Medical Policy – Students with Health-care needs
Date: 13/10/2020
Many students will at some time need medical treatment and/or advice while resident in, or attending courses at St. Clare’s. These may be as a result of –
- short-term conditions, perhaps requiring a course of medication;
- medical conditions such as asthma or diabetes that if not properly managed could limit their access to education;
- conditions that also require emergency treatment e.g. severe allergic conditions (anaphylaxis) or epilepsy.
Students with such conditions are regarded as having health care needs.
1. Information about the health care needs of individual students
1.1 Parents or guardians have prime responsibility for the health of their son or daughter and should provide St. Clare’s with full information about any medical condition they have, by completing the IB Joining Information Form provided from the Admissions Office, prior to the arrival of the student. Parents must give full medical details (in English), in conjunction with their doctor, if necessary. The medical questionnaire section seeks parental consent for routine and emergency treatment. A copy of the Joining Information Form will be made available to the responsible Boarding Staff and Personal Tutor of each student, as well as senior staff who have a welfare role. The medical information will also be shared with the College Nurses.
1.2 When students move from PIB to IB1 or from IB1 to IB2 their parents will be asked to update their personal information and medical forms . Parents should also inform College of any significant changes to a student’s health care needs that take place since forms have been completed.
1.3 Parents are responsible for ensuring that their son/daughter has the meningitis ACWY and the full course of MMR vaccinations prior to arrival at St. Clare’s. If students arrive, unvaccinated, we offer the vaccination here. Parents are notified by email if unexpected outbreaks or epidemics of a particular infection occur. If their child has not been vaccinated against that particular infection, it will be strongly recommended. The College Nurse and/or Vice Principal, Pastoral should be consulted when a student with significant health care needs e.g. diabetes, multiple sclerosis, anorexia, mental illness etc. applies to join St. Clare’s, Oxford. It must be clear that the College has the facilities and personnel to provide adequate care for the student, before their admission is agreed.
1.4 Parents should reach an understanding on the College’s role in helping with the student’s health care needs. Parents’ cultural and religious views should be respected.
1.5 Other than the medical questionnaire in the Joining Information Form, the College seeks the student’s agreement before passing on information about their health to other College staff e.g. Personal Tutors, boarding staff. Sharing information is important if staff and parents are to ensure the best care for a student – (see ‘Protocol for sharing of welfare information – Nurse’).
2. Staff responsibility for health care of students
2.1 Only the College Nurse has ‘meeting the health care needs of students’ as her/his prime duty. However, boarding staff have emergency supplies of homely medicines that can be administered to students outside of the College Nurses’ working hours, where deemed necessary.
2.2 The College Nurse will draw up individual Welfare Plans for students with serious health care needs, which may include information already provided by parents and the student’s doctor.
2.3 The College Nurse will train boarding staff in the administration of specified homely medicines. They may also train other College staff who are authorised to administer medication, or take responsibility for other aspects of support.
2.4 When College staff are authorised to give students help with their health care needs, the Vice Principal, Pastoral should agree to their doing this, and must ensure that they receive proper support and training where necessary. Day to day decisions about administering medication will normally be taken by the Nurse.
2.5 Any member of staff who agrees to accept responsibility for administering prescribed medication to a student should have proper training and guidance from the Nurse. They should also be made aware by a health professional of possible side effects of the medication and what to do if they occur.
2.6 College staff should never administer any medication without appropriate training from the Nurse.
2.7 The Vice Principal, Pastoral is responsible for implementing the College policy in practice and for developing procedures for meeting the health care needs of students. The Vice Principal, Pastoral will need to agree with the parents exactly what support the College can provide for a student with significant health care needs. Where there is concern about whether the College can meet a student’s needs, or where the parents’ expectations appear unreasonable, the Vice Principal, Pastoral can seek advice from the College Nurse or College Doctor.
2.8 Any staff noticing an apparent deterioration in a student’s health over time should inform the Nurse who will consult with the Vice Principal, Pastoral regarding informing of parents.
3. Meeting Short Term Health Care Needs
3.1 Many students will need to take medication at College. Mostly this will be for a short period only, e.g. to finish a course of antibiotics or to take some cold treatment remedy. To allow students to do this will minimise the time they need to be off College.
3.2 Advice regarding appropriate treatment may only be given by the College Nurse or a health care professional to whom the Nurse refers the student. Non-prescription medication must not be provided to any student by staff other than the College Nurse, boarding staff or other staff trained and authorised to administer non-prescription medicine.
