Taking Type 1 to School

Joe and Tom Taking Type 1 to School

Why are you here? Child about to start at nursery/school? Problems with care for your kids? Great experience to share?

Managing Medicines in School ‘There is no legal duty that requires school or setting staff to administer medicines. A number of schools are developing roles for support staff that build the administration of medicines into their core job description. Some support staff may have such a role in their contract of employment. Schools should ensure that they have sufficient members of support staff who are appropriately trained to manage medicines as part of their duties.’ Teachers’ conditions of employment do not include giving or supervising a pupil taking medicines. Schools should ensure that they have sufficient members of support staff who are employed and appropriately trained to manage medicines as part of their duties. Any member of staff who agrees to accept responsibility for administering prescribed medicines to a child should have appropriate training and guidance.

Why problems since 2005? Legal duty missingLegal duty missing Will to support missingWill to support missing Cost employing support staffCost employing support staff Clinics supporting older regimesClinics supporting older regimes

“PCTs, Local Authorities and school governing bodies should work in cooperation to determine need, plan and co-ordinate effective local provision within the resources available.”

Effective Local Provision Agreed LA & PCT Protocols Nottingham Essex Leeds Oxford Leicester Lambeth

Essex Protocol

‘ In some cases the Local Authority seek reimbursement from Health Authorities for children and young people that require complex medical intervention. To apply for reimbursement the Local Authority requires schools to provide a detailed health care plan for the pupil outlining the frequency of interventions and length of time the interventions take. To apply for funding for managing a pupil’s diabetes Nottinghamshire County Schools should contact…’ ‘Many schools are ensuring that support staff have specific duties to provide medical assistance as part of their contract. Support staff with medical experience can be a valuable addition to any school, benefiting both disabled and non- disabled pupils.’ Nottinghamshire Policy

The RCN is aware of inequality in the care provision for children and young people with diabetes in schools and early years settings. Available as PDF on line at Royal College of Nursing website.

School Approach Choosing School Before Induction Day Before School Start Train Who will be involved? What do you expect from them? What will the care plan look like? How will this translate into normal school day? What about the out of the ordinary? Monitor Who will be your school contact? How do parents/child feed back to you and you to them? What process do you follow to change things? When will you formally review the care plan?

“There is a difference between admitting and supporting a pupil in a planned manner via the usual transition from the previous school/nursery and a casual admission at some point in the year when support staff are already allocated - whichever scenario we would not recover additional funds to appoint staff to this role.” Headteacher 2011

Who should be involved? DSN, Head teacher, School nurse, child, Head of Year, SENCO/INCO, Parents, Class teachers, Teaching assistants, First Aiders, PE teachers, School Office staff, Old Uncle Tom Cobbley and all…

What do you expect? Unless you have a picture of what good care looks like it can be very hard to help a school understand what you believe should be in place for your child For younger children, show them what a typical day is like for your child; make a picture diary Talk to older children about how care has been and how they would like it to be Be realistic

You are the Teacher Do not assume everyone understands just because they nod. Prepare your lesson before hand as a teacher would. If not comfortable ask DSN but make sure you agree on the care before hand. Do not ask for help at the start, just explain and demonstrate.

‘ Injection’ conjures different images

Blood test?

Higher Education and Type 1 Harder to control: hormonal changes of puberty and emotional roller-coaster of adolescence Higher rates of Diabetic emergencies and risk of death Yet the time when young people are often expected to ‘take ownership’ of their medical condition and parents discouraged from participating

What does a Care Plan Include? CARE PLAN BG Tests PE Rules Hypo Protocols Hyper Protocols Emergency Contact Numbers Food Protocols Exam Protocol School Trip Illness Travel to school Pump/ Injection protocols

Try to adjust to their need May not be ideal but makes them feel more confident Schools like clear instruction

Start as you need to go on with tests and exams Do not wait for GCSEs Help teachers to see association between school work and BG levels

The Normal School Day! Talk to the school about how the Care Plan will translate into every day routine Use it to follow a pretend day on the timetable – do you have problem areas? Look at where people need to be – is it physically possible? Can technology help? In Secondary school might you make a more ‘User Friendly’ copy? Don’t set child or school up for failure - look for issues that may arise before they happen - it is hard to come back from.

Feelings of school staff Huge responsibility Lack of knowledge Fear of making A mistake Anxiety Pressure from Bill Lamb Therefore they need support, education and training – and this will prevent these feelings taking over!

Any questions? Sharing solutions