This page is dedicated to our Making Schools Safer Project and includes all the resources that we have produced for schools, from allergy awareness presentations to teach pupils, to links to our free online e-learning AllergyWise courses. As part of this project, we recently made contact with over 26,000 UK schools on the lessons that can be learnt based on the inquest into Karanbir Cheema’s death.
Karanbir Cheema was a 13-year-old schoolboy who passed away following a tragic incident involving his allergies. This occurred at William Perkin Church of England High School on the 28th June 2017. We attended the inquest into the death of Karanbir Cheema, which concluded on 10th May 2019. Please read our full statement regarding the inquest into the death of Karanbir Cheema by clicking here.
The Coroner at the inquest highlighted significant areas of concern surrounding the responsibilities of schools. In our contact with schools, we highlighted these concerns alongside a number of our resources and links to further information to help schools raise awareness of allergies with their staff and pupils. These concerns and our associated schools resources are set out below, along with other additional resources.
The Matters of Concern Raised by the Coroner1. Pupil's Awareness of Allergies
The Coroner highlighted that there is a lack of awareness with pupils surrounding allergies and their lack of knowledge as to how serious allergies can be, and this is something that needs to be improved.
Resources that can help:
Our schools allergy awareness resource packs were created to facilitate an allergy awareness raising session with pupils. There are two separate packs, one for KS1 to 2 and another for KS3 to 5, and include all the materials a staff member should need including presentations, lesson plans and activities.
KS1-2 Schools Allergy Awareness Resource Pack
We have developed an allergy awareness resource pack for infant and primary schools allowing them to facilitate an allergy awareness session with their students. This includes materials such as lesson plans, presentations, worksheets and word searches.
KS3-5 Schools Allergy Awareness Resource Pack
The newest addition to our Making Schools Safer Project, our KS3-5 resource pack is designed to facilitate an allergy awareness session with secondary school students. This aims to improve student’s knowledge of severe allergies and to raise an awareness of the emotional impact that severe allergies can have. This resource pack includes a presentation and a lesson plan with included activities and videos.
The Coroner highlighted that the school’s healthcare plan and the medical box for Karanbir were not checked by school staff. It was also found that his adrenaline auto-injector was out of date by several months.
Resources that can help:
Supporting Pupils at School with Medical Conditions Guidance
Schools have a responsibility to develop individual healthcare plans for pupil’s with medical conditions, and this includes those with severe allergies. This falls under the Section 100 of the Children and Families Act 2014.
This healthcare plan must identify the pupil’s medical condition, triggers, symptoms, medication needs, and the level of support needed in an emergency. There must also be procedures in place to manage medicines on the premises, and ensure staff are appropriately supported and trained.
Specific statutory guidance has been developed under Section 100 of the Children and Families Act 2014, for England, Wales, Scotland and Northern Ireland on supporting children at school with medical conditions. The statutory guidance in this document is intended to help governing bodies meet their legal responsibilities and sets out the arrangements they will be expected to make, based on good practice. Please view these below.
Labels for Pupil’s Adrenaline Auto-Injector Boxes
Our printable labels are an ideal way to label boxes containing individual pupil’s adrenaline auto-injector pens. These can be printed off, filled in and stuck to the pupil’s medical box. This means that key information such as the pupil’s allergies and adrenaline auto-injector expiry dates are clearly visible on the outside of the box.
The Coroner emphasised that there is a need for standardisation with allergy action plans.
Resources that can help:
Allergy action plans are designed to function as Individual Healthcare Plans for children with food allergies, providing medical and parental consent for schools to administer medicines in the event of an allergic reaction, including consent to administer a spare adrenaline auto-injector.
The Anaphylaxis Campaign would recommend that all parents and schools use the British Society of Allergy and Clinical Immunology (BSACI) Allergy Action Plan to ensure continuity. This is a national plan that has been agreed by the BSACI, the Anaphylaxis Campaign and Allergy UK.
BSACI Allergy Action Plans
Allergy Action Plans are intended for children at risk of anaphylaxis, developed by the BSACI Paediatric Allergy Group.
These plans have been designed to facilitate first aid treatment of anaphylaxis, to be delivered by people without any special medical training nor equipment apart from access to an adrenaline auto-injector (AAI). They have been developed following an extensive consultation period with health professionals, support organisations including the Anaphylaxis Campaign, parents of food-allergic children and teachers.
Please note that it is the parent/carer’s responsibility to complete the allergy action plan with help from a healthcare professional (most likely a GP), and provide this to the school.
There are four plans available; a generic plan for individuals assessed as not needing an AAI, and a personal plan for individuals prescribed an EpiPen, Jext or an Emerade.
It was understood that two adrenaline auto-injectors were not available for Karanbir at school, and it was emphasised that two adrenaline auto-injectors must be available at all times.
Resources that can help:
In August 2017, the Medicines and Healthcare products Regulatory Agency (MHRA) released updated advice for healthcare professionals and people with allergies and their carers on adrenaline auto-injectors (AAIs) following a review of all devices approved in the EU. The review recommended that healthcare professionals prescribe two AAIs, which patients should carry at all times
The Anaphylaxis Campaign actively campaigns for people to be prescribed two AAIs. We firmly recommend that once prescribed they should always be kept with the patient so they have access to them at all times in case one is broken or misfires, or a second injection is needed before emergency help arrives. We therefore welcome this expression of support from the MHRA that patients should actively be prescribed two AAIs.