3.3 College staff should never administer medication without permission and appropriate training from the Nurse.
3.4 Students are instructed to attend the Nurse’s surgery if unwell. If they are unable to attend the surgery, they inform the boarding staff, or Domestic Assistant and the information is passed to the Nurse who will visit these students in their house.
3.5 Medical rooms – Most students are able to stay in their room if they are unwell and will be checked on by the Nurse and the House Warden. However, College has number of medical rooms set aside for the accommodation of students under the following conditions:
- have infectious conditions;
- are unable to go to the Dining Room to get meals;
- require the enhanced supervision provided by the Nurse and the Head of Boarding and boarding staff.
If a student is admitted to a medical room, they will be cared for by the Nurse and the Head of Boarding and boarding staff.. The Nurse will arrange for meals to be delivered to the medical rooms when students are present there. Students will have access to a mobile phone so they can contact a staff member in an emergency.
Please refer to Procedures for Supporting Students who are unwell for more detail.
4. Meeting Long Term Health Care Needs
4.1 It is important for the College to have sufficient information about the medical condition of any student with long term health care needs. Early warning of such issues will also allow the necessary procedure to be put in place. If a student’s health care needs are inadequately supported this can have a significant impact on academic attainment and/or lead to emotional and behavioural problems. The College therefore needs to know about any health care needs before a student starts College, or when a student develops a condition. For students who attend hospital appointments on a regular basis, special arrangements may also be necessary.
4.2 The most common medical conditions in College age students, which require support, are asthma, diabetes, epilepsy, eczema, mental health problems, trauma injuries, allergic reactions (anaphylaxis if severe), eating disorders and cystic fibrosis.
4.3 When Admissions staff are informed that a student has significant healthcare needs, the College Nurse and/or Vice Principal, Pastoral (VPP) should be consulted and if possible a meeting arranged between the Nurse, VPP, the student and parents. The purpose is to ensure that College has the resources to meet the expectations of parents and needs of the prospective student.
4.4 If a Welfare Plan is needed, e.g. for diabetics, epileptics, haemophiliacs, anorexics and students with multiple sclerosis, the Nurse will draw up the plan, involving parents and the student. The plan will be shared with the student’s Warden, Personal Tutor and the Vice Principal Pastoral to ensure that the student is supported appropriately whilst at the College. If other College staff have agreed to administer medication or be trained in emergency procedures (e.g. epi-pen use), then they also must be informed of and agree to the plan.
4.5 The main purpose of an individual College Welfare Plan for a student with health care needs is to identify the level and type of support that is needed at College. An agreement with parents clarifies for staff, parents and the student the help that the College can provide. College should agree with parents and the student how often they should jointly review the Welfare Plan depending on the health care needs.
4.6 The plan should be tailored to the individual needs of the student but could include:
- details of a student’s condition
- special requirements e.g. dietary needs, pre-activity precautions
- medication and any side effects
- what to do, and who to contact in an emergency
- where medication is stored
- the role the College can play.
4.7 Each plan will contain different levels of detail according to the needs of the individual student. The need for a health care plan and the medical detail of such a plan should be assessed by the College Nurse and the Vice Principal, Pastoral. Detailed plans will not be required for short-term needs where a student for example is taking a course of antibiotics.
5. Information for Staff
5.1 Staff who may have to deal with an emergency will need to know about a student’s health care needs, including boarding staff, Activities teachers and staff who lead trips.
5.2 The College Nurses and the Vice Principal, Pastoral will collate information from medical forms and distribute information to staff as necessary e.g. to boarding staff regarding students in their house, to Catering Dept. regarding students with food allergies etc.
5.3 All College staff should treat medical information confidentially. Information on a student’s health care needs is covered by the Data Protection Act 2018. Care must therefore be taken to ensure that consent is obtained before passing information to another party. Sensitive information about a student should be shared only with those who need to know.
5.4 A person under the age of 16 has legal capacity to consent to any surgical, medical or dental procedure if in the opinion of a health professional that person is capable of understanding the nature of the treatment. This means that parental consent will only be relevant if the Nurse feels that the student does not have sufficient understanding. However, in situations where parental consent is not legally required good practice would seek to involve parents, with the offspring’s consent, in any decisions about medical examinations or procedures.
