Impact of asthma attacks in school
In the UK there are approximately 25,000 emergency hospital admissions for asthma in children each year. With each admission costing between £600 and £2200, dependent on severity, the savings to the NHS from improving the care of asthmatic children in schools is significant.
In England and Wales approximately twenty children of school age die each year from asthma, most of these deaths occur before the child reaches hospital. In the UK a child is admitted to hospital every twenty minutes.
Current Legislation
In a bid to reduce the number of asthma related deaths, UK schools can hold stocks of salbutamol inhalers for the urgent treatment of asthma attacks. The legislation changed following a consultation by the MHRA and the UK health departments in May 2014 where there were more than 4,000 responses in support of changing the law. This support was received from parents, asthmatic patients, paediatric and respiratory clinicians, school nurses, GPs, pharmacists and key organisations including the Royal Pharmaceutical Society, Royal College of Physicians and Asthma UK.
The necessary amendment to the Human Medicines Regulations came into effect on 1st October 2014. This provides a legal basis for the supply of a POM at the request of a head teacher.
Since 1st October 2014 schools were able to purchase salbutamol inhalers and spacer devices from pharmacies for the emergency treatment of asthma attacks. It should be emphasised that schools will not be required to hold stocks of inhalers, it is simply a discretionary power. However, the Children and Families Act 2014, requires governing bodies of English schools to "make arrangements for supporting pupils at school with medical conditions".
Schools who take appropriate steps to assist their pupils in managing their asthma, such as by holding stocks of inhalers for emergency use, would be considered to be reasonably fulfilling the school's "duty of care".
To make a supply the pharmacist will need a written request signed by the principal or head teacher, ideally on headed paper, that includes the following details:
- The name of the school for which the inhaler or spacer device is required.
- The purpose for which the product is required.
- The total quantity required.
Pharmacists will need to make an entry in the POM register to record all supplies of salbutamol inhalers to schools which should detail the following:
- The date the supply was made.
- Name, quantity, formulation and strength of product supplied.
- Name and address of the person and school to whom the medicine was supplied.
- The reason the supply was made.