HelplineGovernment legislation
Schools have a legal duty to support pupils with medical conditions, including allergy. Schools must adhere to legislation and statutory guidance on caring for pupils with medical conditions, including the administration of allergy medication and adrenaline auto-injectors (AAIs).
- The English Government’s guidance on supporting pupils at school with medical conditions, published in December 2015 is available from this link.
- The Scottish Government’s guidance on supporting children and young people with healthcare needs in schools, published in December 2017 is available from this link.
- The Welsh Government’s guidance on supporting learners with healthcare needs, published in March 2017 is available from this link.
- The Northern Ireland Government’s guidance on supporting pupils with medication needs, published in February 2008 is available from this link.
These allergy guidelines are designed to be included within your school’s medical conditions policy. It is recommended that they should be made available on your school’s website. The regulations concerning the management of medical conditions in schools varies depending on whether the school is situated in England, Wales, Scotland or Northern Ireland. The Health Conditions in Schools Alliance has published a helpful guide to these laws (please note that some of the information about Wales and Scotland has been updated since this document was published.
Health and Safety Policy
An allergy policy must be read in conjunction with the schools’ Health and Safety Policy as the management of anaphylaxis is integral within the management of First Aid. Designated first aiders will need to have specific training on anaphylaxis and understand their responsibilities in this regard:
Roles and responsibilities
- The governing body are required to develop policies to cover their own school. This should be based on a suitable and sufficient risk assessment carried out by a competent person. The governing body has general responsibility for all the school’s policies, even when it is not the employer. In county and controlled schools, the governing body should follow the health and safety policies and procedures produced by the LEA as the employer. In practice, most of the day-to-day functions of managing health and safety are delegated to the head teacher.
- The head teacher is responsible for putting the governing body’s policy into practice and for developing detailed procedures. The head teacher should also make sure that parents are aware of the school’s health and safety policy, including arrangements for managing children with allergies and at risk of anaphylaxis.
- Teachers’ conditions of employment do not include giving first aid, although any member of staff may volunteer to undertake these tasks. Teachers and other staff in charge of pupils are expected to always use their best endeavors, particularly in emergencies, to secure the welfare of the pupils at the school in the same way that parents might be expected to act towards their children. In general, the consequences of taking no action are likely to be more serious than those of trying to assist in an emergency. The employer must arrange adequate and appropriate training and guidance for staff who volunteer to be first aiders/ appointed persons. The employer must ensure that there are enough trained staff to meet the statutory requirements and assessed needs, allowing for staff on annual/sick leave or off-site.
Introduction
Allergy is the response of the body’s immune system to normally harmless substances. These do not cause any problems in most people, but in allergic individuals the immune system identifies them as ‘allergens’ and produces an inappropriate ‘allergic’ response. This can be relatively minor, such as localised itching, but it can also be much more serious, causing anaphylaxis which can lead to breathing problems and collapse. Common allergic triggers include nuts, cow’s milk and other foods, venom (bee and wasp stings), drugs, latex and hair dye. The most common cause of anaphylaxis in children/young people are foods. Symptoms often appear quickly and the ‘first line’ emergency treatment for anaphylaxis is adrenaline which is administered with an adrenaline auto-injector (AAI).
2-5% of children in the UK live with a food allergy.
Around 2-5% of children in the UK live with a food allergy, and most school classrooms will have at least one allergic pupil. These people are at risk of anaphylaxis, a potentially life-threatening reaction which requires an immediate emergency response. 20% of serious allergic reactions to food happen whilst a child is at school, and these reactions can occur in someone with no prior history of food allergy. It is essential that staff recognise the signs of an allergic reaction, and are able to manage this. In order to keep pupils with allergy safe, schools should have a clear and consistent policy on managing allergies at school. Schools should take a whole-school approach which involves all members of the school, including teaching staff, caterers, pupils and parents to ensure that the needs of the allergic pupils are met.
20% of severe allergic reactions to food happen whilst a child is at school.
Parents need to be confident in schools’ ability to keep their children safe, and be reassured that staff are sufficiently trained to act immediately in the event of an allergic reaction. Regular communication with parents is vital.
It is important that allergic pupils are not stigmatised or discriminated against in any way at school due to their allergy. For example, they should not be separated at mealtimes or excluded from class activities (unless this has been specified in the pupil’s Allergy Plan). Drawing attention to the allergy in this way could result in allergy bullying by other pupils, so inclusivity and overall awareness amongst pupils is vital.
