Best Practices for Storing and Dispensing Medication in Schools

Students may require routine medication on a daily basis, either for health issues or allergies. Others may live with medical conditions that mean they require an Individual Healthcare Plan (IHCP), which is a collaborative document that outlines the steps a school needs to take to support a pupil’s healthcare needs during the school day. 

Medication needed in school may range from tablets such as painkillers or antibiotics to eyedrops or allergy medicine, to potentially life-saving medicine such as inhalers or EpiPens that might be needed in an emergency situation. 

To ensure the safe management of a student’s medical needs, it is important that schools uphold best practices around storing and dispensing medicine to pupils. 

Legal and regulatory framework

Statutory guidance is available to all institutions (such as state schools, academies and pupil referral units) online, alongside templates that provide all of the information required to support children with managing their medical conditions at school. 

Statutory advice offers sample wording to assist with:

• Collaborating with parents regarding a pupil’s individual healthcare plan (IHCP)
• Writing parental consent forms
• How to keep accurate records of medication that is administered to children
• Recording any staff training in relation to the administration of medication at schools

Schools must act in accordance with the law regarding the administration of medicine to pupils. When thinking about how to handle medication in the school setting, schools should consider:

• How they receive and store medication at school
• How often they check the expiry dates on medicine
• How they administer or support the administration of medication at school
• How they record the medication that they administer
• How they keep records of accidents or incidents
• How they monitor reactions, side effects or anything else related to medication at school

In response to the above, school leaders need to carefully consider how they can most effectively communicate relevant information to parents, carers and stakeholders. This includes how to keep them updated on any changes to protocol and how they might address complaints or concerns.

Schools are only able to administer medication when a consent form has been completed and signed by the parent/carer of the child who needs the medication.

Key legislation covers the administration of medication in school, such as:

• Children and Families Act (2014)
• Health and Safety at Work etc. Act (1974)
• Misuse of Drugs Act (1971)
• School Premises Regulations (2012)
• Education Act (1996)

Schools have a duty under section 100 of The Children and Families Act to make reasonable arrangements to support all children at school who have medical conditions.

Under the Health and Safety (First Aid) Regulations 1981, employers must provide first aid facilities (including a first aid kit) and a trained person to administer them. This will usually be outlined in the school’s Health and Safety policy. Schools and colleges are advised to include all pupils, as well as staff, in their first aid protocol. 

The minimum first aid provision for schools and colleges is:

• A fully stocked first aid box that contains all the basics (bandages, plasters, gauze, gloves etc.) and holding at least the minimum requirements suggested by HSE
• An appointed person/persons or designated first-aider(s) to take charge of first aid
• Information available to employees detailing the location of equipment, facilities and relevant personnel

Your school’s Health and Safety policy and any first aid information should be written in a clear and accessible way and available to any parents, carers or stakeholders who request to read it.

In addition to risk assessments and a Health and Safety policy, all schools are required to draft a Medication Policy. 

Minimally, a school’s medication policy should include:

• The parent/carer’s duty to inform the school of any medical conditions
• How these needs should be met/supported
• How medication should be delivered and stored
• How medication is accessed and by whom (staff, pupils etc.)
• Any medication that is to be administered and the dose, frequency etc.
• Staff responsible for healthcare support and their training (including dates)
• Record-keeping in relation to medication
• Confidentiality/privacy information

Roles and responsibilities

Many children with allergies will need to keep medication in school in case of an allergic reaction. This may include:

• Antihistamines (tablets or oral solutions)
• Inhalers
• Auto-injectors (such as EpiPens)

Additionally, some children may require short-term medication at school, such as antibiotics if they are getting over an infection or painkillers if they have an injury or suffer from severe menstrual cramps. 

Usually, schools prefer medication to be managed outside of school hours and may have a policy that states that medicine will only be given in school when it would be detrimental to the student’s health or school attendance not to do so. 

When it is not possible to manage a student’s medical needs outside of the school day, school staff play a crucial role in ensuring the safe and effective storage and dispensing of medications for students. It is important that all of the people at school who come into contact with children who require medication understand their roles and responsibilities in relation to:

• Storing medication (where to keep it and how to keep it)
• Accessing medication (how to access it and who has access)
• Administering medication (determining the correct dosage and method)
• What to do in case of an emergency (how to access medication and how to react in an urgent care situation)

There are often multiple different staff within school settings who have different job titles and backgrounds. This might include: 

People who work in the school office such as:

• Receptionists
• Office managers
• Administration assistants
• IT support staff

Educators:

• Headteacher/Principal
• Teachers
• Teaching Assistant

There may also be other support staff in and around the school buildings on a daily basis, such as lunchtime supervisors, cooks, cleaners and sports coaches. Clear communication and collaboration among all school personnel are essential for maintaining a safe and effective medication management system. It is important that only competent and trained school staff handle and dispense medicine to pupils.

School staff cannot be forced to give medication and must do so voluntarily; however, children have the right to be able to access education. It is therefore important for schools to support staff to carry out their roles in relation to students’ medical needs and provide adequate training to them. 

It is also important that medicine is stored safely and securely and that only specific people can access it. This helps to maintain:

• Safety
• Organisation
• Continuity of care
• Accountability

Safe medication storage

To be able to accept medication, schools will usually require it to be:

• In date
• Marked with the student’s name and details
• Provided in the original container
• Labelled with instructions about dosage, administration and storage

Medication that does not satisfy these requirements will usually be returned to the parent/carer so any issues can be corrected. Medication that is not in line with the school policy generally cannot be kept on the premises.

