Administration of medicines in school: who is responsible?

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 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 …