Policy for Supporting Pupils at School with  Medical Conditions 2022-2023 

Designated Lead Person:

Ratified by Governing Body:         11/10/23                        Chair of Governors: Chris Wright

INTRODUCTION

We want all children and young people to have successful and fulfilling lives. Section 100 of the  Children and Families Act 2014 places a statutory duty on all schools to effectively manage and  meet the needs of pupils with medical conditions, medical needs and physical disabilities. The aim  is to ensure that all children with medical conditions, in terms of both physical and mental health,  are properly supported in school. The outcome should be that they can play a full and active role  in all aspects of school life including trips, educational visits, residential and extended school  activities, in that they remain healthy and achieve their academic potential.  

This policy document should be considered in conjunction with all other relevant duties, policies  and guidance, for example, Health and Safety legislation, the SEND code of practice and the  Equality Act 2010 that may impact on support / provision for pupils with medical conditions.  

Some children with medical conditions may be disabled. Where this is the case the governing body  must comply with the duties under the Equality Act 2010. For example, schools are required to  make reasonable adjustments to minimise or remove barriers to access and participation and  ensure that individuals are not subject to less favourable treatment because of their disability.  Some children may also have special educational needs (SEN) and may have a statement or  Education, Health and Care Plan (EHC Plan) which brings together health and social care needs  as well as their special educational provision. For children with SEN this policy should be read in  conjunction with the school SEN policy.

Supporting a child with a medical condition during school hours is not the sole responsibility of one  person and the Academy’s ability to provide effective support will depend on co-operative working  with other agencies including healthcare professionals, the local authority, parents/carers, the child and, where appropriate, social care or other outreach professionals. This type of partnership  working aims to ensure that the needs of pupils with medical conditions are met effectively.  

Medical conditions can sometimes result in short term, frequent or long term absence from school,  which can impact on educational attainment. Schools are required to recognise and consider the  potential social and emotional implications associated with a medical condition, as well as the  educational impact, when planning to meet the pupil’s needs.  

In some instances, medical conditions may become a safeguarding issue, on these occasions the  Designated Safeguarding Lead would be informed and the Safeguarding Policy be followed.

PURPOSE OF DOCUMENT 

The purpose of this policy is to put in place effective management systems, arrangements and  practices to support children and young people with medical conditions to attend school.  

This policy also aims to give confidence to parents/carers that the academy will provide effective support  for their child’s medical condition and support their child to feel safe.

This policy clarifies the range of medical needs that may result in a child requiring support, namely:

• children with long term and/or complex medical conditions who require support to manage their  medical needs on a day to day basis to keep them healthy;
• children requiring monitoring and/or intervention in emergency circumstances; ∙ children whose health needs may change over time in ways that cannot always be predicted.

All staff in schools and academies have a duty to maintain professional standards of care and to  ensure that children and young people are safe. It is considered to be good practice that schools  and academies will consider and review cases individually and actively support pupils with medical  conditions, including administering medicines or medical interventions in order to meet the all round needs of the child. However, there is no legal duty requiring individual staff to administer medication, carry out medical interventions or to supervise a child when taking medicines. Any member of staff may be asked to administer medicines or medical interventions but they cannot be  required to do so. This is a voluntary role.

This policy aims to ensure that appropriate support is put in place to limit the impact on educational  attainment in the event of a short or long term absence from school. Refer to Co-op Academy  Broadhurst’s Attendance policy on managing attendance.