If medicine is presented to the school in line with the school’s guidelines and administering it is deemed in the best interests of the student, once it has been accepted, the next step is to store it appropriately.

Proper storage of medications is crucial to maintain their effectiveness and prevent tampering. Schools should follow best practices for safe storage, including:

• Storing medicine in an appropriate place. This may be a secure, locked area with controlled access (such as a locked cupboard in the school office or headteacher’s office)
• Maintaining proper temperature and humidity conditions in line with instructions
• Using inventory tracking and labelling systems to monitor medication supply
• Storing medications in their original containers with clear labels

Not storing medication correctly increases the probability of an incident occurring. It can also affect the efficacy and stability of the medicine which puts students at risk. 

To uphold best practice for storing and dispensing medication in school, the most basic requirements are:

• Schools should only accept medication in unopened, original bottles or packaging
• All medication must be clearly labelled with the student’s details
• Consent forms must have been completed by parents/carers for all medication (including over-the-counter medicine, such as painkillers)
• Prescribed medicines should be printed with the pharmacy label
• Medicine must be stored as per the original instructions in an area with limited access
• Staff dispensing medication should be competent and trained
• Schools must act in line with legislation and best practice

Schools will also need to draft instructions in their policy for how medication is to be stored or administered on school trips or residentials.

Medication dispensing protocols

Standardised protocols for medication dispensing are essential to ensure student safety. Schools should establish procedures for:

• Verifying student identity before dispensing medication
• Confirming the correct dosage and medication
• Measuring the correct dosage out
• The correct method for administering medication
• Documenting medication administration and maintaining accurate records
• Ensuring that students receive medication at the correct time and in the correct dosage
• Checking any relevant consent forms and paperwork has been completed

Medicines should be stored in a safe and secure area. This will usually be a cupboard in the school office. Some medication may need to be kept at a specific temperature and may need to be placed in a refrigerator. 

Controlled drugs should be kept in a locked container (that is not portable) and only named staff should have access.  

Students should also feel safe and dignified when they are receiving their medication. This may mean taking them to a quiet and/or private place to receive their medicine.

Emergency medication access

In an emergency situation, students will need to be able to access their medication as soon as possible. To reduce wasting valuable time or panicking, staff should be fully trained in what to do in an emergency, such as if a child is stung by a bee and has an anaphylactic reaction. 

Schools need to have clear protocols in place for accessing emergency medications, such as epinephrine auto-injectors (EpiPens) and inhalers for asthma. Emergency medication should be kept in a safe location but does not need to be locked away as it should always be readily available to children who need it. 

Emergency protocols should include:

• Designating a specific location for emergency medications
• Ensuring easy access to emergency medications
• Making sure that students know how to access their emergency medication
• Training staff members on emergency medication administration
• Documenting and recording emergency medication administration

Sometimes, it may have been agreed that a student is responsible enough to keep their emergency medication on them, for example in their school bag.

One million children are receiving treatment for asthma in the UK and it is the most common long-term medical condition for children. Some schools choose to purchase salbutamol inhalers and space-saver devices to be kept in school in case of an asthma-related emergency. 

If your school chooses to keep emergency inhalers on the premises, you need to establish protocols for their use. Prior written consent should be given by parents which states that their child may use an emergency inhaler. This will usually be when the child has been diagnosed with asthma and their usual inhaler is unavailable (for example it is broken or has been lost). 

Adrenaline Auto-Injectors (AAIs) should be kept in school for children who are at risk of anaphylaxis (often in reaction to food allergies or insect stings). These can be administered by non-healthcare professionals including parents, teachers and first-aiders. These AAIs should be kept in a named box in a central location and not locked away.

Since October 2017, the Human Medicines (Amendment) Regulations have allowed schools to purchase AAI devices without the need for a prescription. These should only be used in an emergency situation where prior written consent has been obtained from:

• Parents/carers
• A medical professional

This includes children who are known to be at risk of anaphylaxis (who have a medical plan that confirms this) but have not been prescribed their own AAI.

Training and education

Proper training and education are essential for any staff members who are involved in the storing and administering of medication at school. The school’s policy should outline which staff are responsible for supporting students with their medical needs and that they have received relevant education and training. Training will usually be provided by a school nurse, community nursing teams or other medical professionals. 

Any personnel involved in giving children their medicine, storing their medicine or who have access to medicine should have received training about:

• Medication management and administration
• Student medical needs and conditions
• Emergency medication administration
• Documentation and record-keeping

Additionally, school staff should know how to:

• Check expiry dates on medication
• Communicate clearly with parents or carers about medical needs
• Make children feel safe and supported with regard to their healthcare
• Report any concerns they have, address gaps in their knowledge or request additional training

Conclusion

It is good practice to keep clear records of any training and certification that staff have received in relation to caring for children’s medical needs and administering medication. In addition, students should also know who they can go to for support with their health.

It is important to uphold good health and safety practices within schools, which include best practices for medication storage and dispensing. 

Having clear guidelines and well trained staff is essential for ensuring the safety and well-being of students. Schools should establish clear roles and responsibilities, adhere to safe storage practices and follow standardised protocols to create an environment where medication management is effective and efficient.

Communication, clarity and a collaborative approach are key in safely supporting children with their medical needs at school.