School Allergy Forms and Allergy Action Plans: Guidance for GP Practices

The Department for Education has introduced statutory guidance on allergy safety in schools.

The guidance requires schools to have allergy safety policies and appropriate arrangements for supporting pupils with allergies. It also introduces expectations around Individual Healthcare Plans (IHPs) and refers to Allergy Action Plans issued by healthcare professionals.

As schools implement these requirements, some practices have seen an increase in requests for allergy-related documentation.

The first question is whether the request relates to:

• a school Individual Healthcare Plan (IHP);
• an Allergy Action Plan (AAP);
• a request for clinical information;
• a request for a clinical opinion; or
• a request for completion of documentation on behalf of the school.

The answer will depend on the nature of the request.

Practices may find it helpful to identify who owns the document and who is responsible for the decisions being recorded within it.

Schools are responsible for developing, maintaining and reviewing Individual Healthcare Plans.

While schools may need clinical information to help inform their decision-making, responsibility for the IHP itself remains with the school.

In principle, practices should not routinely be expected to complete, approve or sign off school IHPs on behalf of schools.

An Allergy Action Plan is a clinical document.

It provides information to help recognise and respond to allergic reactions and anaphylaxis. It may contain information about allergens, symptoms, medication and emergency treatment.

The guidance states that children and young people with a known food or insect-sting allergy should have an appropriate Allergy Action Plan issued by a healthcare professional.

Not necessarily.

The guidance refers to a healthcare professional rather than specifically to the registered GP.

Depending on the circumstances, the most appropriate clinician may be:

• the clinician currently managing the child’s allergy;
• an allergy specialist;
• paediatric services;
• specialist nursing services; or
• general practice, where the practice holds sufficient information and it is clinically appropriate to provide advice or documentation.

Practices should not assume responsibility simply because a request has been directed to them.

The LMC view is that practices should not be expected to undertake population-level reviews solely because schools are implementing the new guidance.

The guidance does not create a new programme of allergy reviews for general practice.

Where a genuine clinical review is required, practices should apply normal clinical judgement and prioritisation processes.

Schools may ask for clinical information or clarification.

However, practices should be cautious about signing documentation which implies responsibility for arrangements, decisions or processes that sit within the school rather than the healthcare setting.

Practices should not be expected to “rubber stamp” documents where they do not hold sufficient information to take clinical responsibility for their contents.

Where a child is under the care of paediatric, allergy or other specialist services, it may be appropriate for schools to seek relevant clinical documentation from the service currently responsible for the child’s management.

Existing clinical documentation should be used wherever possible.

The answer depends on the purpose of the request.

There is an important distinction between:

• work that forms part of a patient’s ongoing clinical care; and
• requests for completion of documentation for a third party.

For this reason, Surrey and Sussex LMCs do not recommend adopting a blanket position that every allergy-related request is automatically NHS work or automatically non-NHS work.

Practices should consider the circumstances of individual requests and apply their usual approach to clinical work and non-NHS administrative requests.

If systems expect practices to undertake substantial amounts of review, certification or documentation work arising from implementation of the guidance, the LMC view is that this should be supported through an appropriately commissioned and funded pathway.

Practices receiving significant numbers of requests or experiencing difficulties with local implementation are encouraged to contact their LMC.