Allergy Management Policy

The Scottish Government’s guidance states that the policy for pupils with medical conditions, including allergy, should be provided by the local council’s educational authorities. Head Teachers should be aware of this policy and reflect it throughout each of the school’s individual policies and procedures.

An allergy management policy should therefore be in place across all schools. It may be incorporated into a wider medical conditions policy but schools should always have specific arrangements related to the management of children with severe allergies.

This policy should reflect the main goal of the school, as outlined by the European Academy of Allergy and Clinical Immunology (EAACI, 2014), which is to:

“Create a network of support and self-sustaining environment of awareness which will in turn decrease the likelihood of reactions and enable staff to recognise and treat emergencies”

It is important to have a policy in place even if there are no pupils with allergies currently registered.

"Approximately 25% of severe allergic reactions which happen in school occur in pupils with no history of allergies"

Allergy Management Policy - Scottish Government Guidance

The Scottish Government guidance states the Allergy Management Policy should include:

	Procedure for identifying pupils with allergy and high risk pupils.
	Details on developing Individual Healthcare Plans.
	Protocol for storage and access to emergency medication – emergency kits.*
	Arrangements for staff training.
	Policies and arrangements on Preventative Measures.
	Details on the administration of medications.
	Protocol for the emergency response to anaphylaxis.
	The rights, roles and responsibilities of staff, pupil(s) and parent/ carer(s).

*All staff should be able to quickly and easily locate emergency medication. Emergency kits should be stored in an unlocked, central location e.g. school office

Parents/carers of pupils with allergies need to provide the school with the child’s personalised allergy action plan, given by the healthcare professional. This confirms the allergy has been medically diagnosed which will help with the management in school.
This will state the allergen(s) to avoid and how to manage a mild, moderate or severe allergic reaction.
An example of a management plan is the BSACI Allergy Action Plan.

NB: Different health boards may use a different design or style of plan, but they should all include the same information.

Clear Communication

The whole school and any visitors must be made aware of the allergy management policy, including breakfast clubs, after-school clubs, and other committees run at school.

Helpful resources

Online resources are available to help schools develop an anaphylaxis policy from Allergy UK:

Whole School Allergy Awareness & Practical Action Management Video
Allergies in Schools Self Audit
FAQ’s worksheet for schools
School Allergy Action Group Resource Kit

A model school’s policy that is currently available can be accessed from Allergy UK here.

The National Association of School Nurses (United States of America) have examples of allergy policy templates and other useful documents. These can be used as a guide when drafting the school’s own policy, but local policies must be taken into consideration.

Some of the preventative measures or procedures outlined may not need to be implemented if there are no pupils with allergies currently enrolled. However, it is good practice that staff are aware of safe allergy management practices and when they should be implemented. It is also recommended by the European Academy of Allergy and Clinical Immunology that staff should have general knowledge of the emergency response to anaphylaxis in order to improve preparedness.

Preventative measures

Measures to prevent reactions happening in the school and increase the preparedness for anaphylaxis should be incorporated into the allergy policy.

The European Academy of Allergy and Clinical Immunology (EAACI) and the Department of Health (DoH) have guidelines on how to manage pupils with allergies at school:

1. Allergy lessons as part of the curriculum for pupils.

2. Education for all school staff in preventing cross contamination of allergens during handling, preparation

and serving of food.

3. Emergency medication stored in school for pupils with allergies.

4. Distribution of menus to parents/carers and pupils with the 14 allergens listed

(a full ingredients list should be made available upon request)

5. Supervision during meal times.

6. Allergen free areas, where there may be a high risk of allergen exposure, e.g. canteen or cooking classes.

7. Clear allergen labelling of all meals, drinks and snacks in the canteen.

8. Labelling individual cups/ bottles/ containers with children’s names.

9. No food sharing policy.

10. No eating utensil sharing policy.

11. Routine Cleaning (with warm soapy water and disinfectant) of tables, floors and food preparation areas,

especially after meal times.

12. Encourage hand-washing after meals/ snacks.

13. Discuss with parents/carers and obtain their permission before giving food treats to pupils with allergies

(e.g. birthday parties or special events).

14. Risk assessments completed for school trips, exchanges and excursions.

15. No eating policy on school buses.

A PDF version of this checklist is available here.

Things to consider

Policies and procedures should always be structured around ethical principles, empowerment of pupils with allergies, fairness and inclusion.

Head Teachers should consider the following when implementing preventative measures, as recommended by the European Academy of Allergy and Clinical Immunology:

QUESTION	EXAMPLE
Do preventative measures benefit all pupils with allergies?	Placing a peanut ban does not reflect the needs of a pupil with a milk allergy. On the other hand, a no food sharing policy considers all allergies.
Do policies cause pupils with allergies to stand out or seem different to peers?	Having separate tables or queues for children with allergies can isolate the pupil and may encourage bullying.
Are pupils with allergies given the same opportunities as other pupils?	If all school meals state they are not guaranteed to be nut free, this excludes pupils with nut allergy from having school meals altogether. Catering services and staff should ensure that meal options are available for all pupils with allergy and that measures are in place to reduce the risk of allergen cross contamination.

Stay prepared for emergencies

Teachers should know what is included in the school’s Allergy Management Policy and Emergency Response Protocol.

The Head Teacher or member of the SMT should be able to provide clarification on the teacher’s role. If an anaphylaxis policy or emergency protocol is not in place then the Head Teacher or SMT should provide guidance.

Teaching staff should be able to quickly locate the emergency medication.

School's Emergency Medication:

It is common for schools to request pupils AAIs are left in school to avoid the situation where a pupil or their family forgets to bring the AAIs. This should be stored as part of an emergency kit in an unlocked, easily accessible place in the school such as the school office or staff room. The kit should be marked clearly with the pupils name. Before school holidays, schools may wish pupils to take their medication home to ensure they remain in date.

Child's own Emergency Kit:

Primary School

Secondary School

The pupil must still have access to an AAI when travelling to and from school. The child’s own emergency kit should be carried by the parent/carer or left at school and passed back to the parent/carer for transport to and from school.

Where children are considered to be sufficiently responsible they should carry their emergency medication on their person. Staff should learn where this is kept.

Ideally pupils will store medication in an emergency bag that is carried with them at all times. However medication may also be stored in convenient places for pupils such as pencil cases, blazer pocket or school bag.

In large schools or split sites, it is often quicker for staff to use an adrenaline autoinjector that is with the child rather taking time to collect one from a central location.

Recognise Anaphylaxis

Teachers should be able to recognise the signs and symptoms of a severe reaction/anaphylaxis and distinguish this from a mild to moderate one.

Lungs

Airway and Breathing Problems:

Persistent Cough
Hoarse voice/high pitched sound (stridor)
Difficulty swallowing, swollen tongue
Difficulty or noisy breathing
Wheeze

Heart beat

Low Blood Pressure affecting the Consciousness Level:

Sudden tiredness/ sleepy
Collapse/ loss of consciousness
Persistent dizziness
Pale or floppy

If any one (or more) of these signs above are present follow the Emergency Response to Anaphylaxis. The symptoms of anaphylaxis may be different depending on the individual. The allergic reaction may also start as mild and progress rapidly to severe. More information can be found in the All About Allergies section.