Emergency management of anaphylaxis (ABC) and involving family/carers
All pupils at risk of anaphylaxis, should have an Allergy Action Plan that describes exactly what to do and who to contact in the event that they have an allergic reaction. The BSACI Allergy Action Plans include this information, and are recommended for this purpose. The plan should include First Aid procedures for the administering of adrenaline. Identify activities which the child may be at risk – for example food-based and outdoor activities. Symptoms of anaphylaxis include one of more of the below:
Airway:
- Swollen tongue
- Difficulty swallowing/speaking
- Throat tightness
- Change in voice (hoarse or croaky sounds)
Breathing:
- Difficult or noisy breathing
- Chest tightness
- Persistent cough
- Wheeze (whistling noise due to a narrowed airway)
Circulation:
- Feeling dizzy or faint
- Collapse
- Babies and young children may suddenly become floppy and pale
- Loss of consciousness (unresponsive)
Action to be taken
- Position is important -lie the person flat with legs raised (or sit them up if having breathing problems)
- Give adrenaline – WITHOUT DELAY – if an AAI is available
- Bring the AAI to the person having anaphylaxis, and not the other way round. Avoid standing or moving someone having anaphylaxis
- Call an ambulance (999) and tell the operator it is anaphylaxis
- Stay with the person until medical help arrives
- If symptoms do not improve within five minutes of a first dose of adrenaline, give a second dose using another AAI
- A person who has a serious allergic reaction and/ or is given adrenaline should always be taken to hospital for further observation and treatment
- Sometimes anaphylaxis symptoms can recur after the first episode has been treated. This is called a biphasic reaction.
Spare pens in schools
Since 2017, schools have been legally able to directly purchase AAI from a pharmaceutical supplier, such as a local pharmacy, without a prescription. Guidance from the Department for Health and Social Care UK Departments of Health (and equivalent guidance for the Devolved Nations) provide further details.
The BSACI Allergy action plans include a consent for parents/legal guardian to sign, authorizing the administration of AAIs in their child.
Under existing UK legislation, a school’s “spare” AAI can in principle be used in the event of an emergency to save the life of someone who develops anaphylaxis unexpectedly, even when parental/guardian consent has not been obtained, for example in a child presenting for the first time with anaphylaxis due to an unrecognised allergy. Note, however, that this provision should be reserved for exceptional circumstances only, that could not have been foreseen.
A supplier e.g. pharmacy, will need a request signed by the principal or headteacher (ideally on appropriate headed paper) stating:
- The name of the school for which the product is required;
- The purpose for which that product is required, and
- The total quantity required.
A template letter which can be used for this purpose is provided in Appendix 1, and can also be downloaded at: www.sparepensinschools.uk.
Please note that pharmacies are not required to provide AAIs free of charge to schools, the school must pay for them as a retail item. The retail price is circa £35 (as of 2023) and your local pharmacy may add a small handling charge.
Allergy Action Plans
Allergy Action Plans have been designed to facilitate first aid treatment of anaphylaxis, by either the allergic person or someone else (e.g., parent, teacher, friend) without any special medical training nor equipment apart from access to an AAI. They have been developed following an extensive consultation period with health professionals, support organisations, parents of allergic children and teachers, and the British Society for Allergy & Clinical Immunology (BSACI).
Please click here to see the sample Allergy Action Plans.
The plans are medical documents, and should be completed by a child’s healthcare professional, in partnership with parents/ carers. The plans can either be printed out and completed by hand, or completed and signed by the healthcare professional and parent/carer online.
Staff allergy training
It is good practice to have two named members of staff at school responsible for coordinating allergy management including the development and upkeep of the school’s allergy policy.
However, an allergic reaction can occur at any time, so all staff should be trained on what to do in the event of an allergic reaction, as a student may be under their supervision when this happens. Allergy training should be refreshed yearly (at a minimum) and new and temporary staff should be trained as soon as they join the school to ensure confidence and competence.
Acting fast is key in reducing the risk of a serious allergic reaction.
Allergy training should include a practical session (trainer AAIs are available to order through the manufacturer’s website.) Training should include a basic understanding of allergic disease and its risks which include:
- Knowing the common allergens and triggers of allergy
- Spotting the signs and symptoms of an allergic reaction and anaphylaxis. Early recognition of symptoms is key, including knowing when to call for emergency services
- Administering emergency treatment (including AAIs) in the event of anaphylaxis – knowing how and when to administer the medication/device
- Measures to reduce the risk of a child having an allergic reaction e.g. allergen avoidance
- Knowing who is responsible for what
- Associated conditions e.g. asthma
- Managing Allergy Action Plans and ensuring these are up to date
Allergies and bullying
By law, all state schools must have a behaviour policy in place that includes measures to prevent all forms of bullying among pupils, and this is a policy decided by the school. All teachers, pupils and parents must be told what it is, and allergy bullying should be treated seriously, like any other bullying. Schools must, under Section 100 of the Children and Families Act 2014, aim to ensure that all children with medical conditions, in terms of both physical and mental health, are properly supported in school so that they can play a full and active role in school life, remain healthy and achieve their academic potential.
32% of children surveyed reported having been bullied due to food allergy at least once.
The Department for Education has provided statutory guidance for schools and colleges on keeping children safe in education. Please view the guidance here.
Bullying UK have provided advice for schools on bullying – Primary / Secondary.
Heads Together have given information on how to adopt a whole-school approach to mental heath and wellbeing.
Other useful websites include Bully Busters, Anti-Bullying Alliance, Childline and NSPCC.
Storage of AAIs
Students should carry two AAIs with them at all times. If the student is unable to carry AAI’s/ medication/inhalers themselves (e.g. primary school-aged pupils) this medication should be stored safely but should be easily accessible in the event of an emergency and not locked away. Ensure that these are labelled for identification of the pupil e.g. with their name and photograph and Allergy Action Plan.
