Medical guidance published by heads’ union amid safety fears

A school leaders’ union has produced guidance in response to fears that schools are feeling increasing pressure to provide medical support for pupils without having the necessary expertise.

The NAHT said the guidance aims to help schools to identify arrangements that may be unsafe or not legally compliant, and to be able to challenge inappropriate expectations placed upon them.

The union has warned that too many schools are being left to plug gaps as local health services have become increasingly stretched - creating “a growing mismatch between what the law requires and what schools are being asked to do in practice”.

Concerns over delay to national guidance

The union also voiced concerns that updated national guidance from the government is now unlikely to appear before the start of the next school year.

The NAHT says its own guidance aims to clarify the existing legal position for schools.

Medical interventions carried out in schools can range from administering medication to respiratory and cardiac monitoring, catheter and stoma care, tube feeding and use of hoists.

The NAHT says that while some tasks can be delegated to schools with clear, robust arrangements in place, “responsibilities, accountability and legal authority are often unclear”. This is leading to a model “that is overly reliant on the education sector” and creates risks for children and school staff, it adds.

The union’s general secretary, Paul Whiteman, said: “Schools care deeply about their pupils and go above and beyond for them, but teachers and support staff are not medical practitioners.

“We hear increasingly from school leaders that they are being pressured to deliver healthcare without the necessary expertise and support, and there are instances where what they are being expected to do is simply inappropriate. School staff are dealing with this issue right now, and they need help.”

He added that there was “a real danger that it is only a matter of time before something goes very wrong”.

Leaders ‘under pressure’ to provide medical support

Emma Smith, director of ESC Management Services, who supported the NAHT in producing the advice, said: “Over many years, schools have increasingly been expected to fill gaps in NHS-commissioned services, leaving school leaders under pressure to provide medical support that extends beyond their role as education professionals.

“This is neither sustainable nor safe, and it can place children, young people and staff at unnecessary risk.”

The NAHT guidance aims to help schools understand statutory duties and responsibilities across education, health and local government and distinguish between school-led support and NHS Act 2006 health services.

The advice adds that many of the healthcare interventions required by pupils with medical conditions during the school day - particularly those that are child-specific, clinically directed and require professional oversight - are “properly characterised as NHS Act 2006 health services”.

“The fact that an intervention takes place on school premises does not in itself alter its legal character or transfer responsibility to the school,” it adds.

The NAHT had previously responded to a government consultation on supporting pupils with medical conditions at school, which closed earlier this year. The union called for the updated guidance to explicitly state that schools’ duty is to make reasonable educational arrangements and not to replace NHS-commissioned healthcare.

It added that where support goes beyond basic first aid, emergency response or clearly agreed reasonable adjustments, there should be an expectation of NHS involvement, health-led planning and expert-led clinical support.

The union has called for updated guidance to explicitly state that schools’ duty is to make reasonable educational arrangements and not replace NHS-commissioned healthcare.

Expectations for schools on pupil allergies

The government has recently published new expectations for schools on pupil allergies.

Life-saving allergy pens will be stored in all UK schools from September as a result.

The new statutory guidance for schools, called Benedict’s Law, will also provide training for teachers to ensure they can act quickly in case of emergencies - including using the pens, also known as adrenaline auto-injectors or AAIs.

The nationwide requirements come after campaigning from the National Allergy Strategy Group and families, including Helen and Peter Blythe, parents of Benedict Blythe, who died after having an anaphylactic reaction at school in 2021.

Schools will also be expected to have clear allergy policies, the DfE has said.