Paediatric Diabetes Specialist Nurses (PDSNs)
Generally, it is the PDSN who will have most contact with schools, though in some cases other members of the paediatric diabetes team will take on this role.
Headteachers and governors have a responsibility to support children with diabetes in school properly. As a PDSN, schools will need your expertise of diabetes and of an individual child’s diabetes to successfully support the child in every part of school life.
Upon diagnosis or a child starting a new school you will need to make sure the school is informed of their diabetes. Parents will normally do this. To help make sure the child gets the care they need, you can provide them and the school with Diabetes UK’s resources for parents and schools.
Good practice checklist
All schools should have the following procedures in place to support students with long termmedical conditions such as diabetes:
Medical conditions policy
Covers what provisions the school has in place to keep children with medical conditions such as Type 1 diabetes safe and fully included in all school activities. It should be available on the school’s website.
Individual healthcare plan
You’ll no doubt have developed or provided input into many individual healthcare plans for your young patients. It’s worth discussing this with parents particularly when a change in the child’s circumstances is on the horizon.
Everyone should be working together in the interests of the child. You should feel happy that parents and schools share information about your patient regularly and constructively.
Training and support
Many PDSNs have told us that they provide training to schools as part of the care they provide their young patients. It’s a good idea to check with parents and schools that training is up to date and that staff feel confident and supported to care for the child’s needs.
Individual Healthcare Plan (IHP)
Every child with diabetes must have an IHP that is especially tailored to them and their diabetes. You will be key in helping the school and parents in putting an IHP together.
Ideally a child’s IHP should be agreed before the start of the next school year, so you and the school have time to get the right support in place. If a child is changing school, this will be especially helpful. For a child with newly diagnosed Type 1 diabetes, the IHP should be agreed as quickly as possible.
Once a school is aware of a child’s diabetes then an initial meeting to agree an IHP should be arranged by the head or the staff member named as the person responsible for the school’s medical conditions policy.
You should be invited to this meeting and you will need to determine what support the child needs and decide what amount of training staff will need.
Schools should plan for contingencies such as staff absences and turnover, so you should take this into account when deciding the level of support a child needs. Diabetes UK believes every school with a child with diabetes must have at least two trained members of staff to support them.
You should be present at each subsequent IHP meeting so you can continue to offer the school advice and review what support the child needs.
You will need to arrange training for all relevant members of staff and sign them off as competent when you are happy they can confidently support a child with diabetes.
This training will need to be kept updated and reviewed regularly. If a child’s diabetes care changes then the school must be informed, especially if more training is required for staff.
Schools should also make sure that all relevant members of staff are aware of a child’s diabetes.This will mean making sure all staff members have an understanding of diabetes and understand the child’s IHP.
You may be asked to run school awareness training. You may want to liaise with the school nurse to help you with this.
You will need to help schools make sure staff know what to do in an emergency and what constitutes an emergency and any preventative measures they can take.
Other important responsibilities
Part of your care for a child with diabetes is making sure they are being supported properly in school. If you, the parents or child, or the school have any concerns about a child’s support in school then it is important this is clearly communicated.
You may need to help reconsider the child’s IHP, or offer more training, or explain specific issues a child is having.
Schools must make sure they do not exclude children with diabetes from any aspect of school life, including school trips. Ahead of a school trip, particularly a residential, you will need to give the school advice on what care and support they will have to provide out of the ordinary school day so the child can take part.
Meet with the parents, child (where appropriate) and relevant school staff well in advance of the trip, to discuss any extra care a child may need.
For a day trip, depending on what is planned, there may be little or no changes needed to the care already provided in school. But for overnight stays, things like blood testing at night or pump changes might be needed. This might mean that school staff need extra training.
The school may need your expertise in planning for exams. This should be done well in advance, to make sure the child is not put at a disadvantage.