A Brief Overview

[Bronco Billy]

This post contains the same information as the Useful Information thread. It has been created to allow discussion on the information provided.



As we near the start of a new school year, I thought it might be helpful to post some information that you may find useful when discussing your child’s care needs with the school, or if you are unsure if the right care is being given. Please note that this won’t apply to independent schools as they are a law unto themselves. However, if your child attends a maintained school or an academy, I hope this information helps.

- Your child should have sufficient support to allow them to fully access school life, including trips and after-school clubs.

- Testing should be allowed in the classroom, as should the administration of insulin and hypo treatments. No child should be made to go elsewhere (the medical room, for example). In fact, as we all know, it can be dangerous to move too far when hypo. However, if your child wants to go somewhere else, that is perfectly ok.

- You can’t beat a good care plan! This can prevent many problems from arising, and help solve them when they do. Your DSN can help write it. When the school signs it, they are agreeing with the content and should observe it. The importance of a care plan can’t be stressed too much.

- Although school staff aren’t legally obliged to administer medicines, including insulin, many are prepared to, especially if the child is very young and recently diagnosed. This is usually included in the training they receive from your medical team.

- Secondary School can be a big change for all children, whether diabetic or not. They give pupils more independence than they will be used to from their time at Primary School. If your child has been supervised while giving themselves insulin, for example, this might not happen in Secondary School. That said, if your child needs or wants supervision, it should be made available.

- Any member of staff providing support to a child should have received appropriate training.

- The attendance record should not be affected if the absence is related to diabetes. For example, clinic appointments should not be counted as being absent from school and should not show on the attendance record.

- If a child needs to eat, drink or go to the toilet as part of managing their diabetes, they should be allowed to do so. If your child is at Secondary School, consider asking for a toilet pass. The variety of teachers involved in your child’s education means that it is possible one or two won’t be familiar with their condition. This possibility increases when a substitute teacher is in the classroom. A toilet pass will save time and, possibly, embarrassment for your child.

- Parents should not be made to feel obliged to go into school to give treatment, go on school trips or attend after-school clubs. Unfortunately, schools sometimes try to insist on this as a condition of the child being able to attend. If you want to be there, that’s fine, but the school shouldn’t insist that you are.

- All schools should have a Medical Conditions Policy. It’s usually available on the school’s website, but is available on request from the office.



More information about all of this, and a lot more besides, can be found at https://www.diabetes.org.uk/Guide-to-diabetes/Your-child-and-diabetes/Schools There are all sorts of useful tools there, including a sample care plan and a Good Practice Checklist.

 

[everydayupsanddowns]

This is a really helpful list. Thanks @Bronco Billy 🙂

 

[Schmee]

Bucking Bronco - I'm slightly concerned to read your post as I don't think it's accurate.

An individual staff member cannot be made to administer medicine to a child, but if there is a need for the child to have that medicine in school, a member of staff must be found or recruited. All staff have a responsibility to know how to deal with a medical emergency (for example this might include supervising the treatment of a hypo, or calling for help if a hypo becomes an emergency). This is really clear in the medical conditions in school guidance.

Secondly, it is not true to say that independent schools are laws unto themselves. It's useful to cover the requirements of independent schools as up to around one in ten of children with type one will be at private school (and should not be required to move to the state sector to ensure their participation and safety). Independent schools must abide by the Equalities Act 2010 and the guidance for schools relating to this Act. This means making reasonable adjustments for children with disabilities (type one diabetes is classified as a disability). Adjustments are considered reasonable unless the school can demonstrate objectively that they are not reasonable. So broadly speaking, the independent sector need to do the same as the state sector - if it is reasonable for an underfunded state school to make adjustments, why would it not be for a well funded independent school with much higher staffing levels per pupil? Secondly, schools have a duty of care under law to act as any prudent parent - this would include ensuring a child's safety.

It's also worth mentioning that extra-curricular activities are covered by all this guidance and legislation too.

 

[Bronco Billy]

Hi Schmee. Thank you for your comments. However, I can assure you that my post is 100% accurate. All information is in the document ‘Supporting Pupils at School with Medical Conditions’. I referred to it when writing my post.

When referencing the administration of medicine, this document says:

“Any member of school 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.”

One example of an emergency situation is the administration of glucagon. I work with medical professionals all over the country. Many of them don’t even allow glucagon to be kept at school, even more refuse to train staff in its use, insisting that only ambulance staff should administer it. Wearing another hat, I am working in partnership with others to change this, but, as things stand, this will happen only if the medical professionals can be persuaded to change their view.

