'They Cannot Be Required To Do So': DfE's Line On Giving Medicines

So, uh, picture this, it is 20 to nine. Okay. You are a teaching assistant and you have, you know, just walked into the building. Right. Your code is half off. Yeah. We all know that feeling. Exactly. And somebody catches you right by the office door. Of course they do. And, um, the ask is always phrased something like this. You couldn't just do his insulin today, could you? Only Mrs. Bennett's off. Right. And obviously you say yes. You absolutely say yes. And you say yes for some.

I mean, very powerful, very human reasons. You say yes because a child needs it. You say yes because the person asking you is stretched thin, probably panicked, and just trying to make the day work. And, well, perhaps most of all, you say yes because saying no at 29 in the morning, standing in front of the busy office, feels exactly like you were refusing to help a child. It really does. And we need to be incredibly clear right at the top of this discussion. Nobody in that corridor is doing anything wrong.

The person asking isn't doing anything wrong, and the person saying yes isn't doing anything wrong, that exact tension, you know, that exact moment is what makes this worth unpacking today. This is the Education Commute. Now, for the purposes of this discussion, we are taking two very specific seats. I am sitting in the reader's chair. Okay. My job is to look at exactly what is written down in the statutory guidance. And I am sitting in the chair of the person who just got asked. I am the teaching assistant.

Yeah. Or you know, I'm the cover supervisor, the midday supervisor, the office staff member. Yeah. Whoever it was standing there with their coat half off. Yeah. And I need to know where I actually stand. Because there is one single page of statutory guidance that answers this entire scenario completely. And the reality is, I would guess that most school staff have never actually seen it. Then let's establish exactly what we're looking at. What is this document? It is titled Supporting Pupils at School with Medical Conditions. This is statutory guidance from the Department for Education issued under section 100 of the Children and Families Act 2014.

Right. And I always have to ask about the date when we look at these things. Well, something being statutory and something being current aren't always the same thing. No, they aren't. So how current is this document? I am so glad you asked that every time, because it matters immensely. This guidance was published in 2014. It was last updated in August 2017. Wow, okay. Yeah. So how are we breaking this down? We have four things to cover off the document, right? We have four things, yes. And they are not necessarily related in the way you might expect.

Oh, really? Yeah. Which is why we need to take them in strict sequence. I will name all four pillars up front so you know exactly where we are going today and then we will tackle them one by one. Perfect. Let's hear the four. Okay, pillar one, any member of school staff may be asked. Pillar two, they cannot be required. Okay. Pillar three, if you say yes, training comes first. And pillar four, which is the one that stops all of this from simply being an excuse, none of that lets you walk past a child in trouble.

Let's start right at pillar one then, the ask itself. I want to read the sentence exactly as it appears in the guidance. I'll go slowly. Yeah, go ahead. Any member of school staff may be asked to provide support to pupils with medical conditions, including the administering of medicines, although they cannot be required to do so. Let's just hold on that very first half. Read that first section again. Any member of school staff may be asked. It is the word any that jumps out there. Any. There is absolutely no carve out in that sentence.

Right. It does not say any teaching staff. It does not say any leadership. There is no exception written for teaching assistants or for the office staff or for the midday supervisors or for the site team. Wow, so no exceptions at all? None. If you work in that building as a member of school staff, you can be asked. I think we really need to sit with that for a second because there are plenty of people working in schools who feel deep down that the ask itself is improper.

Yes, absolutely. That they shouldn't even be put in the position of being asked to do something clinical. But this first pillar says the exact opposite. It does. The ask itself is entirely legitimate. Being asked is normal, and it is explicitly provided far by the Department for Education. Right. It might be the uncomfortable pillar, but it is the reality. The person asking you at twenty to nine is fully within the bounds of the guidance to ask. Okay. That is the first pillar finished. The ask is legitimate.

Which brings us to the second pillar, which is the half of the sentence everyone thinks they know, but often doesn't fully understand. Let's look at the second half of that exact same sentence, although they cannot be required to do so. And just to be completely clear, because the placement of these things really matters, where does that sit in the document? It is the second half of the exact same sentence as the ask. It is not buried in a footnote. It is not hidden away in an annex at the back of the document.

Right there. Right there. Any member of school staff may be asked to provide support to pupils with medical conditions, including the administering of medicines, although they cannot be required to do so. So in writing, in statutory guidance, it is a genuine choice? It is a genuine choice. But here is the part that takes it from being just a theoretical choice on paper to a real choice in practice. Okay. The guidance makes it clear who actually holds the responsibility. The duty does not sit on you as the individual staff member.

