John Scott compares the provision for allergic children in this country with what is on offer elsewhere.

A recent survey of Scottish schools showed that many were failing to reduce pupils' risk of anaphylaxis. Only one in three of the surveyed schools banned the sharing of eating utensils and many did not have any member of staff with appropriate training to deal with allergic emergencies.

The situation appears to be no better in the rest of the UK or in most of the US, whereas, in Victoria, Australia, the government has recently introduced an anaphylaxis kit for educational institutions and legislated to ensure that all teachers and child carers are trained in handling severe allergic reactions.

UK in the slow lane

Here in Britain, training in allergy safety for teachers and child carers is left largely to health authorities but, whilst they and the Anaphylaxis Campaign are jointly involved in promoting training, their efforts are currently limited in scale, mainly due to a shortage of funding.

The primary responsibility for the welfare of allergic children in school undoubtedly rests with schools and local education authorities (LEAs), rather than with any health or voluntary organisation. Unfortunately, most UK education officials are currently asleep at the wheel on this issue - a fact amply demonstrated by my own conversations with the UK Department for Education and Skills (DfES) and a small sample of LEAs and teachers.

The officials to whom I spoke appeared to have very little awareness of the reality and extent of the problem, and many obviously consider allergy safety in schools to be merely a catering and medicines management issue.

All that one LEA could tell me was that there should be one person in every school within their area who has basic training in First Aid. This begs the question what happens when this one person is off sick, or if they transfer to another post before someone else can receive the required training.

Massachusetts sets the pace

There are islands of excellence in some parts of the UK, but arguably the most far-reaching allergy safety initiative is that which has been introduced by the State of Massachusetts, in the US, where the Department of Education has produced comprehensive guidelines for the management and care at school of children who have a life-threatening allergy.

Entitled Managing Life Threatening Food Allergies in Schools, the Massachusetts guidelines have been designed to assist schools in developing their own policies and protocols as well as in planning for the entry to school of any child with a life-threatening allergy.

In response to this exemplary leadership, school committees in each area are producing their own local policies, such as that recently drawn up by the town of Holliston. Their 11-page allergy policy spells out rules for preventing and managing allergic reactions in schools, and states the responsibilities of all involved - teachers, nurses, administrators, bus drivers and parents. Even the input of the police and firefighters has been sought in producing the policy.

Among the provisions of the Holliston policy are the banning of food from classrooms where there are allergic youngsters, the prevention of cross-contamination of foods in the cafeteria, the development of an individual health-care plan for each affected child, and the provision of walkie-talkies to staff who supervise these students.

These guidelines will prove invaluable to any parent in the UK who is unhappy with the level of allergy care at their child's school, and wishes to encourage improvements.

Government guidance

What guidance is available from the UK Government is narrowly focused on the issue of medication and the only 'policy' on other issues appears to be to leave the matter to individual schools and LEAs. Enquirers are typically referred to support organisations such as the Anaphylaxis Campaign and Asthma UK.

The Anaphylaxis Campaign's 'Allergy in Schools' section is excellent but will only be fully effective in increasing allergy safety when those who are directly responsible for children in schools are fully conversant with its contents, and one wonders how many of them are. Indeed, one wonders how many teachers and carers even know of the site's existence.

In the absence of clear guidance from the Government and most LEAs, the majority of UK schools are forced to rely almost entirely on information provided by the parents of allergic pupils, and the protection of this vulnerable group of children is consequently down to a motley assortment of ad hoc policies and procedures.

What parents can do

Any parent who is concerned about the safety of their allergic child while at school should ask for copies of the school's and the LEA's allergy safety policies and compare these, where they actually exist, with the Massachusetts document.

Any concerns which remain after doing this should be addressed to the school's head teacher and the local authority's director of education. If their responses do not fully dispel a parent's concerns, the latter should lobby school governors and county councillors, and enlist the help of local TV and radio, who may prove useful in creating a forum and encouraging wider support for improved allergy safety in schools.

Parents of food allergic children in New Jersey, US, have succeeded in getting a landmark food allergy law passed that calls on their Department of Education to create food allergy management guidelines for schools, and also calls on individual school districts to develop food allergy policies based on the DOE guidance.

It may be that the only way to ensure that all UK schools are made safe for children with life-threatening allergies is for parents here to educate our own government and LEAs and encourage them to follow the lead being set elsewhere in the world.

First published in 2007

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