Medicines optimisation in special schools

Supporting children with complex needs in education needs a partnership approach.

The Specialist Pharmacy Team at Kent Community Health NHS Foundation Trust (KCHFT) is doing just that, working with special schools across the county, supporting students like Sasha and her friends and giving parents peace of mind … 

Sacha Besant maybe blind, non-verbal and have a range of complex medical issues – but she makes the most of every day and absolutely loves going to school.

The 19-year-old is one of 250 students at Foreland Fields special school, in Ramsgate, who needs specialist support, including a daily ritual of medication.

Mum Kimberly, from Ramsgate, said: “Sacha is very saucy. She may be non-verbal but she is very good at letting people know what she wants. She was born with holes all over her brain and has a range of medical issues, including cerebral palsy and epilepsy.

“She has no suck or swallow reflex, so she has a tracheostomy. The school is great and was doing everything they needed to, but realised they would benefit from more support when it came to administering Sacha’s medication.”

Foreland Fields caters for pupils aged to 19 years with profound, severe and complex needs Hundreds of different medications are dispensed on a daily basis, so when the school lost their nursing assistant, deputy head teacher Jeremy Edwards approached Kent Community Health NHS Foundation Trust (KCHFT) for support. 

“We didn’t have a dedicated place to go to ask for help,” explained Jeremy. “Schools are a busy place and we wanted to make sure our staff were as confident as possible at administering a huge range of medications in a challenging environment to reduce the risk of errors. That’s what KCHFT has helped us do.”

KCHFT’s Deputy Chief Pharmacist, Nirusha Govender and the Specialist Pharmacy Team worked with the school to develop a bespoke medicines management package.

They reviewed the school’s existing processes, created new procedures as well as a training package for all staff and year-round support. It was so successful; the team now supports 10 special schools across Kent. In the past year, it has issued more than 200 clinical interventions, improving or changing processes.

Nirusha said: “The expectation for teachers was never to administer medicines. Our aim was to work with the school and support them so they felt comfortable and confident when giving medications and ensure safety and best practice is followed.”

While students used to have to come out of the classroom, the increased understanding and knowledge allow staff to be more flexible as to when and where the medication is given, meaning the students have more time in the classroom and less time away for their peers. Nirusha believes all schools would benefit from introducing the programme.

She said: “It’s not only special schools that have to administer complex medication, mainstream schools do too and there is no legislated guidance for schools to follow. Working with the Specialist Pharmacy Team would make sure procedures are in place and followed correctly, as well as ongoing training and support so the students have the best and safest possible care at the most critical time.”

Kimberley said: “Knowing my child is in safe hands is one of the best feelings.

“Over the years I have had to be careful. I’m not a professional, I’m mum. I don’t know everything and to hand over the responsibility of giving my daughter the right medication in the correct way is scary,” she added.

“My daughter is important – every child is and the slightest mistake could really cause massive problems with them. But with the in-depth training the staff have received from KCHFT, it is clear they are being supported and are confident in giving the medication and that puts me at ease.

 “Sacha’s medication changes regularly, but the training the staff have received from KCHFT helps us feel confident the changes are understood and procedures will be followed safely and the Specialist Pharmacy Team is always on hand if they have any question.”

Next the team plans to continue building on their work locally and nationally to provide support to other schools and pharmacy teams, by sharing what they have learned.

Quality improvement

The work was carried out as a quality improvement (QI) project at KCHFT. QI uses methods and tools to try to continuously improve quality of care and patient outcomes.

The aim of the project was to promote safety in schools through the development of a bespoke medicines optimisation service. The team set out to upskill school staff in administering medicines, reducing medicine errors, to make sure there was consistency across Kent in how medicines are given to pupils in special schools and for pharmacy technicians to develop and expand their skills and role.

The team has been shortlisted for an HSJ Patient Safety Award for its work. Winners will be announced in September 2022. The project team was led by Nirusha Govender and included advanced pharmacist Vanessa Lawrence and specialist pharmacy technicians Sarah Owen, Susan Goss and Chantelle Hay.

Below is the project on a page:

The medicines optimisation in special schools project on a page