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Education And Debate

Administration of medicines in school: who is responsible?

BMJ 1998; 316 doi: (Published 23 May 1998) Cite this as: BMJ 1998;316:1591
  1. M J Bannon, consultant paediatriciana,
  2. E M Ross, professor of community paediatricsb
  1. a Paediatric Directorate, Northwick Park and St Mark's NHS Trust, Northwick Park Hospital, Harrow HA1 3UJ
  2. b King's College London, Mary Sheridan Centre, London SE11 4QW
  1. Correspondence to: Dr Bannon

    By the age of 4 years, Jamie had experienced three severe allergic reactions after exposure to peanuts. His general practitioner diagnosed peanut allergy and advised that Jamie's carers should not only be capable of recognising the early signs of anaphylaxis but should also be prepared to administer subcutaneous adrenaline if necessary. After a meeting with Jamie's schoolteacher, his mother was disturbed to be told that, while the school was sympathetic, teaching staff were unable to administer adrenaline injections as this was a medical rather than a teaching responsibility. She was also advised that the school nurse covered several schools during the working week and could not be always available to give adrenaline injections. Jamie's mother then raised a question that has been asked by many other parents: just who is responsible for the administration of medicines to children while they are at school?

    This has been a contentious issue for many years, regularly resulting in conflict between parents and teachers.1 The background to the problem is complex and is a result of diverse factors.

    Summary points

    Chronic illness is relatively common in schoolchildren and often requires treatment during school hours

    There is no legal requirement for schoolteachers to administer medicines to children at school

    School health services are non-resident and are focused on health promotional activities rather than providing acute medical care for pupils

    Both parents and prescribers of drugs for children must liaise effectively with school staff

    The use of individual healthcare plans in this context represents a constructive way forward, but these have yet to be widely implemented in practice

    Changing nature of childhood illness

    Not only is chronic illness common among schoolchildren but inadequate treatment may impair a child's academic progress and general wellbeing. 2 3 There is also evidence that the epidemiology of childhood illness is changing. Recent research suggests that, for …

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