Ensure that students know where their medication, AAIs and inhalers are at all times.
If a pupil has anaphylaxis, and their AAI is stored away from them, then the AAI must be brought to them. They must not be told to go to the room where the AAI is stored, in order for it to be administered.
Staff should support students who demonstrate maturity and have had appropriate training to carry their own AAIs, medication and/or inhalers.
Expiry dates
- It is the parents’ responsibility to ensure that the child’s AAIs are within the expiry date, however it is good practice for schools to schedule their own regular checks of medication
- Parents and schools can register AAIs on the manufacturer’s websites to receive text alerts for expiry dates
- Schools should return expired medication to parents for safe disposal
- Any sharp items such as AAIs should be disposed of safely using a sharps disposal box
- When the school is closed for long periods e.g. school holidays , it is possible that medication could have expired so it is essential that staff check the expiry dates of AAIs as these may need replacing
- Note that the dose of AAI varies according to the child’s weight, so as the child grows, the correct dose required may change.
Catering at school
As part of school’s duty to support children with medical conditions, they must be able to provide safe food options to meet dietary needs including food allergy. Catering staff must be able to identify pupils with allergy.
All food businesses (including school caterers) must follow the Food Information Regulations 2014 which states that allergen information relating to the ‘Top 14’ allergens must be available for all food products. Schools can therefore identify whether a food product is safe for allergic pupils to eat.
School menus should be available for parents to view with the ingredients clearly labelled.
Handling allergens and preventing cross contamination
Ensure that catering staff keep in contact with food suppliers as ingredients may change.
Some product ingredient lists contain precautionary allergen labelling, e.g. “may contain X”. Some pupils may be able to eat foods labelled as “may contain”, but others may need to strictly avoid them. This information should be included on the Individual Healthcare Plan.
Allergy UK’s resources for managing allergies at school
The following resources designed by Allergy UK are aimed at school staff, parents and pupils with easy-to-understand information factsheets and ‘top tips’ on managing allergies in school. Topics include Understanding Anxiety, Guidance for Early Years Settings, Frequently Asked Questions and more.
- Information for schools
- Information for parents
- Information for pupils
- Guidance for Early Years Settings
- Understanding Anxiety factsheet
- Frequently Asked Questions
Working with parents
Parents/guardians know their child’s allergies best and so it is vital that schools work with parents to ensure they have the most up to date knowledge of each child’s allergies and medication. Parents must be encouraged to
- Provide an Allergy Action Plan signed by a healthcare professional
- Provide two in-date AAIs for their child, which should ideally be kept with the child rather than away from them.
Risk assessments
A detailed risk assessment will enable schools to identify gaps in their systems and processes for keeping allergic children safe.
Download the Wiltshire Children Trust Anaphylaxis Risk Assessment template here.
Sports activities at school
All children with allergies and who have been prescribed AAIs should take their AAIs to the sports ground / hall with them. The teachers leading the sports sessions should all be first aid trained and this must include how to manage serious allergy and anaphylaxis.
Sports activities outside schools
Children with allergies should have every opportunity to take part in out-of-school activities such as holidays, sports events hosted by other schools and educational visits.
Such activities will need careful planning and preparation, but there is no reason to exclude a child with allergies. A meeting with the child’s parents /carers will be necessary to ensure that everyone is happy with the arrangements. If the child is allergic to a food, similar procedures need to be followed to those in operation at
school to ensure that the child does not come into contact with the food.
If the child has been prescribed AAIs, at least one person trained in administering the device must accompany the school party. From the child’s perspective, it is not advisable for a parent/ carer to accompany them on school trips. This should only happen as a last resort. It is a school’s responsibility to have a member of staff present who can support the child.
Sports events
For sports events, it’s advisable to ensure the PE teacher is fully aware of the situation and notifies the schools to be visited that a member of the team has an allergy when arranging the fixtures. Should another school feel they are not equipped to cater for the allergic child you could arrange (as a last resort) for the child to take their own food.
Managing insect sting allergy
Insect sting (including bee and wasp) allergy causes a lot of anxiety and needs careful management. Children need to take special care outdoors, wearing shoes at all times and making sure any food or drink is covered.
Adults supervising activities must ensure that suitable medication, including AAIs, is always on hand for the management of anaphylaxis.
Template Model Policy for Schools
Our template policy is designed to be incorporated into/annexed to the schools wider medical conditions policy as required by the Supporting Pupils in schools with medical conditions statutory guidance.
You can download our template policy at the top of this page.
Additional support
Our helpline offers support to both parents and schools, helping to provide peace of mind and guidance on navigating allergies in a school environment. For further advice and resources call us on 01322 619898, email info@allergyuk.org or use our web chat service to talk directly to one of our advisors.
Navigating allergies in a school setting requires collaboration, understanding, and proactive measures from parents, schools, and the wider community. By working together and staying informed, we can create a safer and more inclusive environment for children with allergies to thrive academically and socially