The School Allergy Care Plan: What Needs to Be Written Down

Most schools in England and Wales use an Individual Healthcare Plan (IHP) for pupils with medical conditions, and for a child with a severe nut allergy, this document matters more than almost anything else you’ll sign that year. It’s not a formality. It’s what a supply teacher reads at 8:45am on a Tuesday when your child isn’t feeling right and you’re not there.

The trouble is, IHPs vary wildly. Some schools have a tight, well-run template. Others hand you a form clearly written for asthma and expect you to make it fit anaphylaxis. If you’ve been through this before, you’ll know the plan is only as good as the detail you insist on putting into it.

Why the paperwork actually matters

An IHP isn’t legally mandatory everywhere in the UK in the same way, but the Department for Education’s guidance on supporting pupils with medical conditions expects schools to have one for any child with a significant, ongoing medical need. Severe nut allergy with a history of anaphylaxis absolutely qualifies.

What it does in practice:

• Gives a substitute teacher, cover staff or new TA the exact same information your child’s regular teacher has
• Removes the “wait, whose allergy is it again?” panic during an actual reaction
• Creates a paper trail if something goes wrong, protecting your child and the school
• Forces conversations (about lunches, trips, cookery classes) to happen before they become a crisis

What should be written down

Push for specifics. Vague plans kill people during a reaction, because nobody wants to be the one who decides “is this bad enough for the adrenaline pen yet?”

The essentials

• Named allergen(s) — not just “nuts”, but which ones (peanut, tree nuts, and whether “may contain” is a genuine risk for your child)
• Reaction history — what’s happened before, including anything mild that could escalate
• Recognised symptoms — written in plain terms a non-medical adult would recognise, ideally taken straight from your GP or allergy clinic’s written plan
• Step-by-step action plan — when to give antihistamine, when to use the adrenaline auto-injector, and crucially, when to call 999 (the answer is: as soon as an auto-injector is used, every time)
• Auto-injector details — brand, dose, expiry date checked termly, and where it’s kept (classroom, office, PE bag — ideally more than one location)
• Named staff trained — who can actually administer it, not just who’s “aware”

The everyday detail people forget

• Lunch hall and packed lunch arrangements, including what happens on trip days, cake sale days and “bring a plate” events
• Cookery/food tech lessons and art class (glue, seed pots, dried pasta collages — genuinely a source of trace nut exposure)
• Supply teacher protocol — how the plan gets communicated when the regular teacher is off
• Trips and residentials, including who carries the auto-injector and how far it is from a hospital
• A photo of your child attached to the plan, so new or agency staff can identify them instantly in an emergency

Getting it right before September

Book the meeting before term starts, not during the first hectic week. Bring your child’s written management plan from their GP, allergy clinic or paediatrician — ideally the one issued alongside their prescribed adrenaline auto-injector, since school staff should be working from the same document your family uses.

Ask directly:

• Who has completed anaphylaxis and auto-injector training this year, specifically (not “everyone did it two years ago”)
• Where the auto-injectors are stored and whether that location is accessible during lunch, PE and off-site trips
• What the school’s policy is on spare auto-injectors kept in school stock, separate from your child’s named ones
• How the IHP gets shared with new staff mid-year, not just at the start of term

Put your key concerns in writing after the meeting, even a short follow-up email, so there’s a record of what was agreed. Not because you expect the worst, but because “I thought we’d agreed that” is a much weaker position than an email trail.

Reviewing it through the year

An IHP shouldn’t be a one-off. Auto-injectors expire, doses change as children grow, and reaction history sometimes changes too. Ask for a review at least once a year, and definitely after any reaction, any change in prescription, or a change of year group and teacher. Moving from primary to secondary school is a particular flashpoint — more staff, more classrooms, more people who’ve never met your child before.

When schools push back

Some schools are brilliant. Others are stretched, under-resourced, and genuinely unsure of the legal expectations. If you’re getting resistance, the DfE guidance and your local authority’s allergy policy (many now have one) are worth quoting directly. Persistence here isn’t being “that parent” — it’s the job.

Frequently asked questions

Is a school legally required to have an IHP for my child’s nut allergy? Schools are expected to support pupils with medical conditions and to have appropriate plans in place, but exact legal duties vary by nation and by whether your child has a formally diagnosed, ongoing condition. Speak to your GP or allergy clinic about getting a written management plan you can hand to the school, and raise anything you’re unsure about with the school and your local authority directly.

Can teaching assistants give an adrenaline auto-injector? Any staff member can administer an auto-injector in an emergency if they’ve been trained and are willing to, regardless of job title. The school should confirm which named staff have had training.

What if the school won’t act on our concerns? Escalate in writing to the headteacher, then the governing body or academy trust if needed. Local authorities often have a named SEND or medical needs officer who can help.

Should I write my own version of the care plan? Yes — many parents keep their own summary alongside the school’s IHP. It doesn’t replace medical advice, but a clear one-page version in your own words is often what actually gets read in a hurry. Base it on the plan your GP or allergy specialist has already given you.