ROLES AND RESPONSIBILITIES

The Trust 

The Trust is responsible for:

• ensuring the Head Teacher develops and effectively implements policy with partners and Academy staff, including regular policy review;
• ensuring the Head Teacher makes all staff aware of this policy on supporting pupils with  medical conditions and all staff understand their role in its implementation;
• designating a named individual who is responsible for effective implementation of this policy – Clare Bardsley;
• ensuring this policy clearly identifies how the roles and responsibilities of staff who are involved  in the arrangements to support pupils at school with medical conditions are made clear to both  staff, parents/carers and the child;
• ensuring that all relevant staff are aware of an individual child’s medical condition and needs;
• ensuring that sufficient numbers of staff receive appropriate training to fulfil the roles and  responsibilities of supporting children with medical conditions i.e. are able to deliver against all  Individual Healthcare Plans (IHCPs) and implement policy, including in contingency and  emergency situations;
• ensuring that a system is in place which identifies procedures to be followed on receipt of  notification of a pupil’s medical needs; procedures should cover any transitional arrangements  or when pupil needs change (see Appendix 1);
• ensuring that cover arrangements are always available in the event of staff absence or staffing changes including briefing for volunteers, supply teachers and appropriate induction for new  members of staff;
• ensuring that individual healthcare plans (IHCPs) are in place, where appropriate, and  developed in consultation with parents/carers, healthcare professionals, relevant staff and (if  appropriate) the child or young person;
• ensuring that individual healthcare plans (IHCPs) are monitored and are subject to review, at  least annually, or sooner if needs change;
• ensuring that risk assessments relating to the school environment are in place, as appropriate,  including consideration for actions to take in the event of emergency situations;
• ensuring that risk assessments relating to off-site visits, residential trips and extended school  opportunities offered outside the normal timetable are in place, as appropriate, including  consideration for actions to take in the event of emergency situations;
• ensuring that appropriate insurance is in place to support staff to undertake this role; ∙ ensuring that a complaints procedure is in place and is accessible.

The Head Teacher 

The Head Teacher is responsible for:  

• ensuring that the notification procedure is followed when information about a child’s medical  needs are received (Appendix 1);
• ensuring that parents/carers provide full and up to date information about their child’s medical  needs by completion of ‘Parent/Carer Information about a Child’s Medical Condition’ form  (Template A)
• deciding, on receipt of a ‘‘Parent/Carer Request and Agreement for the Academy to Administer  Medicines / Medical Interventions’ form (Template B), on case by case basis, whether any  medication or medical intervention will be administered, following consultation with staff;
• deciding, on receipt of a ‘Parent/Carer Request for the Child’s Self–administration of  Medication/Medical Intervention (Template C), on a case by case basis, whether any  medication will be carried by the child, will be self-administered by the child or any medical  intervention will be self-administered by the child, following consultation with staff, if  appropriate;
• ensuring that procedures are understood and implemented by all staff, volunteers and pupils.

Staff

Any member of staff may be asked to provide support for a child with a medical condition, including  the administration of medicine(s) and medical intervention(s), although they cannot be required to  do so; this is a voluntary role.

School staff will receive sufficient and suitable training and achieve competency before they take  on responsibility for supporting children with medical conditions.

Where children have an Individual Healthcare Plan (IHCP) the roles and responsibilities of staff will  be clearly recorded and agreed.

Parents/Carers 

Parents/carers are required to:

• provide the school with sufficient and up to date information about their child’s medical needs  and to update it at the start of each school year or, if needs change, by completion of  ‘Parent/Carer Information about a Child’s Medical Condition’ form (Template A);
• complete, if appropriate, a ‘Parent/Carer Request and Agreement for the Academy to  Administer Medicines / Medical interventions’ form (Template B) to gain consent for medicines /  medical interventions to be administered at school;
• complete, if appropriate, a ‘Parent/Carer Request for the Child’s Self–administration of  Medication/Medical Intervention’ form (Template C) to gain consent for medicines / medical  interventions to be administered by the child;
• provide up to date contact information so that parents/carers or other nominated adults are  contactable at all times;
• carry out any action they have agreed to as part of the implementation of an Individual  Healthcare Plan (IHCP);
• provide any medication in its original packaging, with the pharmacy label stating the following:

a) the child’s name

b) the child’s date of birth

c) name of medicine

d) frequency / time medication administered

e) dosage and method of administration

f) special storage arrangements

• ensure that medicines or resources associated with delivery of a medical intervention have not  passed the expiry date;
• collect and dispose of any medicines held in school at the end of each term or as agreed; ∙ provide any equipment required to carry out a medical intervention e.g. catheter tubes; ∙ collect and dispose of any equipment used to carry out a medical intervention e.g. sharps box.

