Minutes:
Kay Watson, Health Education Nurse Adviser gave a presentation on how the educational needs of pupils with medical needs were met in mainstream schools.
The presentation covered the following issues:-
- Background to the role of the Health Education Nurse Advisor
- Training – Individual named child/young person – Staff trained to care for individual, not the “medical condition”
- The Process of Referral – from child/young person/school/school nurse/consultant or any other relevant health care professionals
- Uncomplicated Training Plan
- Meeting Complex Health Needs
- Next Steps
- Training Needs
- Outcome so Far
- Conclusion
Kay explained that her responsibility was to make contact with all parties involved with the child/young person once a referral was received, family members and the child/young person being a key part of this work. It was very important that a pupil, particularly a younger child, was able to feel confident with what was happening around them in school. Every child of school age had a named nurse who was trained to pull together the care package/delivery programme in all areas of a child’s care.
Two Case Studies were given of a child at risk of Anaphylaxis and a child with Congenital Hypertrophic Cardiomyopathy, both of whom were being educated in mainstream schools. This highlighted the roles Head Teachers and teaching staff were being expected to fulfil, and explained how teaching staff are often trained as part of the pupil’s Care Plan.
The Cabinet Member, Education, Culture and Leisure Services praised the work of all professionals involved in the care of children as part of the inclusion policy, the major feature of which was to integrate these children into school within their own communities.
Members of the Scrutiny Panel raised the following issues;-
- What system was in place for use of the Epipen (rescue medication for anaphylaxis) – including teaching staff from Agencies?
A mixture of practices were in operation. For practical reasons, older students were allowed to carry an Epipen. They are not taken home. The pen is used under certain circumstances and after five minutes a second dose is given if the first is not effective. A child is then taken to hospital if the need is such. The second pen is held centrally where the staff know of the location. Awareness training was given to all schools. All staff knew who was trained to give the pen and each school set their own strategy for dealing with this. Parents agreed to share confidential information with Agency staff and, in the same way as fire procedures were shared, all teachers needed to know about a problem and how to summon help immediately.
There had been two incidents of Epipens having to be given in four years and both to fourteen year old girls. Staff had handled the situation appropriately in both cases.
- What happened if a room was locked where the Epipen was stored?
The pen was never kept in a locked cupboard but was out of reach of small children and in a central place which all staff were aware of. A child could be sent for a pen and it was only used for the child it was prescribed to.
Regarding allergies, in general, there was a Public Health Directory from which there may be support to look into allergies. This would be carried out across the Children’s Services in terms of working together.
Some of the medical issues and needs could be very complex and challenging and the work of the Health Education Nurse Advisor had to be commended in meeting those needs, and the confidence gained by teachers and children.
- How many schools had children with complex health needs? As anaphylaxis was dietary-related, how did it impact on the School Meals Service? As asthma in general seemed to be on the rise, with a greater problem than peanut allergy, and children not being able to use inhalers in school, was there a generic plan? Could some children continue to be educated in mainstream and how were severe cases handled?
Increasing numbers of children now have allergies – often to peanuts. Asthma is also rising and the medical needs of these pupils is met by the School Nursing Service. Brittle asthma could exacerbate to a life-threatening situation very quickly and a child with such significant needs was given a Care Plan.
If a child’s medical needs are very great, professionals negotiate with parents as to whether mainstream is appropriate for that individual. However, it should be noted that several children with complex needs are currently being managed in mainstream provision.
- What research was taking place into the cause of allergies and would the influence of Jamie Oliver on the quality of school meals help the situation?
In respect of peanut allergies it was not a simple answer but it is increasing at a rapid rate. There appear to be a number of factors, including raising children in an extremely clean environment at home, higher levels of parental awareness and exposure to peanut products in a wide range of foods. A diagnosis always starts with hospital tests and it was quite likely that a person with a peanut allergy would be allergic to other products.
In terms of school meals, there was a need to work together to provide dietary requirements for children and it was possible to provide a nut-free diet. However, a completely nut-free environment cannot be achieved at school as there was no control of what children bring in packed lunches.
- What training was given to staff to recognise an allergic reaction for the first time?
This was covered in the general awareness training to schools’ groups, which was not child specific. On one occasion staff in one school had recognised localised symptoms and had acted appropriately in saving a child’s life.
The Cabinet Member, Education, Culture and Leisure Services referred to the wide range of skills required from teaching staff in the education of children and the support given to pupils in school.
Resolved:- That Kay Watson be thanked for an interesting and informative presentation.