Medicines and Allergies in Children's Clubs: Care Plans, Auto-Injectors and Who Can Give Medicine

Since 1 October 2017, schools in England have been allowed to buy spare adrenaline auto-injectors without a prescription. Clubs, classes and activity groups have no such permission, so a club with an allergic child is only as safe as the two pens that child brings and the adult who knows where they are.

What are clubs actually allowed to do with medicines?

Less is written down for clubs than for schools, which catches people out. Schools work to the Department for Education's guidance on supporting pupils with medical conditions. Registered childcare, including many holiday clubs and breakfast clubs for under-eights, works to the EYFS statutory framework, which requires written parental permission before any medicine is given, a written record every time and telling the parent the same day.

A Saturday football club or a dance class is not covered by either. Use the EYFS rules anyway. They are short, sensible and exactly what an insurer, a governing body or a parent will expect after something goes wrong.

One exception matters more than any other. UK medicines law, in regulation 238 of the Human Medicines Regulations 2012, lets anyone give adrenaline by injection to save a life in an emergency. No volunteer should ever hesitate over a pen because they are "not allowed".

What should a care plan for a club say?

One page. If it runs to three, nobody on a rainy touchline will read it. A good plan answers seven questions:

1. What is the condition, in plain words? ("Severe peanut and tree nut allergy", not a code.)
2. What are the triggers at this club? Snacks after training, bee stings on the field, cold air for asthma.
3. What does a mild reaction look like, and what do you do?
4. What does a serious one look like, and what do you do? For anaphylaxis: pen into the outer thigh, call 999 and say "anaphylaxis", second pen after five minutes if no improvement.
5. Where is the medicine during a session? Name the bag and who holds it.
6. When does each medicine expire?
7. Who do we call, and how fast can they get here?

For allergies, ask the family for the action plan their GP or allergy clinic has already given them. Most children with a prescribed auto-injector have one, and copying it is safer than writing your own. Keep the plan with the child's member record, visible to the adults on their sessions and nobody else, because it is health data. Our guide to member records, medical details and consent covers where to store it.

Who should keep the auto-injectors during a session?

The child, if they are old enough to carry them, or a named adult who stays with that child's group. Never a locked cupboard, never the office, never "in the car".

The MHRA advises that anyone at risk of anaphylaxis carries two in-date auto-injectors at all times. Clubs should build that into the start of every session, the same way they take a register. Two pens seen, expiry dates checked, location noted.

Our position on the hard case is firm. If a child at risk of anaphylaxis arrives without their pens, they do not train until a parent brings them. That rule will upset someone, usually once. We would still take that conversation over a session spent hoping nobody opens a cereal bar. A club cannot borrow a spare from the school down the road, and an ambulance in a rural area can take far longer than the few minutes a severe reaction allows.

Inhalers follow the same rule with a lighter touch: the child keeps their reliever inhaler with them, and the coach knows which pocket.

What does this look like in a real club?

Take Millbrook Junior Netball in Swindon: 52 players aged eight to 14, two evenings a week in a school sports hall and Saturday fixtures across Wiltshire. Three players carry adrenaline auto-injectors, six have asthma inhalers and one takes a daily antihistamine.

The head coach set up three habits. At the door, the volunteer taking the register ticks "two pens seen" next to the three allergic players' names. In the first week of every term, each family confirms their expiry dates, and anything due before half-term gets replaced. And for away fixtures, the team manager's kit bag carries a laminated copy of each plan, because the home club will not have them.

In its first term the door check found pens missing four times. Each time a parent was back within 20 minutes. By the second term it had not happened once, because families knew the question was coming.

Coaches we speak to often say something like: "The pens were never the problem. Not knowing whose bag they were in was the problem."

How should a club record a dose of medicine?

Every time medicine is given, write down the child's name, the date and time, the medicine and dose, why it was given, who gave it, who witnessed it, and when and how the parent was told. A puff of a reliever inhaler during a session counts. So does a single antihistamine.

If an auto-injector is used, record the time of each pen, when 999 was called and when the ambulance arrived, then treat it as a serious incident. Our guide to accident and incident reporting covers who to tell and how long to keep the record.

What about food at sessions and parties?

End-of-term parties and post-match treats cause more reactions in clubs than training does. Two rules handle most of it: food for a group with a severe allergy comes in its original labelled packaging, and nobody hands an allergic child food without checking the label with them. Homemade cakes are lovely and impossible to check. Ask families to send a packaged alternative instead.

How does Bitir help?

In Bitir, each child's care plan sits on their member record, visible only to the managers of that child's channel, so the volunteer covering on Thursday can open it on their phone and other parents never see it. Expiry dates become dated tasks for the family and the coach. The attendance register can carry a "two pens seen" check for the children who need it, and a dose or incident record goes to the parent the same day through the channel rather than a text from a volunteer's personal number.

Related reading: how a Kendal forest school stopped starting sessions without a child's pens, and how a Leicester BMX club moved its accident book off paper.