Oh Interesting. Yeah, the document states that the governing body must ensure that arrangements are in place to support pupils with medical conditions But governing body not the teaching assistant Exactly. That is their duty. Your participation is voluntary that completely changes the psychology of the word No, completely. Let's really look at what that means If you are standing there at 20 to 9 and you decide to decline the request, you haven't left a gap that the guidance ever expected you to fill. What you have done is leave a gap that the governing body was already required to have covered.

That is a massive shift in perspective. If I say no, I am not feeling the child. I am simply declining to voluntarily bridge a gap in the governing body's arrangements. Yes. Those are very, very different conversations to be having with yourself when you are driving home at half past three. They are. And it also means the school cannot fix the gap simply by asking you, again, perhaps more firmly, or asking someone else who feels less able to say no. Because the duty is still theirs. Exactly.

The guidance says the governing body must ensure arrangements are in place. An arrangement has to be an actual arrangement. Not just hoping someone says yes on the day. That is the second pillar finished. The duty sits with the governing body and you cannot be required. Let's move to the third pillar. And this is the one that really dictates what happens if you do actually want to say yes. This is where we talk about training. And this is the pillar with teeth. The guidance says this. Any member of school staff providing support to a pupil with medical needs should have received suitable training and must be competent before taking on that responsibility.

Should have received suitable training. That is the first part. But then the document delivers a much harder line. And I want to read this exactly as it stands, word for word, because the phrasing is critical. I'm listening. Staff must not give prescription medicines or undertake health care procedures without appropriate training. Let's focus purely on those two words. Must not. Must not. It doesn't say you should think carefully before doing it. Right. It doesn't say you should ideally have training. It says you must not. Let me push back slightly from the chair of the person being asked.

Let's go back to that corridor. 20 to 9. I am asked to help with the insulin and I genuinely want to help. Sure. I am perfectly willing to say yes. Maybe I've even seen Mrs. Bennett do it a dozen times. So I feel like I know how it works, but I haven't formally had the training. Right. What then? Then the answer is not yes. Wow. Not because you're being difficult. not because you don't care about the child or because you aren't trying to be a team player.

The answer isn't yes because the statutory guidance explicitly says you must not. That is genuinely useful for someone standing in that corridor. Because looking someone in the eye and saying, you know, I'd love to help, but I am not trained is a much easier, much more supportive sentence to say than a flat no. It's easier, but more importantly, it is the accurate sentence. And pointing out that you aren't trained actually points directly at the actual fix for the problem. Which brings us to the Individual Healthcare Plan.

Tell me exactly what the guidance says is supposed to be in one of those plans. Because well, if you walk into five different schools, you might see five entirely different documents passing as a healthcare plan. The guidance doesn't leave this up to guesswork. It lists exactly what needs to be in the plan. I'll read the list. Go for it. First, the condition itself. Second, the pupils needs, which specifically includes medications and treatments. Okay. Third, the educational, social, and emotional support required. Fourth, the level of support needed.

Let me pause you there. It includes educational, social, and emotional support. Yes, it does. It recognises that a medical condition impacts the whole child, not just their physical state. That makes sense. But the list continues. Fifth, and this is the crucial one for us, staff training needs. Sixth, what staff need to be aware of. Right. 7th, permissions for medication. 8th, arrangements for school trips. 9th, confidentiality. And 10th, emergency procedures. I really want to highlight number 5. Staff training needs is actually supposed to be written into the plan itself.

In the plan itself, the individual health care plan is the very document that is supposed to have answered the 20-9 question weeks or months earlier. Wow. The plan is where you identify exactly who is trained and exactly who is the second named person for when the first person is off. And how often is that plan supposed to be looked at? Because, I mean, children grow, conditions change, staff leave. The guidance is clear on the review frequency. The plan must be reviewed at least annually or earlier if evidence is presented that the child's needs have changed.

That is the third pillar finished. Training comes first. It is a must not without it and the training needs belong in the annually reviewed health care plan. Let's move to the fourth pillar. Okay. And I want to set this up by pushing back because I guarantee I can hear a staff room somewhere forming an opinion right now. Oh, I'm sure. Somebody is listening to this and thinking, well, this is just a charter for saying no. Yeah. If everyone knows they can't be required and everyone knows they must not do it without training, then everybody just refuses.

Nobody gets trained and the child suffers. And that exact pushback is the fourth pillar. It is exactly why I would never do this episode without stating this final point clearly. Right. Because nothing in this document, nothing in any of the sentences we have read, lets anyone stand back from a child in difficulty. The governing body must ensure that the school's policy sets out what should happen in an emergency situation. So there's a firm distinction being made here. It's a very firm distinction. An emergency is not the routine administration we have been discussing for the last 10 minutes, and the two things must never be blurred together.

