Funding spare adrenaline pens for schools could save lives and millions for the NHS, study finds 

A new UK study led by Imperial College London, published in Archives of Disease in Childhood, finds that providing every school with spare adrenaline auto-injectors (AAIs) could improve emergency care for children and save the NHS at least £4.6 million a year. 

Anaphylaxis is a serious and potentially life-threatening allergic reaction that can happen within minutes of exposure to a trigger such as foods, insect stings, or medicines. Adrenaline is the first-line treatment and can quickly reverse symptoms. 

In the UK, around 3% of school-aged children have food allergies — meaning that in most classrooms, one or two pupils could be at risk of a serious allergic reaction.  

Why the study was needed 

Government guidance says children at risk of anaphylaxis should always carry two AAIs. Since 2017, UK law has allowed schools to hold “spare” AAIs for emergencies. However, many schools do not have them because they must pay for the AAIs themselves, often costing more than £100 each. 

Instead, families are frequently asked to supply extra AAIs to be kept at school. This creates several problems: 

• Cost and waste: Extra devices are prescribed to named individuals for school use, but most go unused and expire.  

• Safety gaps: Some schools still have no spare AAIs, even though around 20% of reactions at school occur in pupils without a prior diagnosis. 

• Delays in treatment: Staff may lose vital minutes looking for the correct named device rather than being able to use a universal spare immediately. 

The researchers therefore looked at whether it would be safer and cheaper for the NHS to supply spare AAIs centrally to schools rather than relying on extra prescriptions per child. 

How the study was carried out 

The team used anonymised NHS prescription data and national school numbers for the 2023/24 and 2024/25 school years. They compared current practice (prescribing extra AAIs so a set can be kept at school) with a proposed system in which each school receives four spare AAIs per year for use in any emergency. They also looked at the likely financial impact across local NHS regions. 

Key findings 

• Not all at risk children have AAIs: In the study cohort, not every child at risk of anaphylaxis had a recorded AAI prescription. 

• Many children are prescribed more than two AAIs: In 2023/24, 63% of children with an AAI prescription were given more than two devices; 60% received four or more – likely to cover both home and school. 

• High current cost: Providing more than two AAIs per child cost the NHS over £9 million in one year. 

• Supplying schools directly would be cheaper: Giving every UK school four spare AAIs would cost about £4.5 million a year – less than half the current spend and saving at least £4.6 million a year. 

• Most local NHS boards would save money: Out of 42 Integrated Care Boards (ICBs), three quarters would save over £10,000 each year, and some areas could save more than £400,000. 

What this means going forward 

The study suggests a centrally funded programme to supply spare AAIs to schools could be both safer and more cost-effective. Benefits would include: 

• Immediate access to lifesaving treatment for any pupil having anaphylaxis — including those without a prior diagnosis. 

• Reduced financial burden on families who currently provide multiple devices. 

• Simpler, faster training for school staff, using a single device type. 

• Less waste and stronger supply-chain management, helping to avoid shortages. 

The study follows recommendations from HM Coroners investigating recent tragic deaths and echoes successful models in Australia, Canada and the United States, where government funding has already reduced risks and improved outcomes for allergic children. 

Tracey Dunn, AllergyWise® and Education Manager at Anaphylaxis UK, said:  

“We are delighted about the findings of this research as there is an opportunity to remove the lottery of whether adrenaline auto-injectors are available in a school.  Having spare adrenaline auto-injectors available in every school ensures that young people are safeguarded — whether they already have a diagnosed allergy or are having anaphylaxis for the first time.” 

Read the full story here.