6. Nut allergies and food allergens
6.1 The following nuts will not be used in products cooked at St. Clare’s or sold in the Sugar House: macadamia, pistachio, brazil, pecan, cashew, walnut, hazelnut, almond and peanut.
The Catering Department and Sugar House provide a nut-free environment.
6.2 The Catering Dept will use signage to provide allergen information for foods sold non-prepacked and it is the student’s own responsibility to check this allergen information.
6.3 Students will be made aware of the significance of food allergies and strongly encouraged to avoid bringing nuts into the College in order to minimise incidences of allergic reactions of those students who suffer from nut allergy.
7. Non-Prescription (Homely) Medicine
7.1 Students sometimes ask for non-prescription medication such as paracetamol. Aside from the College Nurse, or staff trained and authorised by the College Nurse, College staff should not give non-prescribed medication to students. They may not know whether the student has taken a previous dose, or whether the medication may react with other medication being taken. In cases where an authorised member of staff provides the student with non-prescription medication, they should record:
- The name of the student
- The name of the medication
- The dose administered
- The time of administering
- Reason(s) for administering
The information is recorded electronically. The College Nurse has access to this record.
7.2 Students may self-medicate if judged competent to do so by the College Nurse e.g. if a student suffers regularly from acute pain, such as migraine. Before permitting a student to self-medicate, the student will need to meet with the College Nurse to discuss administration and storage of the medication. The student will be required to sign a Self-Medication Assessment Form. This form will be shared with the student’s warden.
7.3 Students are not allowed to bring any over the counter/homely remedy or non-prescription medication into college at any time.
8. Prescribed Medication
8.1 Self-Management – some students can manage their own medication from a relatively early age. An example would be inhalers for students with asthma. Some students with diabetes may have to inject insulin during the College day. Appropriate facilities should be provided to allow the student to do this in private. Students who are prescribed medication will have met with the College Nurse and completed a Self-Medication Assessment Form and, where necessary, a Welfare Plan will have been agreed.
8.2 Any member of staff giving prescribed medicine to a student (where authorised and trained by the College Nurse) should check:
- The student’s name
- Written instructions provided by parents or doctor
- Prescribed dose
- Dose frequency
- Expiry date
- Any additional or cautionary labels.
If in doubt about any of the procedures the member of staff should check with the Nurse before taking further action.
8.3 Administration of medication to students is recorded electronically and the College Nurse has access to these records. Each time the member of staff gives prescribed medication to the student, the following details are recorded
- The name of the student
- The name of the medication
- The dose administered
- The time of administering
9. Refusing Medication
9.1 If a student refuses to take medication, College staff should not force them to do so. Should this cause welfare or medical concern (e.g. a diabetic who refuses to self-medicate with insulin), the College should inform the student’s parents.
9.2 If refusing medication leads to disciplinary problems (e.g. a depressive who refuses to take anti-depressants), the Vice Principal, Pastoral will consult the Nurse and other staff involved in the welfare of the student before deciding the course of action to follow.
10. Record Keeping
10.1 Parents are responsible for supplying information about medicines that a student needs to take at College and for letting the College know of any changes to the prescription or the support needed. The parent or doctor should provide written details including:
- Name of medication
- Dose
- Method of administration
- Time and frequency of administration
- Other treatment
- Any side effects
The student will need to meet with the College Nurse so that a Self-Medication Assessment Form can be drawn up.
10.2 Records must be kept of the administration of medicines to students and the staff involved. Records offer protection to staff and proof that they have followed agreed procedures.
11. College Trips and sporting activities
11.1 Sometimes the College may need to take additional safety measures for outside visits. Staff supervising excursions should always be aware of any medical needs, and relevant emergency procedures. Lists of students who are proposing to go on overnight or overseas trips must be forwarded by the trip leader to the Nurse so she can identify any students with medical problems. Arrangements for taking any necessary medication will also need to be taken into consideration.
11.2 Emergency contact arrangements as detailed in the trips forms must be followed. If staff are concerned about whether they can provide for a student’s safety, or the safety of other students on a trip, they should seek medical advice from the Nurse.
11.3 Should a student refuse to have a vaccination that is recommended (e.g. yellow fever in South America) then the parents should be informed (if the student is under 18) and/or the student must sign a disclaimer acknowledging that he/she is aware of the medical advice but has refused to adhere to it. Refusal to be vaccinated must be taken into account during the risk assessment process which identifies the risks of taking individual students on College trips. The Vice Principal, Pastoral may decide that the student cannot participate in the trip.
