure that the right support can be put in place.  

Individual healthcare plans  

Children with medical needs attending the school have an individual healthcare plan where this is required, providing clarity about what needs to be done, when and by whom. The parent/carer, school and appropriate healthcare professional agree, based on evidence, when a healthcare plan is inappropriate or disproportionate; and the Head Teacher, Ian Hyde takes the final decision when consensus cannot be reached. Decisions to not make a healthcare plan are recorded appropriately on the child’s file.  

A model for developing individual healthcare plans is outlined in Appendix A. Further information  about these plans is outlined in Appendix B.  

Children with Special Educational Needs & Disabilities [SEND] and Medical Needs  

Some children with medical needs also have SEND. If a child with SEND also has a medical need, and he or she has a Statement of SEND or an Education, Health and Care (EHC) Plan, their individual healthcare plan is part of that Statement or EHC Plan. For children who have SEND and a medical need but no Statement or EHC Plan, their individual healthcare plan includes reference to their Special Educational Need or Disability.  

Roles and Responsibilities  

Any member of school staff may be asked to provide support to children with medical conditions, including the administering of medicines, although they cannot be required to do so. Any member of staff must know what to do and respond accordingly when they become aware that a child with a medical condition needs help.  

The named person with overall responsibility for policy implementation is Ian Hyde. Specific tasks within the policy are delegated to Rachael Johnson. Details regarding roles and responsibilities are outlined in Appendix C.  

Links to achievement and social and emotional wellbeing  

There are often social and emotional implications associated with medical conditions. Children may be self-conscious about their condition and some may become anxious or depressed. Long-term absences due to health problems may affect child’s attainment, impact on their ability to sustain friendships and affect their wellbeing and emotional health. We work closely with the child, their parent/carer and other practitioners to ensure that the impact of their medical needs on their achievement and social and emotional well-being is minimised. 

The school has an excellent social and emotional learning support service in place, which provides support to children whose emotional health has been affected by their medical needs, and may also provide support during transition if a child is being reintegrated back to school following a long period of absence. Class teacher’s work closely with outside agencies in ensuring appropriate support is put in place for all children in their class, including those absent due to illness.  

Procedures for Managing Medicines  

Medicines are only to be administered at school when it would be detrimental to a child’s health or school attendance not to do so. No child is given prescription or non-prescription medicines without their parent’s written consent, or given medicine containing aspirin unless prescribed by a doctor. Medication, e.g. for pain relief, is never administered without first checking maximum dosages and when the previous dose was taken.  

The following procedures are also followed:  

• where clinically possible, medicines should be prescribed in dose frequencies which enable them to be taken outside school hours  
• we only accept prescribed medicines that are in-date, labelled, provided in the original container  as dispensed by a pharmacist and include instructions for administration, dosage and storage (the only exception to this is insulin which must still be in date, but will generally be available to us inside an insulin pen or a pump, rather than in its original container)
• all medicines are stored safely. Children know where their medicines are at all times and are able to access them immediately. Medicines and devices such as asthma inhalers, blood glucose testing meters and adrenaline pens are always readily available to children and not locked away and are accessible on school trips.  
• a child who has been 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. Otherwise, we keep controlled drugs that have been prescribed for a child securely stored in a non-portable container and only named staff have access. A record is kept of any doses used and the amount of the controlled drug held in school  
• staff may administer a controlled drug to the child for whom it has been prescribed, doing so in accordance with the prescriber’s instructions. We keep a record of all medicines administered to individual children, stating what, how and how much was administered, when and by whom. An appropriate adult will sign the drug log when the medicine has been administered. Any side effects of the medication are also noted  
• when no longer required, medicines are returned to the parent/carer to arrange for safe disposal. Sharps boxes are used for the disposal of needles and other sharps.  

Emergency Procedures  

Where a child has an individual healthcare plan, this defines what constitutes an emergency and explains what to do, including ensuring that all relevant staff are aware of emergency symptoms and procedures. Other children in the school know what to do in general terms, such as informing a teacher immediately if they think help is needed. If a child needs to be taken to hospital, staff stay with the child until the parent/carer arrives, or accompanies a child taken to hospital by ambulance.  

Extra-curricular activities  

We are fully committed to actively supporting children with medical needs to participate in the full life of the school (including trips and visits) and to not prevent them from doing so. Healthcare plans endeavour to make teachers aware of how a child’s medical condition will impact on their  participation, but there is flexibility for all children to participate according to their own abilities and   with reasonable adjustments [unless evidence from a clinician states that this is not possible].  