PUPIL INFORMATION 

Parents/carers are required to give the following information about their child’s medical condition  and to update it at the start of each school year or sooner, if needs change, by completion of ‘Parent/Carer Information about a Child’s Medical Condition’ form (see Template A):

a) Details of pupil’s medical conditions and associated support needed at school

b) Medicine(s), including any side effects

c) Medical intervention(s)

d) Name of GP/Hospital and/or Community Consultants/Other Healthcare Professionals

e) Special requirements e.g. dietary needs

f)  Who to contact in an emergency

g) Cultural and religious views regarding medical care

MANAGING MEDICINES / MEDICAL INTERVENTIONS ON SCHOOL PREMISES 

Administration of Medicines / Medical Interventions 

Medicine / medical interventions will only be administered at school when it would be detrimental to  pupil’s health or attendance not to do so. Parents/carers must, in this case, sign the appropriate  form allowing a named member of staff to administer the medication (please see form in Appendix)

It is expected that parents/carers will normally administer medication / medical interventions to their  children during their time at home, where at all possible.  

No medication / medical intervention will be administered without prior written permission from the  parents/carers. ‘Parent/Carer Request and Agreement for School to Administer Medicines /  Medical Interventions’ (Template B)

The Head Teacher will decide whether and by whom any medication or medical intervention will be  administered in school, following receipt of the above form and after consultation with staff.

No changes to administration method or dosage of medication or changes in procedures relating to  medical interventions will carried out without written authority from parents/carers and recorded  amendment to the ‘Parent/Carer Request and Agreement for School to Administer Medicines /  Medical interventions’ form (Template B)

The Head Teacher / Principal will decide whether a child is able to carry and self-administer any  medication or self-administer any medical intervention, following consultation with staff as  appropriate ‘Parent/Carer Request for the Child’s Self–Administration of Medication/Medical  Intervention’ (Template C);

All medicines / medical interventions will normally be administered during school breaks and/or lunchtime.

If, for medical reasons, medicine has to be taken at other times during the day or a medical  intervention delivered at a different time, arrangements will be made for the medicine / medical  intervention to be administered at other prescribed times.

Pupils will be told where their medication / medical intervention equipment and resources are kept  and who will administer them.

Any member of staff, on each occasion, giving medicine / medical intervention to a pupil should  check:

a) Name of pupil

b) Written instructions provided by the parents/carers or healthcare professional or as agreed  in an Individual Healthcare Plan (IHCP)

c) Prescribed dose, if appropriate

d) Expiry date, if appropriate  

Any member of staff, on each occasion, will make a written record of medication / medical  interventions administered on the ‘Record of Administration of Medicines/Medical Intervention to an  Individual Child’ (Template C)

No child under 16 will be given medicine containing aspirin unless prescribed by a doctor.

Child’s Role in Managing their own Medical Needs

After discussion with parents/carers, children who are competent will be encouraged to take  responsibility for managing their own medicines and medical interventions.

Written permission from the parents/carers will be required for pupils to self-administer medicine(s)  / medical intervention(s). The school’s ‘Parent/Carer Request for the Child’s Self–administration of  Medication/Medical Intervention (Template C) must be completed by parents/carers.

Written permission from the parents/carers will be required for pupils to carry medicine(s) or  resources associated with a medical intervention(s). The school’s ‘Parent/Carer Request for the  Child’s Self–administration of Medication/Medical Intervention (Template C) must be completed by  parents/carers.

Children who can take medicines or manage medical interventions independently may still require  a level of adult support e.g. in the event of an emergency. In this situation agreed procedures will  be documented in an IHCP.

