Every school is likely to have at least one pupil who is severely allergic to a type of food, and many schools will have more.
Our FREE online anaphylaxis training course AllergyWise for Schools is designed to ensure that key staff in schools are fully aware of the signs and symptoms of anaphylaxis, how to provide emergency treatment and the implications for management of severely allergic children from Key Stages 1 to 5 in an education setting. Find out more and register here.
For many children, the symptoms of allergy are mild. However, occasionally the symptoms are severe and they may even be life-threatening. The common causes of severe allergic reactions (anaphylaxis) include foods such as peanuts, tree nuts, milk, eggs, shellfish, fish, sesame seeds and kiwi fruit, although many other foods have been known to trigger anaphylaxis. Peanut allergy is particularly common – with one in 70 children nationwide thought to be affected.
Non-food causes of anaphylaxis include wasp or bee stings, natural latex (rubber) and certain drugs such as penicillin.
The good news is that even the most severe form of allergy is manageable. The vast majority of the children affected are happily accommodated in mainstream schools thanks to good communication between parents, school staff, doctors and education authorities. With sound precautionary measures and support from the staff, school life may continue as normal for all concerned.
Purchasing Adrenaline Auto-Injector (AAI) Generic Pens for Schools
The DOH 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. A supplier will need a request signed by the principal or head teacher (ideally on appropriate headed paper) stating:
- The name of the school for which the product is required;
- The purpose for which that product is required, and
- The total quantity required.
A template letter which can be used for this purpose is provided in Appendix 1, and can also be downloaded at: www.sparepensinschools.uk
Please note that pharmacies are not required to provide AAIs free of charge to schools: the school must pay for them as a retail item. The retail price is circa £26 and your local pharmacy may add a small handling charge.
We are aware that some schools are being charged substantially more than this. Please contact the Helpline on 01252 542029 if you have concerns regarding the cost of AAIs.
Information for school staffThe law and guidance for schools in the UK
The laws relating to looking after children with medical conditions in school in the UK vary depending on whether the school is in England, Scotland, Wales or Northern Ireland.
The Department of Health in England published statutory guidance “Supporting pupils at school with medical conditions” in December 2015 which is available to read on the Government website here.
The Scottish Government published “Guidance on Healthcare Needs in Schools” in December 2017 which is a guidance document for NHS Boards, education authorities and schools about supporting children and young people with healthcare needs in schools. This guidance replaces the previous guidance on the administration of medicines in schools which was published in 2001 and is available on the Scottish Government website here.
The guidance document “Access to education and support for children and young people with medical needs” was published by the Welsh Government in 2010. This has been revised to take into account changes to equalities legislation and replaced with the statutory guidance “Supporting learners with healthcare needs“, published in March 2017, and is available on the Learning Wales website here.
Joint guidance “Supporting pupils with medication needs” was published by the Department of Education and the Department of Health, Social Services and Public Safety in February 2008 and is available to read on the Department of Education website here.
The Health Conditions in Schools Alliance
The Anaphylaxis Campaign is part of the Health Conditions in School Alliance, made of over 30 organisations, including charities, healthcare professionals and trade unions who work collaboratively to make sure children with health conditions get the care they need in school.
The Alliance has produced an explanation of the legal situation in each nation in the UK about supporting children with medical conditions in schools. You can access this document here. Please note some of the information about Wales and Scotland has been updated since this document was published.
About the spare pens in schools campaign
For two years the Anaphylaxis Campaign – together with Allergy UK, the British Society for Allergy & Clinical Immunology (BSACI), the British Paediatric Allergy Immunity and Infection Group (BPAIIG), and the Royal College of Paediatrics and Child Health (RCPCH) – campaigned for a change in the law to allow schools, pre-schools and nurseries to hold generic adrenaline auto-injectors, and ensure they have sufficient trained staff to operate the device in case of an emergency.
From 1st October 2017, the Human Medicines (Amendment) Regulations 2017 will allow 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.
You can read more about the campaign here.
FAQs about spare pens in schools
Our Helpline and Information Team have received questions through the Anaphylaxis Campaign helpline from school nurses and school staff about spare pens in schools and The Human Medicines (Amendment) Regulations 2017. Links to guidance for schools and our top tips and advice to some of the most frequently asked questions are here.
Our tips for how school staff can help children with allergies at school include…
- Ensure that catering supervisors are aware of an allergic child’s requirements, this may be done by creating a log with photographs of children with allergies. However, this should be dealt with sensitively, and not be visible to students. Review health records submitted by parents.
- Be aware that some allergens, such as milk, are much more common in schools, and therefore may require a more extensive strategy.
- Include food-allergic children in school activities. Pupils should not be excluded based on their allergy. School activities should be designed and developed to ensure the inclusion of food allergic pupils.
- Ensure the staff have received high-quality training in managing severe allergies in schools, including how to use an adrenaline auto injector. The Anaphylaxis Campaign offers online training through its AllergyWise training programme.
- Identify a core team to work with parents to establish prevention and treatment strategies. Arrange staff training (your school nurse should be able to help you to arrange this). Ensure all staff can recognise symptoms; know what to do in an emergency, and work to eliminate the use of allergens in the allergic pupil’s meals, educational tools, arts and crafts projects.
- Ensure that medications are appropriately stored, and easily accessible in a secure location (but not locked away) central to designated staff members.
- Review policies after a reaction has occurred.
You can find more information and advice in our FAQs in Schools Factsheet.
Children who are considered to be at risk of life-threatening allergic reactions are prescribed adrenaline injectors and school staff may be asked to be trained to administer them.
AllergyWise for Schools
Our free online anaphylaxis training course AllergyWise for Schools is designed to ensure that key staff in schools are fully aware of the signs and symptoms of anaphylaxis, how to provide emergency treatment and the implications for management of severely allergic children from Key Stages 1 to 5 in an education setting. Find out more and register here.
