Almost one in five school support staff feel forced to administer medicine to pupils and care for their health despite receiving little or no training, according to research by the Royal College of Nursing.
The study, conducted with Unison, the main union for support workers, found that staff were left feeling "worried and vulnerable" after taking on tasks in which they had no expertise. Support staff are expected to dress wounds and carry out skilled procedures including physiotherapy and tube feeding, the research showed.
The study, which surveyed more than 2,300 school support staff and registered nurses, found that the majority of support staff do not receive regular training and some do not receive any training at all. Almost eight in 10 support staff said they were expected to administer medicines as part of their job, with a similar number saying they undertook medical procedures, including administering insulin for diabetic children and supporting pupils with mental health problems.
Nearly one in three said they did not feel competent or comfortable with what was expected of them. The majority of support staff said they had attended a first aid course, but less than half said they had received any additional specific training.
The findings were outlined to the National Council for Child Health and Wellbeing at a conference this week.
Dr Peter Carter, chief executive of the Royal College of Nursing, said the survey highlighted the "risk to children and young people when authorities and schools do not have robust arrangements in place to support pupils with health needs".
"While there are a number of examples of good practice, it is clear that more needs to be done to ensure all schools are able to provide safe and well-planned healthcare support," he said. "There is also a clear need for more school nurses, community children's nurses and children's nurse specialists to adequately train and support staff in schools."
Lorraine Petersen, chief executive of SEN organisation Nasen, said the pressure on support staff to provide medical assistance was a result of schools' being more inclusive to children with different needs.
Unison general secretary Dave Prentis said the situation was "a tragedy waiting to happen". "We want every child to enjoy school life to the full - so do teaching assistants and other school support staff," he said. "But all too often that relies on pressurising staff into administering medicines or complex procedures that they do not feel confident or trained to do."
Russell Hobby, general secretary of heads' union the NAHT, said there was a "lack of clarity" about how schools were expected to care for children with medical needs. "There is no clear guidance for schools on what should be done in these circumstances, how they decide what the risks are and how they respond to them," he said.
A Department for Education spokeswoman said the government was considering whether existing guidance needed to be improved. "Schools must ensure that any staff members providing healthcare or administering medicines to pupils receive suitable training and are covered by appropriate insurance," she said.