Refusing Medication / Medical Intervention

If a child refuses to take their medication / medical intervention, staff will not force them to do so.  Refusal to take medication will be recorded and dated on the child’s record sheet. Reasons for  refusal to take medications / medical intervention must also be recorded as well as the action then  taken by the member of staff.  

Parents/carers will be informed as soon as possible. Where the child is potentially placing  themselves at risk by refusal, parents/carers will be informed immediately.

Storage of Medicines / Medical Intervention Equipment and Resources

All children will know where their medicines / medical intervention equipment/resources are at all  times and will be readily available as required.

Controlled drugs

A child who is 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.

Where controlled drugs are not an individual child’s responsibility, they will be kept in a non portable locked cabinet in a secure (named) environment - admin office. Only named staff will have  access.

Controlled drugs will be easily accessible in an emergency as agreed with parents/carers or  described in the child’s IHCP.

Where controlled drugs are not an individual child’s responsibility, records will be kept of any doses  used and the amount kept on the premises.  

Non-controlled drugs and medical resources

All medicines and medical equipment / resources will be stored safely as agreed with  parents/carers or described in the child’s IHCP.

Records

The Academy will keep a record of all medicines / medical interventions administered to individual  children on each occasion, including the following:  

a) Name of pupil

b) Date and time of administration

c) Who supervised the administration

d) Name of medication

e) Dosage

f) A note of any side effects / reactions observed  

g) If authority to change protocol has been received and agreed.  

Record of Administration to an Individual Child (Template D) and Record of Medicine Administered  to All Children (Template E).  

TRAINING 

Staff must not give prescription medicines or undertake healthcare procedures without appropriate  training. A First Aid Certificate does NOT constitute appropriate training in supporting children with  medical conditions.

All staff will be made aware of the school’s policy for supporting pupils with medical conditions and  their role in implementing that policy through for example whole school awareness training,  involvement in development of IHCPs, staff briefing sessions etc.

Specialist training and advice will be provided by appropriate healthcare professionals, e.g.  specialist epilepsy nurse, asthma training by school nurse etc, for staff involved in supporting  pupils with medical conditions including the administration of relevant medicines / medical  interventions.  

Training for all staff will be provided on a range of medical needs, including any resultant learning  needs, as and when appropriate.

Training will be sufficient to ensure 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. Induction training will raise awareness of the school's policy and practice on  supporting pupils with medical condition(s).

The Academy will make every effort to ensure that specialist training will be completed as quickly as possible to ensure that the child is able to attend school safely.

A record of staff training carried out will be kept, identifying the date review or refresher training will  be required where appropriate.

INDIVIDUAL HEALTH CARE PLANS (IHCP)

Where appropriate, an Individual Health Care Plan (IHCP) will be drawn up in consultation with the  Academy, parents/carers, health professionals and any other relevant professionals.  

The content of an individual child’s IHCP will be dependent on the complexity of their needs and  may include the following:  

1. an overview (Pen Portrait / One Page Profile) of the child’s needs and provision in place in  school to manage those needs;
2. a description of the medical condition, its presentation (signs, symptoms, triggers etc) and  impact on access to the school environment and learning opportunities;
3. arrangements around administration of medication(s) / medical intervention(s);
4. arrangements around management of medical emergency situations;
5. arrangements around management and support for personal care needs, including intimate  and invasive care e.g. catheterisation, toileting support, gastro-tube feeding etc;
6. risk assessment for access to the school environment and curriculum;
7. arrangements for evacuation in the event of an emergency;
8. the level of support required in school, who will provide this support, their training needs  and cover arrangements for when they are unavailable;
9. how, if agreed, the child is taking responsibility for their own health needs; j) a reference to staff confidentiality.

Appendix 2 is a FlowChart to guide schools through deciding which elements of the IHCP are  relevant to an individual child.

Individual Health Care Plans will be reviewed annually or sooner if needs change.

Intimate and Invasive Care

Cases where intimate or invasive care is required will be agreed on an individual basis. Decisions  made about procedure and practice will be recorded within the pupils Individual Healthcare Plan  IHCP and take account of safeguarding issues for both staff and pupils.