Risk assessments are carried out so that planning arrangements take account of any steps needed to ensure that children with medical conditions are included. This includes consultation with the child him or herself, the parents/carer and any relevant external agency involved in the care of the child.  The school staff also make reference to the Health and Safety Executive guidance on school trips when making a risk assessment.  

Unacceptable Practice  

It is not acceptable practice (unless there is evidence included in the child’s individual healthcare plan from a medical professional) 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 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  
• prevent children from drinking, eating or taking toilet or other breaks whenever they need to  in order to manage their medical condition effectively
• require parents/carers, 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. 

Support for children with allergies and medical conditions

For any child who has a food allergy and or medical need the following procedures must be applied. Medical staff receiving the information have a responsibility to ensure all the respective staff are made aware of the allergy or medical need immediately. If applicable, two Epi-Pens must be requested from the parent or carer (1 kept in class and 1 in the office) and asthma pumps must be stored in the class with the children. Other medication should be kept in the school office.  The information must be entered onto Kelvin Grove SIMS recording system

•  The SENCO must ensure that all children with conditions that are potential emergencies have health care plans in place.
• The class teacher must have a full dietary and medical needs report printed from SIMS and must ensure that the details of these are considered before every trip
• The Lunchtime Coordinator must have a full dietary and medical needs report printed from SIMS
• The Club Xtra Leader must have a full dietary and medical needs report printed from SIMS
• The Breakfast Club Leader must have a full dietary and medical needs report printed from SIMS
• Club Leaders must have a dietary and medical needs report for the children that attend their club

Teachers and support staff will be trained on how to use an Epi-Pen. The SENCO keeps a list of the staff trained and their training.

Children with allergies now wear yellow lanyards and those with dietary preferences red (if they are below certain age).  Resources Manager liaises with the nutritionist as children join the school or their dietary requirements change.  Before the nutritionist has reviewed the child’s allergies, the school chef can provide a basic menu, however, most parents and carers provide the child with a packed lunch until the review has taken place.  The nutritionist produces a bespoke menu to match the child’s needs, this is sent to the child’s parents/carers for agreement.  Once the menu has been agreed, it is sent to the school office and the school chef.  Resources Manager sends dietary requirements to Club Xtra and Breakfast Club as and when they change​

Training  

Training to support the school in meeting the needs of children with medical conditions is provided on a regular basis, and from a range of practitioners (e.g. the administration of Epi-pens). This includes whole school awareness training, induction training for new members of staff and training for individually identified members of staff. On the basis of the need identified and the implications for school staff, we work to:

1. identify who the key people in school who require training/support are  
2. ascertain what their training needs are and who can provide the training  
3. ensure that the right staff access this training as swiftly as possible, and that it is implemented appropriately 
4. regularly review whether the child or staff training needs have changed, and act to address this.  

Staff must not give prescription medication or undertake health care procedures (e.g. changing tubes) without appropriate training (updated to reflect any individual healthcare plan).  

Other professionals  

The school works closely with a range of other professionals when supporting a child with medical needs including community paediatrics, audiology, community care nursing teams, specialist provision in hospitals, local GPs, etc. Our school nurse is keen to work closely in partnership with the school and parents/carers. Should a parent/carer wish to make an appointment with the nurse, please contact the SENCo (Rachael Johnson) who will be happy to assist? The school’s Education Welfare Officer (EWO) supports the school when children are absent, especially long- term absences associated with a medical need.  If you wish to contact the EWO, please liaise with Sara Hurst in the school office.

Complaints  

Should children or parents/carers be dissatisfied with the support provided, they should discuss their concerns directly with the class teacher. If for whatever reason this does not resolve the issue, they should discuss their outstanding concerns with the SENCO. Hopefully, the outcome of this will be satisfactory; however, if parents/carers remain concerned they may make a formal complaint via the school’s complaints procedure.  

Monitoring and Review  

This policy is monitored regularly by the Senior Leadership Team and is reviewed annually by the governing body.

Appendix A: Process for Developing Individual Healthcare Plans

Appendix B: Further Information about Individual Healthcare Plans

Plans are: 

• developed with the child’s best interests in mind  
• based on an assessment and management of any potential risk to the child’s education, health  and social well-being  
• easily accessible to all who need to refer to them while preserving confidentiality  
• capture key information and actions required to support the child effectively
• drawn up in partnership by parents/carers, the school and the relevant healthcare professionals who can best advice on a child’s unique needs  
• include the child him or herself as much as possible  
• reviewed at least annually or earlier if evidence is presented that the child’s needs have changed.

