Chris Rumney and Chris Hale

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• Chris Rumney and Chris Hale
• Nurse Advisers, Medical Needs in Schools and
  Early Years Service
• South Birmingham Primary Care
  NHS trust

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Medical Needs in Schools and Early Years Service
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Setting the Scene

• The pattern of childhood diseases has changed
  dramatically over the last 50 years
• Mortality has decreased
• Increase in children who have more complex
  medical conditions
• Over the last decade, new medical conditions
  Attention Deficit Hyperactivity Disorder,
  Autistic Spectrum Disorder, emergence of type 2
  Diabetes increase in allergic diseases e.g
  Anaphylaxis, Asthma

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Incidence of Chronic Childhood Conditions

• Asthma 1 10 children
• Allergy 1 100 children
• Epilepsy 1 200 children
• Diabetes 1 400 children

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Childhood Asthma

• UK has the highest incidence in the world of
  children reporting asthma symptoms
• 1 in 10 children in the UK has asthma
• Every class teacher will have daily contact with
  pupils who have asthma
• Lets make school asthma
• policies/training mandatory!!

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• Medical Needs Audit
• Primary School (700 pupils)
• Severe Allergies (Epipens) 10
• Asthma 74
• Hay fever 14
• Eczema 28
  
• Diabetes 4
• Epilepsy 6
• Reflex Anoxic Seizures 1
• ADHD 3
• Autistic Spectrum Disorder 5
• Blood Disorders 2
• Brain Tumour 1
• Morquios Syndrome 1
• Downs Syndrome with severe
  heart condition 1

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Birmingham

• Largest metropolitan LA in the UK
• 500 Schools (5 residential units)
• School nurses x 100
• 3 Primary Care Trusts

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Birmingham Model

• March 1995 - Education and health partnership
  developed local medicines in school guidelines
• Sept 1995 Two nurses employed (joint funded)
• Sept 1998 - Project success, and with inclusion
  drive in Birmingham, nurse posts become permanent
• 2004 -Nurse educators x 2 part time posts
• -All schools issued with school health
  folders partnership health education
  
• -Medical needs audit undertaken (all
  schools)
• 2005 Funding obtained to develop service across
• Early Years Settings (approx 300)

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Medical Needs In Schools and Early Years Service
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Guidance available For Schools

• National -
• Access to Education for Children and Young People
  with Medical Needs DFES 2001
• Childrens NSF-DOH 2004
• Standards 8 10
• Managing Medicines in Schools and Early Years
  Settings-DFES/DOH 2005
• National Support Organisations school packs -
• Asthma UK, Diabetes UK, Anaphylaxis
  campaign
• National Society for Epilepsy

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Also a Need for Local Guidance That includes

• Clear statement about employers/employees
  responsibilities
• Clarification of insurance cover provided
• Details of training available
• Named health professionals who can provide
  support and advice around management of
  medication/medical conditions in all
  educational settings

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Training Available

• Asthma
• Allergy/Anaphylaxis-Epipen (Adrenaline
  auto-injector) administration
• Epilepsy-Rectal Diazepam/Buccal
  Midazolam administration
• Diabetes
• Sickle Cell Disease
• Medication policy development
• School Asthma policy development
• Emergency guidelines

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At Individual School/Nursery

• Preferred Option
• As targets all staff, though may need
• several visits to cover all staff e.g lunch
• time staff, support staff
• Teacher training days
• After school sessions
• Breakfast briefings
• End of Nursery day(6pm -7pm)
• Saturdays

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Supporting Children With Medical Needs

• Whose responsibility ?
• Multi agency Partnership Approach
• Collaborative Working
• Clear Policies and Procedures

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Summary

• All Schools and Early Years settings should have
  access to training, guidance and support from
  Healthcare Professionals
• Policies and Guidelines on Managing Medicines
  should be developed locally by the key players
  involved to ensure a clear, consistent and
  evidence based approach, enabling Children with
  medical needs to be included in all aspects of
  education in the knowledge that they are being
  supported by trained and informed School staff

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Chris RumneyNurse AdviserTel no
0121 627 8868Chris HaleNurse AdviserTel No
0121 373 0313

April 2006