Information about the types of training required for administration of medicines and medical  interventions commonly found in schools is contained in Appendix 3 (Medicines and Medical  Interventions).

OFF-SITE AND EXTENDED SCHOOL ACTIVITIES

Pupils with medical conditions will be actively supported in accessing all activities on offer including  school trips, sporting activities, clubs and residential / holidays.  

Preparation and forward planning for all off-site and extended school activities will take place in  good time to ensure that arrangements can be put in place to support a child with a medical  condition to participate fully.

The Academy will consider what reasonable adjustments need to be put in place to enable children  with medical conditions to participate safely and fully.

The Academy will carry out a thorough risk assessment to ensure the safety of all pupils and staff.  In the case of pupils with medical needs the risk assessment process will involve consultation with  child, parents/carers and relevant healthcare professionals to ensure the pupil can participate  safely. Please refer to Health and Safety Executive (HSE) Guidance on School Trips.

In some circumstances evidence from a clinician, such as a hospital consultant, may state that  participation in some aspects offered is not possible. Where this happens the school will make  alternative arrangements for the child.

Arrangements will be in place to ensure that an IHCP can be implemented fully and safely when  out of school. Risk assessment will identify how IHCPs will be implemented effectively off-site and  where additional supervision or resources are required.

MANAGING EMERGENCIES AND EMERGENCY PROCEDURES 

The Head Teacher will ensure that all staff are aware of the school’s general risk management  processes and planned emergency procedures.

Where a child has an IHCP this will clearly define what constitutes an emergency and describes  what to do. This may include:

1. an Emergency Medical Protocol that details the actions to be taken by staff and supported  by specialist training where relevant e.g. seizure management and administration of rescue  medication;
2. a Personal Emergency Evacuation Plan (PEEP) that details the actions to be taken by staff  to support the child’s evacuation from the building, supported by specialist training where  relevant e.g. use of an Evac chair; the Personal Emergency Evacuation Plan should also  detail the actions to be taken by staff to support how staff will manage the child’s medical  needs during the evacuation e.g. ensuring appropriate medication is taken outside and is  available whilst at the assembly point.

School has a procedure for contacting emergency services (Template G) which is displayed in  the appropriate places e.g. office, staff room etc.

CONFIDENTIALITY AND SHARING OF INFORMATION WITHIN SCHOOL

The Academy is aware of the need to manage confidential information sensitively and respectfully,  maintaining the dignity of the child and family at all time.

The Academy will disseminate information to key members of staff involved in the child’s care on a  needs-to-know basis, as agreed with parents/carers.

Where the child has an Individual Healthcare Plan (IHCP) this will be shared with key staff with  regular scheduled re-briefings.

The Academy will ensure that arrangements are in place to inform new members of staff of the  child’s medical needs.

Clare Bardsley will ensure that arrangements are in place to transfer information on a child’s  medical needs to staff during any transition.

LIABILITY AND INDEMNITY

The Academy insurance policies provide liability cover relating to the administration of medicines.

In the case of medical interventions, individual cover may be arranged for any specific healthcare  procedures, including information about appropriate staff training and other defined requirements  of the insurance policy.

Information on the Academy insurance arrangements can be provided on request.

COMPLAINTS PROCEDURE 

In the first instance parents/carers dissatisfied with the support provided should discuss their  concerns directly with the Headteacher or Inclusion Manager.

If, for whatever reason, this does not resolve the issue then a formal complaint can be made in writing to the school’s governing body.  

Information on the school’s complaints procedure can be provided on request.

