The Department for Education is consulting on draft statutory guidance to replace the current guidance on supporting pupils with medical conditions, in place since December 2015. The proposed changes are significant. 

Allergy management receives dedicated treatment for the first time, the scope of Individual Healthcare Plans (IHPs) is widened, incident reporting is formalised, and obligations on governors are sharpened. 

Schools that act on the direction of travel now will be better placed once the final guidance is issued. The consultation closes 1 May with a response expected in summer 2026.

This article sets out the key changes and how schools can prepare, including a new allergy safety policy, broader use of IHPs, more frequent whole-school training, and tighter incident reporting.

1. Two policies, not one - and both must be published

Under the current guidance, schools must have a policy for supporting pupils with medical conditions. The draft retains that requirement but adds a second: a dedicated allergy safety policy.

Both policies must be published on the school's website, owned by a named governor and senior leader, and reviewed at least annually. Medical condition risks must also feature on the school's risk register, and any serious incident or near miss should prompt an interim review.

What this means in practice

Schools should treat these as two distinct governance documents. The allergy safety policy should address allergen identification, food safety, staff training, emergency response, spare adrenaline auto-injectors (AAIs), and incident reporting, not simply cross-refer to the medical conditions policy.

Common pitfall

Governors often sign off a medical conditions policy without reading it critically against current practice. With two policies now expected, both require genuine scrutiny. A policy that says "appropriate training will be provided" without specifying scope, frequency, or staff groups will not meet the standard being set.

2. Individual Healthcare Plans: Broader use, richer content, clearer review triggers

The current guidance says not every pupil needs an IHP, with the decision largely resting with the headteacher. The draft shifts this meaningfully. An IHP is expected for any pupil whose medical condition requires supportive arrangements; a formal diagnosis is not a prerequisite.

The draft is explicit about situations where an IHP is particularly expected:

• Any pupil who needs medication administered in school.
• Any pupil with a known allergy requiring active management (with a clinical action plan attached).
• Any pupil whose condition constitutes a disability and requires reasonable adjustments.

The expected content is also more detailed. Alongside the basics (condition, medication, emergency contacts), the plan should now include impact on learning and wellbeing, catch-up arrangements for condition-related absence, inclusion arrangements for trips and extracurricular activities, named trained staff and cover arrangements, and any clinical action plans in full.

Review triggers are also formalised. Annual review remains the minimum, but any serious incident or near miss must automatically prompt a review. Schools should build this into their incident recording process.

Practical scenario

A pupil with Type 1 diabetes moves to your school mid-year. Even before a formal care plan arrives from the hospital team, the draft guidance expects supportive arrangements to be in place and documented. Do not wait for the laminated plan before acting.

3. Staff training: Widen the net, be specific about frequency

A first-aid certificate has never been sufficient to meet the training expectations of the statutory guidance. The draft sharpens expectations significantly about who must be covered and how often.

All staff should have appropriate awareness and training, including support staff, supply and cover teachers, and those delivering breakfast clubs, after-school clubs, and wraparound provision (including third-party providers). Where a member of staff is likely to support a specific pupil, they must be trained to do so competently before providing that support.

For allergy, the draft goes furthest: annual whole-workforce allergy awareness training is expected, covering recognition of anaphylaxis, when and how to administer adrenaline, and incident reporting. This is not specialist training for a designated first-aider; it is baseline competency for everyone.

Common pitfall

Many schools train a handful of named staff and consider the obligation met. If those staff are absent, on a trip, off sick, or on a training day, and no qualified cover is in place, a pupil may be excluded from education or placed at risk. The draft guidance is explicit that staffing gaps should not prevent pupils from attending or participating.

What to do now

Build a training matrix recording which staff are trained, in which conditions, to what level, and when training was last refreshed. Schedule annual refreshers. Make allergy awareness compulsory for new-starter induction, including supply staff.

4. Allergy management: A step-change in expectation

This is the area of greatest change. The draft guidance treats allergy management as a whole-school safeguarding responsibility rather than a condition-specific niche.

The key shifts are:

• All staff must be able to recognise and treat anaphylaxis: This includes administering an AAI while waiting for emergency services. This is not a skill reserved for the school nurse.

• 'Nut-free’ policies are actively discouraged: The draft guidance says these are less effective than they appear and can create false reassurance. An ‘allergy-aware’ approach, with active risk controls, clear labelling, no food-sharing rules, and trained staff, is what schools should adopt.

• Schools are expected to stock spare AAIs: Current legislation already permits maintained schools and academies to purchase spare adrenaline auto-injectors without a prescription. The draft guidance now makes it clear that the expectation is that all schools will do so.

• Spare AAIs must not be locked away: Adrenaline must be accessible within five minutes from anywhere on the school site, stored at room temperature, checked regularly for expiry, and replaced promptly. A locked cabinet requiring a key-holder to be present does not meet this standard.

• Spare AAIs can be used without prior consent: This applies to an unforeseeable emergency, including for a pupil not previously known to be at risk. Staff should be trained to act on clinical need, not to hesitate because a consent form has not been completed.

Food provision

Pupils with allergies should eat alongside their peers, not be segregated. Schools and catering providers should use at least two identification methods to manage allergen risk (for example, a catering card and photo register). Packed lunches and classroom activities involving food also need consideration.

Practical scenario

A parent complains that their child always sits alone because the school operates a ‘nut-free table’. Under the draft guidance, this is not recommended. The better response is an allergy-aware mealtime environment with trained supervision, clear labelling, and no food-sharing, enabling the pupil to sit with classmates safely.

5. Incident reporting: Formalise your near-miss culture

The draft guidance introduces a formal framework for recording and learning from serious incidents and near misses. A near miss, for example, a child almost receiving the wrong medication, or an AAI not being accessible in time, is treated as equally important as an incident resulting in harm.

Schools should record what happened, when, and where, why it happened, how staff responded, whether emergency services were called, and the outcome. Reports should be shared with parents and the governing body. Governors are expected to use incident data to drive policy review and improvement.

What to do now

• Review your incident form. 
• Add a near-miss category and a prompt: "Does this trigger an IHP review?" 
• Add a field for governing body notification. 
• Incidents should not be resolved at operational level and filed; they should feed into governance.

Key takeaways for schools

Start your gap analysis now: The final guidance is not yet in force, but the direction of travel is clear. Use the draft to audit your current policies, IHPs, training, and incident processes.

• Two published policies are expected: Medical conditions and allergy safety, each with a named governor and senior leader ownership.
• IHPs should be used more widely: If a pupil requires any form of school-based support for a medical condition, an IHP is expected.
• Training must cover everyone: This includes supply staff and wraparound providers, with annual refreshers for allergy awareness as a minimum.
• Stock spare AAIs: Ensure they are accessible within five minutes from all areas of the site. They should not be locked away.
• Near misses count: Build them into your recording and reporting framework and ensure the governing body receives reports.

If you would like advice on reviewing your current policies, drafting updated documentation, or training your governing body on the new obligations, our education team is here to help.

This article reflects the draft statutory guidance issued for consultation in March 2026 and should be read in that context. Schools should confirm their obligations against the final published guidance once issued.