Pupil’s name: Date of birth: School: Review agreement of parent/carer Review agreement of Head Teacher/designated member of senior management I to the procedures detailed in this plan being administered in school. The I can confirm that the existing Individual Healthcare Plan for my child continues to medication will be administered by staff who have attended a of Diabetes reflect the current needs of my child, and propose that a further review is undertaken in ‘Management in Education Establishments’ Career Long Professional Learning session within the last line with the next review date which I have detailed below*. two years. I will inform the school if my child’s needs change prior to the next review date, and will In the event that these procedures cannot be implemented at any time the school will arrange with the school for a replacement Individual Healthcare Plan to be completed. follow advice received from the health professionals in summoning the emergency I realise that the school is not obliged to undertake healthcare and that any healthcare services as appropriate. provided by the school will be carried out on a voluntary basis under the guidance of NHS staff. I give my consent for the school to contact the named healthcare professional(s) and for those professionals to advise the school in any relevant matters in connection with this. I accept full responsibility for keeping the school informed of anything that might be relevant in relation to the implementation of this care. I accept responsibility for ensuring that there are supplies of any relevant medication, materials or equipment for my child’s needs. I will collect all unused medication from the school at the end of the summer term. I accept that the school will destroy any unused medication that remains uncollected. I wish my child to have the care/medication detailed in this plan and I accept that the emergency services will be summoned, where appropriate, in the event that the school staff are unable to administer the plan at any time. Date review Name of parent/carer Parent/carer signature *Next proposed Name of staff member Job signature undertaken signing review date / / / / / / / / / / / / / / / / / / / / / / / / / / / / Copies held by and Head Teacher
Pupil’s name: Date of birth: School: Review agreement of parent/carer Review agreement of Head Teacher/designated member of senior management I can confirm that the existing Individual Healthcare Plan for my child continues to reflect the current needs of my child, and propose that a further review is undertaken in line with the next review date which I have detailed below*. I will inform the school if my child’s needs change prior to the next review date, and will arrange with the school for a replacement Individual Healthcare Plan to be completed. I realise that the school is not obliged to undertake healthcare and that any healthcare provided by the school will be carried out on a voluntary basis under the guidance of NHS staff. I give my consent for the school to contact the named healthcare professional(s) and for those professionals to advise the school in any relevant matters in connection with this. I accept full responsibility for keeping the school informed of anything that might be relevant in relation to the implementation of this care. I accept responsibility for ensuring that there are supplies of any relevant medication, materials or equipment for my child’s needs. I will collect all unused medication from the school at the end of the summer term. I accept that the school will destroy any unused medication that remains uncollected. I wish my child to have the care/medication detailed in this plan and I accept that the emergency services will be summoned, where appropriate, in the event that the school staff are unable to administer the plan at any time. I to the procedures detailed in this plan being administered in school. The medication will be administered by staff who have attended a ‘Management of Diabetes in Education Establishments’ Career Long Professional Learning session within the last two years. In the event that these procedures cannot be implemented at any time the school will follow advice received from the health professionals in summoning the emergency services as appropriate. Date review undertaken Name of parent/carer signing Parent/carer signature *Next proposed review date Name of staff member Job signature / / / / / / / / / / / / / / / / / / / / / / / / / / / / Copies held by and Head Teacher