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Diabetes in schools – responsibilities of trained staff

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As a member of school staff, whether you have volunteered to be trained about a child’s diabetes or it forms part of your contract – thank you! The help and support you will offer them will not only help make sure they get the most out of their time in school but you will also be making sure their parents can be confident that their child is getting the right support.

 

Many of the responsibilities around supporting children with diabetes are for the school’s management team, governors or responsible body. A lot of them exist to make sure you get the support you need to confidently look after a child with diabetes.

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You are not alone

Any member of school staff can volunteer to look after a child with diabetes, whether it is a teacher, teaching assistant, a SENCO, pastoral year head, a deputy head, head teacher or a member of staff in the office.

Simply because you have volunteered to be trained about a child’s diabetes, it doesn’t mean it is just you who is responsible for them.

If a school has a child with diabetes in there should be at least two trained members of staff. The school must also be prepared for absences and staff turnover so there should always be a trained member of staff available.

As part of a school’s medical conditions policy all members of staff should understand the role they play in making sure children with diabetes are supported properly. This means each teacher who takes a child with diabetes for a lesson should understand and help you make sure the child’sIndividual Healthcare Plan(IHP) is followed.

The headteacher, school governors or responsible body have overall responsibility for making sure the medical conditions policy is carried out, so the responsibility for each child with diabetes (or any other medical condition) runs through the whole of the school.

Even when you have been trained, do not be afraid to ask questions. A child’s IHP will state who you should speak to – normally their parents or the child’s paediatric diabetes specialist nurse (PDSN).

Training

When a child is newly diagnosed with diabetes or joins the school the headteacher should call a meeting between the child and their family, the child’s PDSN and any relevant staff. This meeting will decide what training members of staff will need.

The child’s PDSN will most likely carry out training, as they have expertise about both diabetes and that particular child’s diabetes care. The parent may well be involved as well. 

Depending on the level of support needed, training might include administering insulin by a pen or a pump, testing blood glucose (blood sugars), understanding what these readings mean, carbohydrate counting and making sure you know what a hypo and hyper are and how they are treated.

You must be properly trained and signed off as competent by a suitable healthcare professional (usually the child’s PDSN) before you are asked to support a child with diabetes. You should never administer insulin or undertake any of their medical care if you have not been properly trained.

The school must make sure your training is reviewed and updated regularly. If a child’s care changes, eg if they move from using an insulin pen to a pump, then your training must be updated.

If you are asked to provide care for a child with diabetes without being trained then you should immediately speak to a senior member of staff and, if necessary, your trade union.

Emergency procedures

An emergency for a child with diabetes means an incident that requires immediate treatment. In most cases this will be a hypo – low blood sugars – or a hyper – high blood sugars. It is inevitable that at some point a child you have been trained to support will have a hypo or hyper.

Find out more on emergency procedures

Insulin, record keeping and communication

Depending on how much support the child needs, you might be required to look after the child’s insulin and equipment. This should always be easily accessible and never locked away. The child’s IHP must make clear where it is kept.

If a child is taking part in PE you may have to make sure the teacher is given the child’s equipment, treatment or hypo kit. What happens in PE will be included in the child’s IHP.

Schools should keep a record of any prescribed medicines given to children, which means doses of insulin for children with diabetes. It is likely keeping these records will be your responsibility. A log book will help you do this. In this you can record what dose of insulin has been given, carbohydrates eaten, blood sugar levels and room to record any emergency incidents like hypo and hypers.

If a child refuses their insulin or other treatments, then what happens next will be covered in their IHP. The school must inform parents of this.

Along with formal record keeping, good communication with parents will be very important, particularly if the child you are supporting is young or newly diagnosed. The IHP will state exactly when parents need to be contacted but do not be afraid to ask questions or let them know of any concerns you have.

A child and their parents will often know the most about their diabetes so it is important you listen to their views and thoughts.

Individual Healthcare Plans

Before you begin supporting a child with diabetes, you should have read and understood their individual healthcare plan. The IHP would have been developed after a meetin between the school, parents and the child's PDSN. At this meeting the support the child needs would have been identified. You might not have been at this first meeting, but you should be invited to subsequent ones, as you will be well placed to see how well they are doing in school or progressing with self-management of their diabetes. For instance, you might spot there is a particular lesson a child has a hypo in, which may be a trigger no one else has spotted.

Promoting self-management

Along with treating each child with diabetes as an individual, school staff can be helpful in promoting self-management of the condition. This is something you will need to contribute to.

If a child is very young or newly diagnosed it is likely you will be required to test blood sugars, administer insulin and count carbohydrates (carbs).

As the child gets older or more confident with looking after their diabetes, what you will be required to do might change, and should be updated in the child’s IHP. A child who has just started injecting themselves might still want you to be there to check they’re doing it right, and you might still need to inject them if they’re having a bad day.

It is also important to remember that self-management isn’t always going to constantly improve. An 11-year-old who is very diligent with their care may, as they hit their teenage years, suddenly start skipping insulin doses or avoid treating hypos as soon as possible. Keeping parents and the school informed of any issues you spot is very important.

Further information and support

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