While it is true to say that independent schools are required to abide by the Equalities Act, which includes the Reasonable Adjustments Duty, there is not a guidance document like the ‘Supporting Pupils….’ document for independent schools. The nearest equivalent they have is ‘The Education (Independent School Standards) Regulations 2014’. The only reference in this document of any relevance to this subject is contained in the ‘Welfare, health and safety of pupils’ section, and says:

“The standard in this paragraph is met if the proprietor ensures that—


(a) arrangements are made to safeguard and promote the welfare of pupils at the school”


I hope you will agree that this is very flimsy and completely lacks the depth of the Supporting Pupils….’ Document. The ‘Supporting Pupils….’ document is written with day to day care in mind, and is therefore referred to much more frequently than the Equalities Act, which will only come into play in the most extreme of cases. For these reasons, I am happy to leave the “law unto themselves” statement unedited. In my time as a volunteer for the DUK Care in School Helpline, I dealt with almost 50 cases. Only one involved an independent school.


I totally agree that it is worth mentioning that extra-curricular activities are covered by the legislation. In fact, the first paragraph of ‘useful information’ says

“Your child should have sufficient support to allow them to fully access school life, including trips and after-school clubs.”


I notice you are also a parent of a child with diabetes, so I hope your child is receiving the care they need at school. Most are fine, some need a little nudge in the right direction.

 

[Schmee]

As I said, individual teachers cannot be forced to be the ones who administer medication. The responsibility rests with the school/LA to find volunteers amongst their staff who are willing to be trained to do so. Notwithstanding there is a duty of care on all members of staff. This is really important to be clear about as a number of parents are being asked by schools to go in and administer insulin which, as you point out, is in direct contravention of the Supporting Pupils document. I fear that someone reading your posts would think that school does not have a responsibility and that it is voluntary. It is not (it is for the individual teacher, but not for the school in general). This has been supported by tribunal cases. Glucagon is a moot point and a separate argument (about what is proportionate in an emergency situation and clinic's resources for training/knowledge of the Medicines Act) but it is encouraging that many clinics (including the "top" ones) will train volunteers (and also in line with the NICE Guidelines depending on your interpretation of "carer" and the duty of care)

Re independent schools, my concern here is that someone reading your post would think that independent schools can do what they want - that "they are a law unto themselves". That's absolutely incorrect and could have devastating consequences for thousands (probably approximately 2,000) of children with diabetes who attend independent schools.

The Supporting Pupils... document is not statutory guidance for independent schools but it is explicitly intended to be used as a guide for those schools. The recourse for an independent school pupil would be different - via the Equalities Act. I'm not aware of any tribunal cases which could be used to support the argument, but it would be difficult for an independent school to demonstrate that it is objectively unreasonable to provide support in line with practice in state schools.

I don't want to be critical as it's really helpful to have a forum for discussion, but it must be remembered that people may read posts and interpret them as factual, so it's important to be factual.

 

[Bronco Billy]

The guidance document makes no specific reference to the responsibility of LAs or schools to administer insulin beyond what I have already quoted. There are a couple of paragraphs that could be used by them to check what their responsibilities are. For LAs, they are:

“Training should be sufficient to ensure that staff are competent and have confidence in their ability to support pupils with medical conditions, and to fulfil the requirements as set out in individual healthcare plans. They will need an understanding of the specific medical conditions they are being asked to deal with, their implications and preventative measures.”

And

“……………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. …………………………………….”


For Head Teachers, it says:

“………………………..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…………………….”



In all of those cases, this information is in a part of the document that is advisory only, it isn’t statutory. I think we will agree that it would be great if it was made statutory. It serves to highlight one of the points made in my original post about the importance of the care plan. If the care plan says the school will provide someone to administer the insulin and they sign the care plan, they will then have to do so.


As I said previously, I stand by what I said about independent schools. The Equalities Act is relevant to them, but a situation has to be serious for it to apply. It won’t be applicable in most everyday situations. While the guidance is intended to be a guide for them also, unfortunately, they are under no obligation to take any notice of it if they don’t want to. I think it should apply to them, but it’s true to say it doesn’t.

My original post was never designed to be an absolute guide to all situations. I wanted to give a brief overview of what parents could expect from their school, highlighting the most common issues that arise. The reason this board was set up was for parents to ask for advice about specific situations.