Prescribing non-prescription (over the counter) medication in nurseries and schools
Direct Link to Article on BMA Website
Non-prescription /over the counter (OTC) medication does not need a GP signature/authorisation in order for the school/nursery/childminder to give it.
The 'The Statutory Framework for the early years foundation stage', which governs the standards of institutions looking after and educating children, used to include a paragraph under specific legal requirements - medicines that stated:
'Medicines should only be taken to a setting when this is essential and settings should only accept medicines that have been prescribed by a doctor, dentist, nurse or pharmacist.'
This has now been amended to read ‘Prescription medicines should only be taken’...
The previous working resulted in some parents making unnecessary appointments to seek a prescription for an OTC medicine so that it can be taken in nurseries or schools. We would like to remind practices that the MHRA licenses medicines and classifies them when appropriate as OTC (P or GSL), based on their safety profiles. This is to enable access to those medicines without recourse to a GP, and the classification applies to both inside and outside the educational environment.
It is appropriate for OTC medicines to be administered by a member of staff in the nursery or school, or self-administered by the pupil during school hours, following written permission by the parents, as they consider necessary. It is a misuse of GP time to take up an appointment just to acquire a prescription for a medicine wholly to satisfy the needs of a nursery/school.
In 2015, the GPC wrote to the Department of Children, Schools and Families seeking an amendment to this paragraph in the EYFS Statutory Framework, who confirmed in a letter that an FP10 is not required, and as a result they have now updated their guidance to clarify that this is only applicable for prescription drugs, whereby non-prescription medication can be administered where there is parents' prior written consent.
If any practice find that this continues to be a problem in their area, Wessex LMC have produced a template letter which can be downloaded from their website and sent to the nursery or school.
The Statutory Framework for the EYFS (Early Years Foundation Stage) outlines the policy for administering medicines to children in nurseries/preschools 0-5 years:
“The provider must promote the good health of children attending the setting. They must have a procedure, discussed with parents and/or carers, for responding to children who are ill or infectious, take necessary steps to prevent the spread of infection, and take appropriate action if children are ill.
Providers must have and implement a policy, and procedures, for administering medicines. It must include systems for obtaining information about a child’s needs for medicines, and for keeping this information up-to-date.
Training must be provided for staff where the administration of medicine requires medical or technical knowledge. Prescription medicines must not usually be administered unless they have been prescribed for a child by a doctor, dentist, nurse or pharmacist (medicines containing aspirin should only be given if prescribed by a doctor).
Medicine (both prescription and non-prescription) must only be administered to a child where written permission for that particular medicine has been obtained from the child’s parent and/or carer. Providers must keep a written record each time a medicine is administered to a child, and inform the child’s parents and/or carers on the same day, or as soon as reasonably practicable”.
Further guidance for pupils at schools with medical conditions, including templates, is available on the Gov.uk website.