Plans also outline our provision for transition if a child is returning to school after a long period of absence. 

Staff involved in drawing up healthcare plans are aware that the following records may be useful to include, depending on the child’s unique needs:

• the medical condition – triggers, signs, symptoms and treatment  
• the resulting needs for the child including medication (dose, side effects and storage), other treatments, times, facilities, equipment, testing, access to food and drink where this is used to manage their condition, dietary requirements and environmental issues (e.g. crowded corridors)  
• specific support for the child’s educational, social and emotional needs  
• level of support needed, including in emergencies – if a child is self-managing their medication, this should be clearly stated with appropriate arrangements for monitoring  
• who provide the support, their training needs, expectations of their role and cover when they are absent
• who in the school needs to be aware of the child’s needs  
• arrangements for written permission from parents/carers and the Head Teacher for medication to be administered by a member of staff or self-administered during school hours  
• separate arrangements or procedures required for school trips/school journey (e.g., risk assessments)
• where confidentiality issues are raised by the child or parent/carer, the designated individuals to   be entrusted with information about the child’s condition  
• what to do in an emergency (e.g. who to contact).  

Appendix C: Roles and Responsibilities

Parents/carers are responsible for:

• providing the school with sufficient and up-to-date information about their child’s medical needs
• participating in the development and review of their child’s individual healthcare plan  
• carrying out any actions they have agreed to as part of the plan’s implementation (e.g., provide medicines)  
• ensuring that written records are kept of all medicines administered to children  
• ensuring they are another nominated adult is contactable at all times.  

The governing body is responsible for:

• making arrangements to support children with medical conditions in school, including making sure that this policy is in place  
• ensuring sufficient staff have received suitable training are competent before they take on responsibility to support children with medical conditions  
• ensuring that the school’s procedures are explicit about what practice is not acceptable  
• making sure it is clear how complaints may be made and will be handled concerning the support provided to children with medical conditions
• Ensuring the school’s policy clearly identifies the roles and responsibilities of those involved in the arrangements they make to support children at school with medical conditions  

The Head Teacher is responsible for:

• Promoting this policy with the whole staff team, parents/carers and interested members of the community 
• ensuring the continuing professional development and training needs of all staff are met, including the whole school staff regarding this policy generally, the First Aiders trained by the school as well as individual members of staff with responsibility for individual children
• Cover arrangements to ensure availability of staff to meet individual children’s needs  
• Monitoring the provision of individual healthcare plans for those children who require one.

The SENCO is responsible for:

• taking an operational overview and monitoring role in relation to this policy  and  school-wide practice in meeting the needs of children with medical needs
• ensuring all relevant staff are made aware of individual children’s condition, and that confidentiality is respected 
• briefing supply teachers or other cover staff who are engaged to meet the needs of individual children with medical needs  
• ensuring staff who provide support to this group of children are able to access information/support materials as needed  
• overall school liaison with the school nurse, including jointly monitoring the plans put in place for each child. 
• ensuring all children with medical needs have a healthcare plan, that it is kept up-to-date and is shared with all of the individuals who need to know about it 
• the related duties outlined in the allergies section. 

Class teachers are responsible for:

• supporting the child as much as possible in self-managing their own condition  
• risk assessment for school visits, school journey and other school activities outside of the normal timetable 
• implementing their actions identified in individual healthcare plans  

• Ensuring that the rest of the children in the class know what to do in case of an emergency (i.e., to tell an adult) 
• notifying the SENCO if there are issues or concerns with a child’s healthcare plan  
• Ensuring that asthma pumps are in date
• Ensuring that parents’ have completed an asthma plan to be stored with the pump

The medical officer is responsible for:

• Sending termly pupil detail reports to parents and carers for update
• Sending termly pupil detail reports to teachers for update
• Providing Club Xtra, Breakfast Club, the School Kitchen and the medical room with medical and dietary reports
• Providing pupil detail reports to teachers in July for class handover meetings
• Gaining permission from parents and carers of children with asthma to administer an emergency asthma pump if required
• Ensuring that two epi-pens are in school, one in the classroom and one in the school office
• Liaising with teachers and TAs in classes to ensure that asthma plans are kept in class and in the pupils file
• Liaising with the SENCO to ensure that care plans for children with conditions that are potential emergencies are up to date and displayed in the staff room, medical room and school office

Teachers and other school staff in charge of children have a duty to act in loco parentis and may need to take swift action in an emergency. This duty also extends to teachers leading activities taking place off the school site. This could extend to a need to administer medicine.                                 