UNACCEPTABLE PRACTICE

The school considers that the following constitute unacceptable practice:  

• requiring parent/carers or otherwise making them feel obliged to attend school to administer  medicines / medical interventions or provide medical support to their child, including around toileting issues – no parent/carer should have to give up working because the school is  failing to support their child’s medical needs;
• preventing children from participating or creating unnecessary barriers to children  participating in any aspect of school life, including trips, e.g. by requiring parents/carers to  accompany the child.
• preventing children from easily accessing and administering their medicines as and where  necessary;
• assuming that every child with the same condition requires the same treatment; ∙ ignoring the views of the child and/or their parents/carers (although this may be  challenged);
• ignoring medical evidence or opinion (although this may be challenged); ∙ sending children with medical conditions home frequently;
• preventing children with medical conditions from staying at school for normal school  activities, including lunch, unless this is specified in their IHCP;
• if the child becomes ill, sending them to the school office unaccompanied or with someone  unsuitable;
• penalising children for their attendance record if their absences are related to their medical  condition e.g. hospital appointments;
• preventing children from eating, drinking or taking toilet / other breaks whenever they need  to in order to manage their medical condition effectively.

POLICY INFORMATION AND REVIEW

This policy has been written in conjunction with the Allergy Awareness Policy and will be renewed annually.

APPENDICES 

1. Individual Healthcare Plan (IHCP)
2. FlowChart to Guide Schools on the Development of an IHCP for a Child
3. Medicines and Medical Interventions
4. Procedure for Contacting Emergencies Services

TEMPLATES 

1. Parent/Carer Information about a Child’s Medical Condition
2. Parent/Carer Request and Agreement for School to Administer Medicines/Medical  Interventions’ form  
3. Parent/Carer Request for the Child’s Self–Administration of Medication/Medical Intervention
4. Record of Administration of Medicines/Medical Intervention to an Individual Child
5. Record of Administration of Medicines Administered to All Children

Appendix 1

Procedure following Notification of a Pupil’s Medical Needs

Appendix 2 

Individual Healthcare Planning (IHCP) Flow Chart 

Flow Chart courtesy of Lancasterian Outreach and Inclusion Service (LOIS)

Appendix 3

Medicines and Medical Interventions

Some of the medicines and medical interventions commonly managed within special and  mainstream schools are detailed below.

Medicines:

Medical Interventions:

Appendix 4 

Co-op Academy Broadhurst

Procedure for Contacting Emergencies Services

Requesting an Ambulance:

• Dial 999
• Speak clearly and slowly
• Be ready to repeat information if asked.

You will be asked for three key pieces of information:

1. your telephone number

2. the location you want the ambulance to be sent to

3. the reason for the call

1. School’s telephone number is: 0161 6814288

2. School Name: Co-op Academy Broadhurst

School Address: Williams Rd, Moston

School Postcode for SAT NAV: M400BX

Best entrance to the school site: Main Gates

Exact location of the patient within the school  

STATE THAT THE AMBULANCE WILL BE MET BY A MEMBER OF STAFF WHO  WILL TAKE THE CREW TO THE PATIENT 

3. Name of Child  

Age of Child

Description of Child’s Symptoms  

Inform if underlying Medical Conditions

Inform if any emergency rescue medication has been administered e.g. midazolam - epilepsy, epipen - allergies, glucose – diabetes

Inform if any emergency procedures have been carried out e.g. suction/trache tube  replacement – tracheostomy, button replacement – gastro feed

On Arrival of the Ambulance:

• Member of staff to meet crew and escort crew to the patient
• Member of staff to pass over empty packaging of any rescue medication  administered, if appropriate
• In the case of a child with complex needs, member of staff to pass over the  child’s IHCP or summary letter stating child’s medical condition and medication
• Member of staff to travel in the ambulance with the patient

Template A 

Co-op Academy Broadhurst 

Parent/Carer Information about a Child’s Medical Condition

Family Contact Information

Healthcare Professional Contact Information

GP Information

Hospital / Clinic Consultant / Specialist Nurse

Community Health e.g. paediatrician, physiotherapist, occupational therapist

Child’s Medical Information

Regular Medicine

Medicine Administered in a Medical Emergency

Regular Medical Intervention e.g. catheterisation, suction/tracheostomy care

Mobility – movement and walking

Personal Care

Parent / Carer Declaration and Signature

I agree that this is, to the best of my knowledge, up to date and accurate information about my child’s current medical needs.  