11.4 Sporting Activities – most students with health care needs can participate in sporting and outdoor activities. However, some activities may need to be modified or precautionary measures may need to be taken, e.g. students with asthma may need to take their inhaler before exercise. Relevant staff members should be aware of students with specific health needs. Any restrictions to a student’s ability to participate should be noted in their Welfare Plan.
12. Storing Medication
12.1 Students whom the College Nurse authorises as capable of self-medicating must keep their medicines in a secure locked container e.g. the safe in their room or in a locked drawer or cupboard. In allowing students to retain medication an assessment needs to be made of the potential risk to others.
12.2 Where students are not deemed capable of self-medication and storage of medicines then the College Nurse will make appropriate arrangements and provide advice for the safe storage of medicines. In such circumstances, students should know where their own medication is stored and who holds the key. A few medicines, such as asthma inhalers, must be readily available to students and must not be locked away. Medicines should generally be kept in a secure place not accessible to students.
If the College locks away medication that a student might need in an emergency, all staff should know where to obtain keys to the medicine cabinet.
12.3 Some medicines need to be refrigerated – the Nurse has a refrigerator for this purpose. Lockable fridges are provided in houses as required.
13. Hospitalisation
13.1 A student taken to hospital for accident or emergency treatment will be accompanied by a member of staff (usually the College Nurse or the House Parent or the Head of Boarding) who should remain for a time period appropriate to the age of the student and the treatment required. The member of staff should have details of any health care needs and medication of the student. The Health & Safety arrangements in connection with “Accidents” apply.
13.2 Generally staff should not take students to hospital in their own car. However, in an emergency it may be the best course of action. The Designated Safeguarding Lead/VPP must be informed before a member of staff takes a student to hospital in their own car.
13.3 If a student is hospitalised, VPP will organise a visiting rota for members of staff from St Clare’s to attend hospital each day to provide pastoral support for the student.
14. Registration with the College Doctor
14.1 St. Clare’s students are registered with the Banbury Road Health Centre at 172, Banbury Road, close to the College main buildings. Students who attend St. Clare’s for less than 6 months will be seen as temporary patients. Dr Antony Maddison is the College doctor and he, or one of her doctor colleagues will see students if an appointment is made. This will usually be done by the College Nurse. The doctor may also visit an ill student in their accommodation if absolutely necessary.
14.2 Emergency GP care is available to everyone in the UK. It is free to people from the EU and countries with reciprocal medical agreements with the UK. Other people must pay to see a doctor or be treated at a hospital. The definition of an emergency is at the discretion of the doctor, but the Department of Health states that it means urgent and immediate care.
14.3 British nationals have full free NHS health care. Students from the European Economic Area also qualify for free health care.
14.4 Students who are here for 6 months or more, of any nationality, are regarded under NHS law to be “ordinarily resident” in the country and also qualify for free care BUT they must be registered at the start of their 6 month stay to qualify. There are other countries which have reciprocal health care arrangements with the UK and a list of them is available from the Nurse. These students will be eligible for more than emergency care from the doctor.
14.5 Students who are here for less than 6 months and who are from neither an EU state nor a country with whom the UK has a reciprocal arrangement will have to pay for treatment, either at hospital or at the doctor’s surgery. They may then be able to use the medical insurance which is part of the travel insurance that they pay for in addition to their fees, to reclaim these medical expenses.
14.6 Students can be registered with an NHS dentist but since NHS waiting lists can be long and many dentists no longer take NHS patients, it might be best to go private. See the Nurse for a list of local dentists.
14.7 Referrals to specialist doctors are made through the College doctor, not directly through the Nurse.
14.8 The Nurse can provide students with information regarding private doctors, on request.
15. College Counsellor
15.1 The College employs a Counsellor to work with students who are in need of additional emotional support. Appointments are usually made through the Vice Principal, Pastoral but students can also self-refer.
15.2 Students who see the Counsellor will not be told that any information they pass to the Counsellor will be kept absolutely confidential but they will be told that confidentiality will only be broken if
- the student has given prior consent to share certain information
- there is serious danger to the individual student or other students
15.3 If confidentiality is broken in either of the two cases above, then
- the people to whom information is passed will be limited to those the College considers necessary in order to safeguard the welfare of individual students and groups of students (e.g. Vice Principal Pastoral, Assistant Principal Pastoral, house parent, personal tutor)
15.4 If there are serious concerns about a student’s welfare then the Vice Principal, Pastoral will, having informed the student, contact parents to discuss the concerns.