Draw the line between those two things then. Define that boundary as plainly as you possibly can. Routine administration is voluntary and trained. Responding to a child in trouble is neither of those things. It is simply what any adult in a school does. Right, of course. The choice that the guidance protects is about whether you take on a scheduled clinical responsibility. It is absolutely not about whether you help a child in an emergency. Helping is not optional. That is the fourth pillar finished. Emergencies are different. So having looked at all four pillars of the guidance, what is the honest concession we have to make here?

What doesn't this document do? The honest concession is admitting the limitations of what we are looking at. First, as we established, this guidance is nine years old. It was last updated in 2017. Right. Second, it is written for governing bodies, detailing their duties rather than being written as a step-by-step guide for the person standing in the corridor. And the third limitation. The third limitation is that it is entirely silent on what happens next in an employment context if you decline the ask, and the school is unhappy about your decision.

That falls into employment territory, and it simply isn't in this document. I am not going to invent an answer to that or pretend the guidance covers it, but what But I can tell you, and what remains unequivocally clear in the text is that you cannot be required. Before we bring this all together, there's one more line from the document that I want to get into because the reality of this hits every single September when new intakes arrive. The admissions line. The document states, no child with a medical condition can be denied admission or prevented from taking up a place in school because arrangements for their medical condition have not been made.

So if a school is struggling to find staff willing to volunteer and be trained, the sentence, we can't take him until we've got someone trained, simply isn't an option. It isn't available. You cannot delay or deny the place. And I should add, nor is the school trip version of that same sentence available. Oh, really? No, you cannot prevent a child taking part because arrangements haven't been made, which is exactly why arrangements for school trips are specifically required to be named in the healthcare plan. Let's look at how this plays out in context.

Let's look at three rooms. Three different settings where this guidance meets reality. Start with a primary setting. In a primary setting, the classic vulnerability is the lunchtime scenario. You have an adrenaline pen sitting in a bag in the office. Right. But the one person who is trained, the one person who knows exactly where it is and how to use it, has gone to the dentist for the afternoon. Exactly. The individual health care plan needs to name two people, not just one. The second name is the one that always gets forgotten until the first person is absent.

What about a secondary setting? In a secondary school, the vulnerability is often the away fixture. You have a people with asthma traveling to an away match, supervised by a member of staff who teaches a different subject and has never seen the individual health care plan. Yeah, that happens all the time. The guidance demands arrangements for school trips in the plan for exactly this reason. The critical question isn't just whether the inhaler exists in the building, it is whether it travels with the child and who knows about it.

And finally, let's look at a specialist setting, because it's worth being honest that the whole dynamic completely inverts there. It does invert. In a specialist setting, the procedures are often daily and routine. Because of that, the systems are usually incredibly strong. Right, they do it all the time. Exactly. The plans are detailed and the pool of trained staff is large. The risk in that setting isn't usually the unasked question or the sudden emergency. The risk is solely the cover day. The cover day? Yeah. It is the day when the primary trained person for a specific pupil is absent and the plan, for whatever reason, only lists one name.

Okay, let's bring this right back to the listener. I have a question I want you to prompt them with for tomorrow. At break tomorrow, go into the staff room and ask whoever happens to be standing next to the kettle. If you are asked to give a child medicine tomorrow morning, do you know whether you are allowed to say no? And I have a question for the school leadership. The governor question. The walk-in. That's a good one. If a governor or a local authority officer walked through the front doors today, picked an individual health care plan for one named pupil, and asked two things.

First, who is trained to deliver this? And second, who covers when that person is absent? Could the school answer both halves of that question today? The second half of that question is where the system usually falls over, but it is fixable this week. It doesn't require money, and it doesn't require rewriting your entire school policy. You just take one plan, you find the training line, and you check that there are two names written against it. Let's bring everything we've talked about into focus. The four things off the drive.

We will recap them sequentially and clearly. Sounds good. Number one, any member of school staff may be asked to provide support to a pupil with medical conditions, including administering medicines. The ask itself is entirely legitimate and provided for. Number two, the second half of that exact same sentence dictates that they cannot be required to do so. Right. The duty to ensure that arrangements are in place sits firmly with the governing body, not with the individual staff member. Number three, if you do agree, training comes first.

Staff must not give prescription medicines or undertake healthcare procedures without appropriate training. That training need belongs in the child's individual healthcare plan, which must be reviewed at least annually or earlier if needs change. And number four, none of what we have just discussed applies to an emergency. Routine administration is voluntary and trained. But the governing body must ensure the school's policy sets out what happens in an emergency situation. Helping a child in trouble is not optional. It is what every adult does. Everything we have quoted today is linked in the show notes.

We're the trailer, not the film. The document is there for you to read. Safe trip in. See you at the gates.