The Anaphylaxis Campaign do understand the difficulty in obtaining more than two AAIs so that two AAIs to be stored on the school premises. There will need to be communication between the parents, school and the healthcare professional to ensure that two AAIs are available for the child at all times.
The Coroner highlighted that there was a lack of awareness and education with the school staff about administering adrenaline auto-injectors, particularly about when to give the adrenaline auto-injector device.
Resources that can help:
AllergyWise is the name for our online e-learning courses and is the easiest way to learn about anaphylaxis, the risks of severe allergies and how to manage them. Below are two of our AllergyWise courses that we would recommend to schools which go into detail about the three adrenaline auto-injectors available in the UK and how to administer these.
Our AllergyWise for Schools Online Training Course
This free online course is designed to ensure that all staff members are fully aware of:
- The signs and symptoms of anaphylaxis
- How to provide emergency treatment
- The implications for management of severely allergic children in school
Our AllergyWise for Healthcare Professionals Online Training Course
This online course has been designed as a ‘train the trainer’ course for school nurses, first aid trainers, community nurses and nursery nurses with responsibility for training others. The course includes topics such as:
- How to recognise the symptoms of a severe allergic reaction
- How to use all currently licensed adrenaline injectors, including EpiPen, Emerade and Jext
- How to manage risks in school, early years and other community settings where severely allergic children and young people are cared for
- How to run your own anaphylaxis training in your school, nursery or other care setting with our easy to follow step-by-step guide
This online course has been accredited by the Royal College of Nursing, and includes resources such as trainer pens, presentations and lesson plans to help you run your own training sessions.
The allergy specialist providing medical knowledge at the inquest had the view that more generic adrenaline auto-injectors should be made available.
Resources that can help:
From 1st October 2017, the Human Medicines (Amendment) Regulations 2017 allowed schools in the UK to buy adrenaline auto-injector devices (known as AAIs) without a prescription to use in an emergency on children who are at risk of a severe allergic reaction (known as anaphylaxis) but whose own device is not available or not working. This could be because their AAI(s) are broken, or out-of-date, for example.
Purchasing Adrenaline Auto-Injector (AAI) Generic Pens for Schools
The Department of Health guidance on the use of adrenaline auto-injectors in schools 2017 sets out that schools can purchase AAIs from a pharmaceutical supplier, such as a local pharmacy, without a prescription, provided the general advice relating to these transactions are observed: i.e. small quantities on an occasional basis and the school does not intend to profit from it.
Our Additional Schools Resources
We have heard anecdotally, through our national helpline service, about allergic children being bullied by their peers at school. This is obviously an issue that should not be tolerated and should be taken very seriously by the school. A scientific paper was published that evaluated food-allergy related bullying incidents in a large sample of food allergic children in the US. This concluded that ‘32% of the surveyed children reported having been bullied due to food allergy at least once‘.
By law, all state schools must have a behaviour policy in place that includes measures to prevent all forms of bullying among pupils, and this is a policy decided by the school. All teachers, pupils and parents must be told what it is, and allergy bullying should be treated seriously, like any other bullying. Schools must, under Section 100 of the Children and Families Act 2014, aim to ensure that all children with medical conditions, in terms of both physical and mental health, are properly supported in school so that they can play a full and active role in school life, remain healthy and achieve their academic potential.
As part of the campaign, we have shared our #TakeTheKit video. The video highlights the importance for students to carry their medication with them at all times. The social stigmatisation of carrying Adrenaline Auto-Injectors and the extreme pressures on teenagers to ‘fit-in’ and seem ‘normal’ can lead to students not carrying their medication with them at all times. This is a risky and potentially life-threatening action. We hope that teachers will share this video in their lessons with all the students to raise awareness of anaphylaxis.
#TakeTheKit Watch. Share. Raise Awareness.
Our Doctor Doyle YouTube videos provide useful advice and tips including how adrenaline works, how to know when to use your adrenaline auto-injector and advice on how alcohol and kissing can affect an allergy.
Living with Anaphylactic Allergies – Izzy and Ben’s Story
A powerful animation involving two characters, Izzy and Ben, who both suffer with anaphylactic allergies. They share their story into how allergies have influenced their daily lives and the emotional impact it has had on them.
‘FAQs in Schools’ Factsheet
This is a Factsheet that we have created to help answer some of the questions frequently asked by schools surrounding allergies. These include questions such as ‘how many adrenaline auto-injectors should an allergic pupil in school have?’ ‘How do I administer an adrenaline auto-injector’ and outlines the responsibilities of the school, the family and the pupil.
Annual Risk Assessment
The headteacher of Fitzmaurice Primary School in Wiltshire and a supporter of the Anaphylaxis Campaign has produced a detailed Annual Risk Assessment that your school can download and undertake to help ensure pupils with allergies are kept safe.