Most recent review / amendment
VPP July 2020
Seen by governors in October 2019
Appendices:
- Self-Medication Assessment Form
- Welfare Plan
- Protocol for Sharing Information
- First Aid Policy
See also the following information:
- Information for House Parents – advice on the use of homely medication e.g. paracetamol
- Medical support sheets – advice on supporting students with conditions such as asthma and diabetes
Appendix 1 Self-Medication Assessment Form
Risk Assessment
Name of Student: ___________________________________ Date _______________
Date of Birth: ___________________________________
Warden: ___________________________________
| Comments (to be discussed with the student) | Risk (Please circle) | |
| Name of medication | ||
| Purpose of the medication | ||
| Dose (how much) and frequency (how many times a day) | Severity of overdose High/Medium/Low Likelihood of overdose High/Medium/Low | |
| Additional instructions eg take with food/water | ||
| Length of treatment. Advise against discontinuing course of medication without consulting the Nurse | ||
| Advise against taking other medication, at the same time, without consulting the Nurse first. | Severity of reaction if taken with other medication High/Medium/Low Likelihood of taking other medication High/Medium/Low | |
| Possible side-effects. Advise the student what they should do if side-effects are observed. | Severity of side-effects High/Medium/Low Likelihood of side-effects High/Medium/Low | |
| If under 16, does the student fully understand the medical treatment that is proposed (is the student ‘Gillick competent’)? | Yes/no | |
| Storage arrangement of the medication | Severity to other students if medication is taken High/Medium/Low Likelihood of other students having access to medication High/Medium/Low | |
| Confirm that student is aware that the medication is for their personal use only | ||
| Advise that any unused medication should be handed to the Nurse |
Is the student permitted to self-medicate Yes/No
Signed College Nurse ________________________________________________________
Signed Student ________________________________________________________
A copy of this form will be given to the student and to the House Parent
Appendix 2 Welfare Plan
- Welfare Plan template
cc. Vice Principal, Pastoral, College Nurses, House Parent, Personal Tutor
Appendix 3 Protocol for sharing of welfare information – Nurse
The Nurse is a College employee and therefore any information relating to the welfare of students which is passed to her, is deemed to be known by the College. In order to ensure that this information is handled appropriately, it must be evaluated and either kept strictly confidential or passed to other College employees responsible for the care of students.
To this end
- the Nurse will meet regularly with the Vice Principal, Pastoral to review general welfare issues relating to students that have arisen
- should urgent welfare issues arise, the Nurse will contact the Vice Principal, Pastoral directly
- the Vice Principal, Pastoral will have access to welfare infomation held by the Nurse if an urgent welfare issue arises, though not to NHS files which she may keep
- welfare related information will be kept in the non-NHS files
- the Vice Principal, Pastoral may, at his/her discretion, keep notes of the contents of any meetings and conversations with the Nurse relating to welfare issues
Students will not be told that any information they pass to the Nurse will be kept absolutely confidential. However, confidentiality will only be broken if
- students have given prior consent
- there is serious danger to the individual student or other students
If confidentiality is broken in either of the two cases above, then
- the people to whom information is passed will be limited to those the College considers necessary in order to safeguard the welfare of individual students and groups of students (e.g. warden, personal tutor)
The following is a list of the type of information that it is useful for College to have general information about (this does not involve a breach of an individual’s right to confidentiality when seeing a health professional) in order to protect and safeguard the welfare of our students
- anti-depressant use
- incidents of self-harm
- incidents of injury due to violence
- incidents of injury due to accidents that may have a Health and Safety implication
- terminations
- drug use and/or addiction
- alcohol abuse and/or addiction
- evidence of bullying
- anorexia, bulimia and other eating disorders
- child protection concerns
If any of the above cause the Nurse to believe that the student is in serious danger or other students are in serious danger, then she/he may break confidentiality, (having informed the student that she will do so and made every effort to get the student’s consent for this).
Appendix 4 First Aid Policy
The wider College First Aid Policy should be read as part of the Medical Policy.
Most recent review and/or amendment
VPP July 2020
Seen by governors October 2019
