Untrained and unsupported school staff are being "increasingly pressured" into caring for children with complex health needs, research has claimed.
Support staff report being asked to administer medicines to students or care for children with long-term conditions such as epilepsy or anaphylaxis without, in some instances, any training at all.
The study of 2,300 support staff and school nurses by UNISON and the Royal College of Nursing (RCN) found that nearly one in five support staff, including teaching assistants, feel “forced" to take on the responsibility for administering medicines of healthcare procedures as they “do not want to let children down".
The survey finds “many examples" of good practice, but also reports that 28 per cent of support staff do not feel comfortable or competent administering to pupils prescribed medicine or supporting health needs.
Tasks reported in the survey included tube feeding, airway suctioning, tracheostomy care and catheterisation. Other students have restricted mobility and require help with standing frames and hoists, while some need help with toileting and dealing with soiling incidents. Support staff are also increasingly expected to give mental and emotional support, the survey reports.
The research finds: “The majority of support staff do not receive regular training, and some report never having any training at all before being expected to provide health care support to pupils.
It adds: "The majority of school support staff – the lowest paid workers in schools – do not receive any extra pay for taking on this extra responsibility."
Elsewhere, two-thirds of registered nurses who supervise care in schools say that specialist care plans are not always in place. UNISON and the RCN are now calling for every school child to have an “up-to-date, individual care plan" which is drawn up with a healthcare professional, while they also want staff to receive specific training for each child.
Other demands include for schools to have clear policies on the management of medicines and health care support in schools.
Dave Prentis, UNISON's general secretary, said: “The lack of training and support for school staff who have to deal with a growing number of children with increasingly complex health needs is a tragedy waiting to happen. And as budget cuts hit schools, our fear is that this will only get worse.
“We want every child to enjoy school life to the full – so do teaching assistants and other school support staff. But all too often, that relies on pressurising staff into administering medicines or complex procedures that they do not feel confident or trained to do."
The research also found that one in four support staff have not seen a copy of their school's policy on the management of medicines, while 83 per cent do not know if they are covered by their employer's liability insurance for the tasks they are being asked to carry out.
Dr Peter Carter, RCN general secretary, added: “This survey clearly highlights the risk to children and young people when authorities and schools do not have robust arrangements in place to support pupils with health needs.
“While there are a number of examples of good practice, it is clear that more needs to be done to ensure all schools are able to provide safe and well-planned health care support. There is also a clear need for more school nurses, community children's nurses and children's nurse specialists to adequately train and support staff in schools to meet the needs of their pupils. Currently, there is a chronic underinvestment in these areas, with a recent survey revealing that one in six school nurses had seen posts cut in the last year."
Commenting on the findings, Jenny Perez, director of childhood continence charity ERIC, said: “Around one in 12 children and young people in the UK suffers with an ongoing continence issue, such as day-time wetting, soiling or constipation, which can have a huge impact on their mental and emotional health, and physical wellbeing.
“Schools must have the necessary policies and procedures in place to care for children with continence needs, and ensure that staff receive appropriate training to support them. As a minimum, we're calling on all schools to have a continence policy in place, and to ensure children with health needs have an up-to-date Individual Care Plan."
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