Prescribing - Nurseries, schools and OTC Medications
Non-prescription (OTC) medication does not need a GP signature/authorisation in order for the school/nursery/childminder to give it.
It has been brought to the attention of the GPC Clinical and Prescribing Subcommittee that the revised 'The Early Years Foundation Stage Statutory Framework', which governs the standards of institutions looking after and educating children, includes a paragraph under specific legal requirements - medicines, that states: 'Medicines should only be taken to a setting when this is essential and settings should only accept medicines that have been prescribed by a doctor, dentist, nurse or pharmacist.' We are aware that in some areas this is resulting in parents making unnecessary appointments to seek a prescription for an OTC medicine, just so it can be taken in nurseries or schools.
The Clinical and Prescribing Subcommittee wishes to remind GPs that the MHRA licenses medicines and classifies them when appropriate as OTC (P or GSL). This is to enable access to those medicines without recourse to a GP. It is appropriate for OTC medicines to be given by parents, as they consider necessary, in the home or nursery environment. It is a misuse of GP time to take up an appointment just to acquire a prescription for a medicine, wholly to satisfy the needs of a nursery/school. The Clinical and Prescribing Subcommittee wrote to the Department of Children, Schools and Families seeking an amendment to this paragraph in the Statutory Framework and we have now heard from that Department. They will amend their guidance to stay consistent with current national standards for day care and childminding, whereby non-prescription medication can be administered where there is parents' prior written consent. Should any practice find that this continues to be a problem in their area we have produced a template letter which can be downloaded and sent to the Nursery/School.
The Statutory Framework for the EYFS (Early Years Foundation Stage) outlines the policy for administering medicines to children in nurseries/preschools 0-5 years
“The provider must promote the good health of children attending the setting. They must have a procedure, discussed with parents and/or carers, for responding to children who are ill or infectious, take necessary steps to prevent the spread of infection, and take appropriate action if children are ill.
Providers must have and implement a policy, and procedures, for administering medicines. It must include systems for obtaining information about a child’s needs for medicines, and for keeping this information up-to-date.
Training must be provided for staff where the administration of medicine requires medical or technical knowledge. Medicines must not usually be administered unless they have been prescribed for a child by a doctor, dentist, nurse or pharmacist (medicines containing aspirin should only be given if prescribed by a doctor).
Medicine (both prescription and non-prescription) must only be administered to a child where written permission for that particular medicine has been obtained from the child’s parent and/or carer. Providers must keep a written record each time a medicine is administered to a child, and inform the child’s parents and/or carers on the same day, or as soon as reasonably practicable”.
Statutory guidance for governing bodies of maintained schools and proprietors of academies in England: Supporting Pupils at School with Medical Conditions - December 2015
- "No child under 16 should be given prescription or non-prescription medicines without their parent’s written consent – except in exceptional circumstances where the medicine has been prescribed to the child without the knowledge of the parents. In such cases, every effort should be made to encourage the child or young person to involve their parents while respecting their right to confidentiality. Schools should set out the circumstances in which non-prescription medicines may be administered
- A child under 16 should never be given medicine containing aspirin unless prescribed by a doctor. Medication, e.g. for pain relief, should never be administered without first checking maximum dosages and when the previous dose was taken. Parents should be informed".
This website is also a useful resource: https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3