Appendix D: Public Health England (2021)

Health Protection in Schools and other Childcare Facilities – Cpt 3: Prevention and Control’

Exclusion table

Infection	Exclusion period	Comments
Athlete’s foot	None	Athlete’s foot is not a serious condition. Treatment is recommended.
Chicken pox	Five days from onset of rash and all the lesions have crusted over
Cold sores (herpes simplex)	None	Avoid kissing and contact with the sores. Cold sores are generally mild and heal without treatment
Conjunctivitis	None	If an outbreak/cluster occurs, consult your local HPT
Diarrhoea and vomiting	Whilst symptomatic and 48 hours after the last symptoms.	See section in chapter 9
Diphtheria *	Exclusion is essential. Always consult with your local HPT	Preventable by vaccination. Family contacts must be excluded until cleared to return by your local HPT
Flu (influenza)	Until recovered	Report outbreaks to your local HPT.
Glandular fever	None
Hand foot and mouth	None	Contact your local HPT if a large numbers of children are affected. Exclusion may be considered in some circumstances
Head lice	None	Treatment recommended only when live lice seen
Hepatitis A*	Exclude until seven days after onset of jaundice (or 7 days after symptom onset if no jaundice)	In an outbreak of hepatitis A, your local HPT will advise on control measures
Hepatitis B*, C*, HIV	None	Hepatitis B and C and HIV are blood borne viruses that are not infectious through casual contact. Contact your local HPT for more advice
Impetigo	Until lesions are crusted /healed or 48 hours after starting antibiotic treatment	Antibiotic treatment speeds healing and reduces the infectious period.
Measles*	Four days from onset of rash and recovered	Preventable by vaccination (2 doses of MMR). Promote MMR for all pupils and staff. Pregnant staff contacts should seek prompt advice from their GP or midwife
Meningococcal meningitis*/ septicaemia*	Until recovered	Meningitis ACWY and B are preventable by vaccination (see national schedule @ www.nhs.uk). Your local HPT will advise on any action needed
Meningitis* due to other bacteria	Until recovered	Hib and pneumococcal meningitis are preventable by vaccination (see national schedule @ www.nhs.uk) Your local HPT will advise on any action needed
Meningitis viral*	None	Milder illness than bacterial meningitis. Siblings and other close contacts of a case need not be excluded.
MRSA	None	Good hygiene, in particular handwashing and environmental cleaning, are important to minimise spread. Contact your local HPT for more information
Mumps*	Five days after onset of swelling	Preventable by vaccination with 2 doses of MMR (see national schedule @ www.nhs.uk). Promote MMR for all pupils and staff.

Infection	Exclusion period	Comments
Ringworm	Not usually required.	Treatment is needed.
Rubella (German measles)	Four days from onset of rash	Preventable by vaccination with 2 doses of MMR (see national schedule @ www.nhs.uk). Promote MMR for all pupils and staff. Pregnant staff contacts should seek prompt advice from their GP or midwife
Scarlet fever	Exclude until 24hrs of appropriate antibiotic treatment completed	A person is infectious for 2-3 weeks if antibiotics are not administered. In the event of two or more suspected cases, please contact local health protection
Scabies	Can return after first treatment	Household and close contacts require treatment at the same time.
Slapped cheek /Fifth disease/Parvo virus B19	None (once rash has developed)	Pregnant contacts of case should consult with their GP or midwife.
Threadworms	None	Treatment recommended for child & household
Tonsillitis	None	There are many causes, but most cases are due to viruses and do not need an antibiotic treatment
Tuberculosis (TB)	Always consult your local HPT BEFORE disseminating information to staff/parents/carers	Only pulmonary (lung) TB is infectious to others. Needs close, prolonged contact to spread
Warts and verrucae	None	Verrucae should be covered in swimming pools, gyms and changing rooms
Whooping cough (pertussis)*	Two days from starting antibiotic treatment, or 21 days from onset of symptoms if no antibiotics	Preventable by vaccination. After treatment, non- infectious coughing may continue for many weeks. Your local HPT will organise any contact tracing

*denotes a notifiable disease. It is a statutory requirement that doctors report a notifiable disease to the proper officer of the local authority (usually a consultant in communicable disease control).

Public Health England (2021) ‘Health protection in schools and other childcare facilities‘.

Public Health England (2021) ‘Health Protection in Schools and other Childcare Facilities – Cpt 3: Prevention and Control’

https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/chapter-3-prevention-and-control Accessed 08/02/2022