What must schools do to support pupils with medical conditions, and what's changing in 2026?

The legal duty

Since 1 September 2014, section 100 of the Children and Families Act 2014 has required the governing bodies of maintained schools, proprietors of academies and management committees of pupil referral units (PRUs) to make arrangements to support pupils at school with medical conditions. In meeting that duty, they must have regard to the Secretary of State’s statutory guidance.

The duty doesn’t apply to independent schools or non-maintained special schools. Children under five in early years provision are covered by the EYFS framework instead.

What’s in force now, and what isn’t

As of 20 October 2026:

• In force: the 2015 statutory guidance, Supporting pupils at school with medical conditions. GOV.UK still lists it as current.
• In force since 1 September 2026: the new allergy safety policy duty, and the Allergy safety in schools statutory guidance that goes with it.
• Not yet published: the replacement for the 2015 guidance. The DfE consulted on it in 2026, but it hasn’t said when the final version will be published or come into force.

What the 2015 guidance requires

The governing body stays legally responsible, even when it delegates the work. The main expectations are:

• A policy for supporting pupils with medical conditions, reviewed regularly and readily accessible to parents and staff (paragraph 9).
• A named person with overall responsibility for putting the policy into practice (paragraph 10).
• Individual healthcare plans where appropriate, reviewed at least once a year or sooner if needs change (paragraphs 12 and 13). Not every child needs one.
• Trained staff. Enough staff should have suitable training and be competent before they take on responsibility for supporting a child (paragraph 16). A first aid certificate is not appropriate training for supporting a child with a medical condition. Staff must not give prescription medicines or carry out healthcare procedures without appropriate training (paragraph 19).
• Self-management. Children who are able should be allowed to carry and manage their own medicines and devices where possible (paragraph 20).
• Procedures for medicines (paragraph 21), including parental written consent for children under 16 and written records of all medicines given (paragraph 22).
• Emergency procedures, and arrangements for trips and sporting activities.

The guidance also lists unacceptable practice (paragraph 25). Examples include stopping children from easily accessing their inhalers and medication, sending them home frequently because of their condition, penalising them for absences linked to their condition, and requiring parents to come into school to give medication.

The allergy safety policy duty

Section 34 of the Children’s Wellbeing and Schools Act 2026 added a new section 100A to the Children and Families Act 2014. It came fully into force on 1 September 2026. For maintained schools, academies and PRUs it means:

• the school’s arrangements for medical conditions must include an allergy safety policy, covering the management of allergies, including pupils at risk of anaphylaxis
• the policy must be reviewed at least once a year
• it must be published on the school’s website, made known to parents, and brought to the attention of all pupils, parents and staff at least once a year
• the school must have particular regard to the DfE’s guidance on managing allergies

The DfE’s Allergy safety in schools statutory guidance, published in July 2026, says a named senior leader should be responsible for the policy. It says the policy should set out how the school will:

• identify pupils with allergies and reduce the risk of exposure, including food allergy
• train staff in allergy awareness and emergency response
• make sure pupils at risk of anaphylaxis can get their own adrenaline devices, alongside “spare” ones
• include pupils with allergies on trips and visits
• capture specific arrangements in individual healthcare plans
• promote the wellbeing and inclusion of pupils with allergies

It also says serious incidents and near misses should be recorded, reported to parents and the governing body, and learned from. Schools are allowed to keep spare adrenaline devices for emergencies, and the guidance says they should.

Section 100B lets the government make regulations adding further requirements, such as stocking spare adrenaline devices and allergy training. The guidance says the government intends to do this. When we searched legislation.gov.uk on 20 October 2026, no such regulations had been made. Independent and non-maintained special schools aren’t yet covered. The government intends to add equivalent requirements to their regulatory standards.

The 2026 consultation

The DfE consulted on replacing the 2015 guidance from 5 March to 15 May 2026. The proposals included:

• a published medical conditions policy for every setting
• stronger individual healthcare plans
• better recording of, and learning from, serious incidents and near misses
• a separate, published allergy safety policy

The government response, published on 6 July 2026, reported strong support. It said the DfE would:

1. revise the draft guidance to reflect the responses
2. work with the Department of Health and Social Care to clarify the roles of schools and of healthcare professionals, before publishing updated guidance “in due course”
3. publish statutory guidance on allergy safety, which it has done
4. seek to use future legislation to extend the section 100 duty to further education colleges, post-16 institutions, non-maintained special schools and independent schools

So the proposals are not in force, apart from allergy safety. Until the new guidance is published, follow the 2015 guidance.

What to do now

• Check your medical conditions policy against the 2015 guidance, and that it names the person responsible.
• Make sure you have a published allergy safety policy, with a named senior leader, reviewed in the last year.
• Check individual healthcare plans have been reviewed in the last year.
• Check training records for staff who give medicines or support specific conditions.
• Record and review serious incidents and near misses involving allergies.
• Watch for the final medical conditions guidance and any allergy regulations. We’ll update this page when they’re published.