Looking after a child with diabetes isn't just the responsibility of one person. The information on the following page explains the role and responsibilities of each person involved, and defines what good practice looks like. In some nations this, or parts of this, are backed up in law.
By following this best practice, your school will meet the requirements of the Children & Families Act (2014) in England – find out more about the legal situation in your nation.
On this page you will find:
- Responsibility of headteachers, school governors and responsible bodies
- Medical conditions policy
- Individual Healthcare Plan (IHP)
- Medicine - insulin and equipment
All schools should look after and support children with medical conditions, like diabetes, so they remain safe and healthy, and help them get the most out of their time at school.
We know that in larger schools the headteacher, school governors and responsible bodies may decide to hand the responsibility of making arrangements for children with medical conditions to a senior member of the school’s management team. If this is the case then they must make sure the responsibilities set out in this section are met.
*All schools in the UK have a governing body of some sort, though they have different names depending on the type of school and the nation it is in.
Headteachers, school governors and responsible bodies should make sure their school has a medical conditions policy.
The policy should recognise medical conditions can be life threatening, understand the impact it can have on a child’s ability to learn and make clear every child with a medical condition is different and should be treated as an individual.
The medical conditions policy must make clear who is responsible for the policy. If it is not the headteacher it must be a senior member of the school’s management team and they should be named in the policy.
How the medical conditions policy will be implemented must be explained, and schools must review and audit their policy regularly to make sure the arrangements for children with medical conditions are working.
The policy must also be readily available for parents and staff to view and the school’s complaints procedure must be part of the medical conditions policy.
What do staff need to know?
Headteachers, school governors and responsible bodies must make clear the plans and procedures they have in place when they are made aware a child has been diagnosed with diabetes.
This will include arrangements for training key members of staff and making sure all relevant staff are aware of the child’s condition. Every teacher who takes the child for a lesson will have to be made aware of their condition and have a basic understanding of diabetes. It is good practice that every member of staff is made aware of the child’s condition.
All staff must understand their role in helping the school look after children with medical conditions.
The policy must set out what members of staff should do in an emergency. An emergency is an incident that requires immediate attention, not simply treatment that requires an ambulance.
Take a look at asample Medical Conditions Policy(PDF, 214KB).
Every child with diabetes will need an IHP. Headteachers, school governors and responsible bodies should make sure each child has an IHP and that it is being carried out.
When a school is informed that a child has been diagnosed with diabetes or will be joining the school the head should organise the initial meeting to agree the IHP. They will need to make sure the child’s parents, the child’s diabetes specialist nurse and all relevant members of staff are present. If it is appropriate, the child should also be present. This should be well in advance of a child starting a new school, and ideally within 2 weeks of a child being newly diagnosed.
A school should make sure it informs the school nurse of the child’s diabetes.
Who should see the IHP?
The child’s IHP should state who needs to see it. Some parents may have issues with privacy. However, in reality every teacher who teaches the child will need to know about their diabetes, have read and understood the IHP and have a basic knowledge of diabetes.
Exactly what a child is able to do themselves should be clearly stated along with what help they need to look after their diabetes. Every child’s ability to manage their own diabetes will differ and progress, and potentially regress, at different speeds.
Your medical conditions policy should state that staff must receive suitable training and make clear how these members of staff will be supported in carrying out their role in supporting a child. The policy should make clear how training needs are assessed (by a specialist diabetes nurse for diabetes) and how training will be provided.
You should make sure sufficient staff are trained to care confidently for children with diabetes. If your school has a child with diabetes, at least two members of staff will have to be trained, normally by the child’s diabetes specialist nurse, and parents may also be involved.
You should make sure staff have received suitable training and be signed off as competent before they support a child with diabetes. If you have staff members who are already trained about one child’s diabetes they will still need to be signed off as competent for another child, as their diabetes care may be very different.
You should make sure the staff members who are trained have their training reviewed and kept up to date. If a child’s diabetes care changes - eg they may move from injections to an insulin pump - then the staff member will need further training.
If no members of staff volunteer to be trained then you will need to employ members of staff who are prepared to be trained.
Contingency plans and absence
Heads, school governors and responsible bodies should also make contingency plans so the school always has someone who is trained available and you are prepared for staff absence and turnover. You should make clear how you will inform supply teachers of a child’s diabetes.
You should make sure the school has a suitable level of insurance in place. You should make clear in your medical conditions policy any requirements of the insurance, such as staff members supporting children being trained properly.
When a child is taking exams, schools should have an agreed exam protocol in place, which is clearly stated in their IHP. It will vary from child to child. For example, some may like to take the exam away from other children in case they need to treat themselves, while others will want to be with their classmates.
This should be agreed well before the exams take place. Invigilators must be made aware of the agreed protocol.
Heads, school governors and responsible bodies should make sure that no child is excluded from any part of school life because of their diabetes. This includes making sure they are able to take part in PE, extra-curricular activities, school trips and residential trips.
You should make sure that all relevant staff organising these activities are aware of this and make necessary plans to make sure the child can take part. This can be included as part of a normal risk assessment plan.
For residential, overnight trips, the lead member of staff should meet with the child (if appropriate), the child's parents, your school’s trained members of staff and, at the very least, speak to the child’s diabetes specialist nurse to agree the support and care needed for them to take part.
Only allowing a child with diabetes to take part in an extra-curricular activity or trip if one of their parents or carers accompanies them is not acceptable practice.
There are several unacceptable practices heads and governors must make sure do not take place in their school:
- No child should be prevented from treating themselves or managing their diabetes when and where necessary.
- No school should assume a child’s diabetes is the same as another child's and requires the same treatment.
- The views of children with diabetes and their parents should not be ignored.
- Children with diabetes should not be sent home unnecessarily.
- If a child with diabetes requires treatment they should never be left alone or sent off to the medical room/school office unaccompanied.
- A child should never have their attendance penalised for attending medical appointments to do with their diabetes. Their IHP should make clear how these are entered in the register so they are not penalised.
- No child should be prevented from eating/drinking/taking toilet breaks if they need to in order to manage their diabetes.
- No child should be prevented from participating in any aspect of school like, including school trips.
- Schools must not require parents to provide support in school for their child or make them feel obliged to do so.
Heads, school governors and responsible bodies should make sure their medical conditions policy includes clear procedures around medicine.
As part of the child’s IHP, parents must give consent for trained members of staff to administer insulin.
The school should check insulin provided to the school is in date. It will generally be made available to the school inside an insulin pen or a pump, rather than in its original container.
All children with diabetes and trained staff should know where their insulin and equipment (such as their insulin pens and blood glucose meters) are kept. It should always be to be easily accessible. Some children with diabetes will look after it themselves and this should be allowed. For those who don't, who will look after it or where it is stored should be made clear. These details will form part of a child’s IHP.
A child’s IHP must also make clear what equipment and treatment they will need for PE and who should look after this when the child is taking part.
A child’s diabetes pen, their pump, or blood glucose meter must never be locked away from them.
If a trained member of staff is administering insulin, whether through a pen or a pump, each dose must be recorded. One way of doing this is by using a communications book.