AllergyWise for Healthcare Professionals
We also have AllergyWise for Healthcare Professionals, an essential “train the trainer” resource for school nurses, first aid trainers, community nurses and nursery nurses with responsibility for training others which is accredited by the Royal College of Nursing (RCN), with discounted access for Professional Members of the Anaphylaxis Campaign. Find out more and register here.
BBC Bitesize has an animation tool called “Living with anaphylactic allergies – Izzy and Ben’s story” that could be particularly useful for teachers to educate pupils about allergies and anaphylaxis and what is means to understand and respect differences. You can access the resource here.
Children with allergies should have every opportunity to take part in out-of-school activities such as ski-ing trips and other foreign holidays, sports events hosted by other schools and educational visits to museums. Such activities will need careful planning and preparation, but there is no reason to exclude a child with allergies. A meeting with the child’s parents will be necessary to ensure that everyone is happy with the arrangements. If the child is allergic to a food, similar procedures need to be followed to those in operation at school to ensure that the child does not come into contact with the food.
If the child has been prescribed an adrenaline auto-injector, at least one person trained in administering the device must accompany the school party. From the child’s point of view, it is not advisable for a parent to accompany them on school trips, although in some cases this may be unavoidable.
In the case of sports events, it’s advisable to ensure your PE teacher is fully aware of the situation and notifies the schools to be visited that a member of the team has an allergy when arranging the fixtures. Should another school feel they are not equipped to cater for the allergic child you could arrange (as a last resort) for the child to take their own tea.
Managing insect sting allergy
Insect sting allergy causes a lot of anxiety and needs careful management. Children need to take special care outdoors, wearing shoes at all times and making sure any food or drink is covered. Adults supervising activities must ensure that suitable medication is always on hand. You can find more information and advice in our Insect Sting Allergy Factsheet here.
“The management of the allergic child at school” is a key recommendation document produced in 2010 by a task force made up of allergy experts from 12 key European institutions, with input from organisations that included the Anaphylaxis Campaign. You can access the document here.
The BSACI has Allergy Action Plans for children at risk of anaphylaxis available to download on their website. These plans are 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 autoinjector (AAI). Find out more here.
School nurses are welcome to join as a Healthcare Professional Member of the Anaphylaxis Campaign. Our members receive information and advice tailored for doctors, nurses, clinical professionals, first aid trainers and researchers with an interest in severe allergy, while helping us to raise the profile of severe allergy and support others who live with life threatening allergies. Find out more here.
Support for related organisations, parents, carers and pupilsInformation for catering staff
Advice for Catering Organisations and Corporate Membership
The Anaphylaxis Campaign provides advice for catering organisations on protecting allergic customers including assessing rick and practical safety measures.
As Corporate Members of the Anaphylaxis Camapign we will provide you with information specifically tailored to the Food Industry and, by supporting us in this way, you will contribute to our work to protect customers with allergies in all aspects of living with severe allergy. One of the many member benefits is the opportunity to attend our Member Conferences where leading UK experts are invited to speak on current issues. You can find out more about becoming a Corporate Member here.
FAQs in Schools Factsheet
Our tips for how parents and carers can help children with allergies at school include…
- Notify the school of the child’s allergies. Ensure there is clear communication.
- Work with the school to develop a plan that accommodates the child’s needs throughout the school including in the classroom, in dining areas, in after-school programmes, during school sponsored activities and on the school bus. Ask your doctor, school nurse, allergy specialist or paediatrician to help.
- Provide written medical documentation, instructions and medications as directed by a doctor. Replace medications after use or upon expiry. Emergency kits in school should be checked termly to ensure they are stored correctly, are still in date, and ready for use.
- Educate the child in allergy self-management, including what foods are safe and unsafe, strategies for avoiding allergens, how to spot symptoms of allergy, how and when to tell an adult of any reaction, and how to read food labels.
- Provide a “stash” of safe snacks for special school events (to be stored in school) and periodically check its supply and freshness.
- Speak to their close friends about the signs and symptoms of a reaction, if the child is happy with them being involved.
- Review policies and procedures with the school staff, school nurse, the child’s doctor and the child (if age appropriate) after a reaction has occurred.
- Encourage the school to purchase a spare pen, as allowed under the October 2017 legislation.
You can find more information and advice in our FAQs in Schools Factsheet.
Anaphylaxis online training
AllergyWise is our allergy information website designed to help people with severe allergies, and those who care for them, learn more about how to recognise the signs of a severe allergic reaction, what to do in an emergency and how to manage their condition day-to-day. We have free courses available for parents and carers of school-age children. Find out more and register here.
Join as a member of the Anaphylaxis Campaign and receive information and advice for managing your child’s allergy, while helping us to raise the profile of severe allergy and support others who live with life threatening allergies. Find out more here.
Our Helpline team provide support in the form of a listening ear and good advice to you confidence in managing the risks associated with your child’s condition. Call the helpline team on 01252 542029 between 9am to 5pm, Monday to Friday or email them via [email protected] for completely free advice and information.
We understand that being young and trying to manage your severe allergy can be hard work and want to help you to face whatever life throws at you with all the best information and support available so that you can get on with life. Our top tips for staying safe at school include…
- Be sure not to exchange food with others.
- Avoid eating anything with unknown ingredients.
- Be aware that cosmetics may also contain allergens.
- Be proactive in the care and management of your food allergies and reactions.
- Notify an adult immediately if you eat something you believe may contain the food to which you are allergic.
- Notify an adult immediately if you believe you are having a reaction, even if the cause is unknown.
- Always wear your medical alert bracelet or some other form of medical identification.
We have a section on our website with advice specifically for young people here.