Examination of Witnesses (Questions 720-729)
MS JOY
WINKS AND
MS SARAH
DAY
7 MARCH 2007
Q720 Lord Selborne: We have heard
from the Anaphylaxis Campaign that they have suggested that generic
auto-injectors should be available in schools where there are
severely allergic children, and that would be available for any
child who might need a second dose. In the light of what you have
told us I suspect that you would feel that that is unlikely to
be needed on the whole.
Ms Day: It is the question of unknown, is it
not? We may not have experienced it but other people have and
every year a child dies from either anaphylactic shock or asthma.
Q721 Lord Selborne: You think it
would be a good idea?
Ms Day: I think it has to be there and it is
being able to recognise the symptoms in an emergency and that
this child needs treatment straight away.
Q722 Lord Selborne: How long does
an EpiPen last in storage? Can you keep it indefinitely?
Ms Day: No.
Ms Winks: They do have dates on them.
Ms Day: 18 months to two years max.
Ms Winks: It will be a part of your protocol
to check.
Lord May of Oxford: I can see that being
a tension with the manufacturer who wants a short date. People
do over interpret the dates on these things and from my understanding
of the functioning of the EpiPen I am at a bit of a loss to see
why there is a date of 18 months.
Q723 Chairman: Do we know the evidence
of when it actually does deteriorate?
Ms Day: I do not know.
Lord Colwyn: I have an EpiPen in my medical
equipment and I have to replace it every 18 months or two years.
Lord May of Oxford: I am asking a different
question.
Q724 Lord Colwyn: It is expensive.
In these days of increasing litigation doctors tend to over-prescribe
rather than under-prescribe and I think your idea of having a
school store of asthma inhalant and an EpiPen is a very good idea.
I am surprised that you cannot do that, I did not know that.
Ms Day: No you cannot. It is a prescription-only
medicine so it is a different legal issue.
Q725 Chairman: It was the Anaphylaxis
Campaign who also told us that they felt the Government was not
adequately training school nurses, so it is developing a training
programme which has been piloted around the UK. Do you think it
is necessary for them to do this and that there is indeed a need
for them to do this nationwide?
Ms Day: It certainly would be good to have a
standard nationwide.
Q726 Baroness Platt of Writtle: The
Government have also told us that it is the responsibility of
the head teacher to assess and monitor whether teachers or support
staff are capable of dealing with allergic emergencies. Do you
think that is appropriate and is this monitoring being carried
out?
Ms Winks: I think the head teacher obviously
has the ultimate responsibility for the children within the school
but they would not have the knowledge or the skill to be able
to say that people are adequately trained. They would be looking
to be working in partnership with somebody from the NHS and obviously
the school nurses at the moment are virtually the only medical
people that go into the schools, and so we are the link between
the school and the specialist and anybody who is training.
Ms Day: The head teachers are academic. I work
in an academic environment all the time and there is a lack of
understanding about the medical and the educational side. To put
the emphasis on teachers and head teachers all the time to meet
government health targets is very unfair. They have enough to
worry about with the academic side. I think there is a lot more
we can do to help.
Q727 Baroness Platt of Writtle: What
further training is needed for school nurses, teachers and—as
you have mentioned several times—dinner ladies, in the management
of our allergic children? You have also mentioned cuts?
Ms Winks: Obviously I am going to say that if
we had more school nurses we would be able to do more on the public
health side. Anaphylaxis is not the only aspect. We are quite
high on the Government's agenda. We are in most of the documents
to do with public health in schools—extended schools, teenage
pregnancy, obesity, all those things—and at the moment we
just do not have the capacity. The RCN did a survey, which I think
you have, to say that whereas the Chief Nursing Officer's review
said that there should be one school nurse for every comprehensive
and its cluster, the survey shows only one to 14 schools, and
that is qualified school nurses.
Q728 Lord Rea: I was just simply
going to ask what is the overall deficit in school nurses compared
to the establishment that there should be? Do we have any information
on this?
Ms Winks: The only information that we have
is the Royal College of Nursing survey that was done which said
that a school and its cluster (which would be one and maybe five
primary schools) should have one whole-time full-time school nurse,
and the evidence is that there is one to 14.
Q729 Chairman: Thank you very much
indeed for coming up today. I know you sat in during the earlier
session. If there is any additional information that you would
like to send into the Committee, then please feel free to do so
and it will be considered as part of your evidence. You will also
be sent the transcript for you to look through and perhaps correct
if you feel that you have been inaccurately transcribed. Thank
you again for coming.
Ms Winks: Thank you very much for inviting us.
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