Supporting children and young people with healthcare needs in schools: guidance

This is a guidance document for NHS Boards, education authorities and schools about supporting children and young people with healthcare needs in schools.

Annex C: Other Relevant Legislation and Policy to Support the Healthcare Needs of Children and Young People at Schools

The Equality Act 2010

Reasonable adjustments

1. Under the Equality Act 2010 (the 2010 Act), responsible bodies have a duty to make reasonable adjustments in schools for disabled children and young people. For example if a policy on school trips has the effect of denying disabled people and young children who need assistance with medication from participating, this might amount to discrimination arising from disability. Since September 2012 the definition of "reasonable adjustments" has included a duty to provide auxiliary aids and services. The duty may require steps to be taken in relation to the administration of medication or to meet other healthcare needs.

2. The 2010 Act requires responsible bodies to take such steps as it is reasonable to have to take to avoid the substantial disadvantage to a disabled child or young person caused by a provision, criterion or practice applied by or on behalf of a school or by the absence of an auxiliary aid or service [115] . Substantial is defined as being anything more than minor or trivial [116] . The duty to make reasonable adjustments is an anticipatory one. Therefore, services should work together to consider, in advance, what adjustments might need to be made for those children and young people with healthcare needs in schools who are considered to have a disability and make those adjustments in advance. These responsibilities extend to prospective pupils at the school.

3. The 2010 Act does not say what is "reasonable". This allows for flexibility for different sets of circumstances so that, for example, what is reasonable in one set of circumstances may not be reasonable in another. The purpose of the duty to make reasonable adjustments is to enable disabled pupils (and prospective pupils) to have access to an education as close as is reasonably possible to the education offered generally to pupils.

4. The Technical Guidance [117] on the Public Sector Equality Duty: Scotland sets out the factors that are likely to be taken into account when considering what adjustments it is reasonable for a school to have to make.

5. The reasonable adjustment duty is owed to disabled children and young people. A child or young person will have a disability if he or she has a physical or mental impairment that has a long-term and substantial adverse effect on his or her ability to carry out normal day-to-day activities. Physical or mental impairment includes sensory impairments such as those affecting sight or hearing. Reasonable adjustments means there is a duty for education authorities to provide auxiliary aids or services for pupils with disabilities. Examples include, but are not limited to, electronic or manual note-taking services, audio-visual fire alarms or specialist computer software. Information is provided in the Equality and Human Rights Commission's Technical Guidance for Schools in Scotland [118] .

6. Some disabled pupils will also have been identified as having additional support needs and may already be receiving additional support in school or may have a coordinated support plan. The fact that a disabled child or young person is receiving additional support does not take away from a school's duty to make reasonable adjustments for that child or young person.

Public Sector Equality Duty

7. The Equality Act 2010 [119] also includes a public sector equality duty that requires public authorities including NHS boards, education authorities and grant-aided schools [120] , in the exercise of their functions, to have due regard to the need to:

eliminate unlawful discrimination, harassment and victimisation; advance equality of opportunity between different groups; foster good relations between different groups

8. The broad aim of the general equality duty is for authorities to integrate consideration to the advancement of equality into their day-to-day work. To enable the better performance of the general equality duty, some public authorities, such as NHS boards, education authorities and grant-aided schools are also covered by specific duties [121] . These specific duties include a duty to assess the impact of new or revised policies or practices (and make arrangements to review existing policies or practices). Reviewing all practices and policies which are relevant to the healthcare needs of children and young people will help a school or education authority or NHS board to ensure that it does not discriminate, as well as help it to comply with the public sector equality duty [122] [123] .

Patient Group Directions

9. Patient Group Directions ( PGDs) are written instructions for the supply or administration of medicines to groups of patients who may not be individually identified before presentation for treatment. These are now commonly used for school vaccination, outbreaks e.g. supply of antivirals in influenza outbreaks (2009 swine flu), antibiotics for meningitis contacts etc. The relevant provisions are contained in Regulations 229-232 of the Human Medicines Regulations 2012 [124] . For further information visit the Medicines & Healthcare products Regulatory Agency ( MHRA) website [125] .

Independent Prescribers

10. There have been a number of changes to the Misuse of Drugs Regulations 2001 and Human Medicines Regulations 2012 to allow a variety of medical practitioners to become independent prescribers in addition to the traditional doctors and dentists who could prescribe prescription only medicines. Links to relevant information and legislation can be found at MHRA website [126] .

Administration of injectable medicines for the purpose of saving life in an Emergency

11. Regulation 238 of the Human Medicines Regulations 2012 allows for certain prescription only medicines to be administered by anyone for the purpose of saving life in an emergency. For more information see Regulation 238 and Schedule 19 of the Human Medicines Regulations 2012 [127] .

Controlled Drugs

12. In recent years there has been a significant number of children and young people receiving schedule 2 controlled drugs to treat ADHD e.g. methylphenidate (Ritalin; Concerta, Equasym, Medikinet) and there is a need for storage and administration of these while at school. The management and use of controlled drugs is currently reserved under the Scotland Act 1998 and is a matter for the Home Office who have UK-wide legislation in place to govern the therapeutic use of CDs. Most recently, the Controlled Drugs (Supervision of Management and Use) Regulations 2013 [128] came into force in 2013.

Health and Safety at Work

13. The Health and Safety at Work etc. Act 1974 [129] and Management of Health and Safety at Work Regulations 1999 [130] both deal with health and safety for employees and non-employees present in workplaces, including schools.

Education (Schools and Placing Information) (Scotland) Regulations 2012

14. Under the Education (Schools and Placing Information) (Scotland) Regulations [131] , schools must publish information about their arrangements for additional support for learning in a school handbook.

The Waste Management Licensing (Scotland) Regulations 2011

15. Paragraph 12 of Schedule 4 of the Waste Management Licensing (Scotland) Regulations 2011 [132] requires schools to register as a professional carrier and transporter of waste with the Scottish Environment Protection Agency ( SEPA).


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