SUPPLY OF SPARE ADRENALINE AUTO-INJECTORS (AAI) TO SCHOOLS

Quick reference guide

In March 2017 the Medicines & Healthcare products Regulatory Agency (MHRA) and Department of Health (DH) undertook a UK-wide public consultation to allow schools to hold spare adrenaline auto-injectors (AAIs), without a named individual prescription, for use in emergencies.

Following overwhelming positive response to the consultation proposal, amending legislation (The Human Medicines (Amendment No. 715) Regulations 2017) has been laid before Parliament that will come into effect on 1 October 2017.
From this date onwards, schools will be able to purchase AAIs without a prescription for use in emergencies from a pharmacy in small quantities provided this takes place on an occasional basis and is not for profit.

This resource aims to support pharmacists receiving requests from schools to supply AAIs.

Who can provide a signed order for AAIs for a school?

A written order signed by the principal or head teacher at the school must be provided to enable a supply to be made to the school.


What information should be included in the signed order?

In line with legislation requirements;

"The order must be signed by the principal or head teacher at the school concerned and state”

(i) the name of the school for which the medicinal product is required,

(ii) the purpose for which that product is required, and

(iii) the total quantity required"

Ideally appropriately headed paper should be used, however this is not a legislative requirement.

A suggested Letter template to Pharmacy to obtain an AAI that schools may find useful is included in the Department of Health Guidance on the use of adrenaline auto-injectors in schools.

Only those institutions described in Regulation 22 of the Human Medicines (Amendment) (No.2) Regulations 2014 may legally hold spare AAIs without named individual prescriptions.


How many AAIs can a school obtain?

The number of AAIs that can be obtained by individual schools is not specified in legislation. Schools will be able to purchase AAIs from a pharmacy in small quantities provided this takes place on an occasional basis and is not for profit, thus in line with MHRA guidance  for pharmacists on the repeal of section 10(7) of the Medicines Act 1968. Pharmacists should exercise their professional judgement when receiving requests for AAIs from schools.


What records do I need to keep in the pharmacy?

The signed order needs to be retained for two years from the date of supply or an entry made into the Prescription-Only-Medicine (POM) register. Even where the signed order is retained it is good practice to make a record in the POM register for audit purposes. In line with normal record keeping requirement an entry in the POM register must include:

  • Date the POM was supplied
  • Name, quantity and where it is not apparent formulation and strength of POM supplied
  • Name and address, trade, business or profession of the person to whom the medicine was supplied
  • The purpose for which it was sold or supplied.

Strength

Pharmacists should be aware of the different strengths of AAIs that are available. The strength required will depend on the patient’s age and bodyweight. Refer to British National Formulary (BNF)  and Summary of Product Characteristics (SPC)  for each product.


Brands

Pharmacists should be aware of the different brands of AAIs that are available, and that each brand may have different instructions for administration. Pharmacists should refer to the individual SPC and Patient Information Leaflet (PIL) for each product when counselling the person collecting the AAIs. 

The Department of Health advises schools to hold an appropriate quantity of a single brand of AAI device to avoid confusion in administration and training but also that the decision as to how many brands they purchase will depend on local circumstances and is left to the discretion of the school.


What other information could I be asked to provide?

  • Pharmacists could be asked to explain the instructions for administration of AAIs and any associated information.
  • General advice e.g. on storage, disposal of used, miss fired or expired stock.
  • Advising schools on the importance of keeping a record of the spare AAIs held and their expiry date and to ensure they are replaced appropriately.

The Department of Health has published Guidance on the use of adrenaline auto-injectors in schools to support schools in England with their management of AAIs.


Where can I locate information on a school, including head teacher/principal details if required?

There is no centralised database containing details of schools and head teachers across Great Britain. Possible sources of information would include:

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