I agree to school informing the School Nursing Service about my child’s needs, if this  service is not already aware.

I agree to inform school of any changes in medical needs or medication,  immediately and in writing.

Parent/Carer’s Full Name (Please print)  

_______________________________________________________________________Signature_______________________________________________________________Date _________________________

Template B 

Co-op Academy Broadhurst

Parent/Carer Request and Agreement for School to Administer  Medicine(s) / Medical Intervention(s) 

The school will not give your child medicine or carry out a medical intervention unless you  complete this form to make a formal request to the Head Teacher. By signing this form you  are also consenting to staff administering medicine or carrying out the medical intervention  and sharing relevant information with staff, if the request is granted.

Medicine

Note: if self – administration of medicine required then a separate form ‘Parent/Carer Request for  the Child’s Self–administration of Medication/Medical Intervention’ must also be completed.

Note: if self – administration of medicine required then a separate form ‘Parent/Carer Request for  the Child’s Self–administration of Medication/Medical Intervention’ must also be completed.

Medical Intervention e.g. catheterisation, tracheostomy care

Note: if self – administration of medicine required then a separate form ‘Parent/Carer Request for  the Child’s Self–administration of Medication/Medical Intervention’ must also be completed.

Parent/ Carer Contact Details

Parents/Carers Declaration and Signature

The above information is, to the best of my knowledge, accurate at the time of writing.

If agreed by the Head Teacher, I give consent to school staff to administer medicine /  medical intervention in accordance with the school policy and following specialist training,  where appropriate.

I will inform the school immediately, in writing, if there is any change in dosage or  frequency of the medication, if the medicine is stopped or if there are any changes to  the procedure for the delivery of a medical intervention.

Parent/Carer’s Full Name (Please print)  

_______________________________________________________________________Signature_______________________________________________________________Date _________________________

Template C 

Co-op Academy Broadhurst

Parent/Carer Request for the Child’s Self–Administration of  Medication/Medical Intervention

Child’s Details

Parent/Carer’s Contact Details

GP

Parent/Carer Declaration and Signature

I confirm that I have completed the Parent/Carer Request and Agreement for School to  Administer Medicine(s) / Medical Intervention(s) (Template B) form.

I request and agree to the following medicine(s) or medical intervention(s) being self administered in school by my child: (please add the names of the medicines or type of  intervention)

1. _______________________________________________

2. _______________________________________________

3. _______________________________________________

I request and agree to: (please tick from the following)

• my child carrying the stated medicine(s) independently and safely
• school holding the stated medicine(s) safely for my child to collect and administer independently
• school holding the stated medicine(s) safely for my child to collect and  
• administer independently under the supervision of a member of staff
• my child carrying any equipment or resources required for the stated medical
• intervention independently and safely
• school holding the equipment or resources required for the stated medical intervention safely for my child to collect and administer independently
• school holding the equipment or resources required for the stated medical intervention safely for my child to collect and administer independently under  the supervision of a member of staff

I undertake to ensure that the school has adequate supplies of stated medicines(s) or  resources required to administer the stated medical intervention(s).

I undertake to ensure that stated medicine(s) or resources: are in the original container as  dispensed by the pharmacy; have the pharmacy label stating the child’s name, dosage  and timing of administration; have not passed the expiry date; have details of storage  instructions, if appropriate.

I undertake to inform the school in writing if there are any changes to medicine(s) or  medical intervention(s) e.g. change of dose, change of timings or frequency or if  administration is stopped.

Parent/Carer’s Full Name (Please print)  

_______________________________________________________________________Signature_______________________________________________________________Date _________________________

Template D

Co-op Academy Broadhurst

Record of Administration of Medicines/Medical Intervention to an Individual Child e.g. under an IHCP

Child’s Name __________________________________    Date of Birth ______________    Y ____

Template E

Co-op Academy Broadhurst

Record of Administration of Medicines/Medical Intervention for all children