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Back to school means back to close contact with other children and an increased risk of infectious diseases. Independents are on the front line when it comes to helping parents looking after their kids’ health. Steve Titmarsh explains…

Returning to school puts schoolchildren at risk of a variety of illnesses.¹ Indeed as the National Pharmacy Association (NPA) Advice and Support Services team notes: “It's normal for children to pick up more coughs, colds, stomach bugs and other minor infections when they return to school.”

So, independent pharmacists can prepare by making sure they are stocked with relevant medicines and appliances and by making parents and local health professionals aware that they are a valuable resource for supporting parents caring for their children’s health during the return to school period.

The NPA’s Advice and Support Services team suggests community pharmacies consider stocking products for common seasonal illnesses as children prepare to go back to school, including:

• Children's paracetamol and ibuprofen.

• Saline nasal sprays and thermometers.

• Antihistamines.

• Oral rehydration salts.

• First aid items such as plasters and antiseptic cream.

• Headlice treatments.

• Treatments commonly supplied through Pharmacy First, based on local demand.

It is essential that all children are up to date with vaccinations with infections such as measles becoming more common and after a significant break out of whooping cough across the country in 2024.

Parents can check their children’s Red Book to make sure they are up to date with vaccinations or contact their GP if they are unsure – it is never too late to find out if a child can catch up on any missed vaccinations.¹

The NPA’s Advice and Support Services team says pharmacists can encourage parents to keep children up to date with vaccinations. “Pharmacists can help by recognising vaccine hesitancy and advising accordingly and respectfully to their local communities,” says the team.

General health strategies such as practising good hand hygiene and ensuring children have enough sleep, healthy food, and fluids, are all important, according to the NPA’s Advice and Support Services team.

Basic hygiene can help prevent infection. So, it is a good idea to remind children to:¹ 

• Wash their hands for at least 20 seconds using soap and water.

• Use tissues for coughs and sneezes then throw them in the bin.

• Avoid touching their face, particularly their eyes, nose and mouth.

The UKHSA provides evidence-based resources such as e-Bug that can be used to teach children aged 3–16 years about hygiene, microbes, vaccinations, and antimicrobial resistance.² 

“Community pharmacies can advise on common childhood illnesses, recommend treatments, and explain when symptoms can be managed at home. Pharmacists can also help parents recognise when a child should be referred to another healthcare professional, GP or A&E,” the NPA’s Advice and Support Services team says.

Among the issues facing children as they return to school are acute conditions that can be managed at home head lice, upset tummy and earache.

Head lice are common in schools especially at the beginning of term when children come back into close proximity with other children as the lice are spread by head-to-head contact. Symptoms such as itchiness usually start two to three weeks after coming into close contact with someone who has head lice.³

Regular inspection is important to detect lice, using a special fine-tooth comb that can also be used to remove lice using a wet combing technique, as follows:⁴ 

• Wash hair with ordinary shampoo.

• Apply lots of conditioner (any conditioner will do).

• Comb the whole head of hair, using the detection comb, from the roots to the ends.

A video showing the technique can be found on the Community Hygiene Concern website – www.chc.org/for-parents-2

An upset stomach has a range of causes. In some cases it may be the result of anxiety, especially when a child goes to school for the first time or moves to a new school.

Avoiding going to school can make a child more anxious about attending.

So, talking with children about what is bothering them about going to school such as bullying, problems with friends, schoolwork or sensory difficulties is important. Working with a child’s school to find ways to support an anxious child is also important.⁵

In cases where upset stomach is a result of infection resulting in diarrhoea and vomiting children should stay away from school until two days after the diarrhoea and vomiting have stopped.⁶

Gastroenteritis may have a viral or bacterial cause. Symptoms tend to occur about a day after infection and usually last no longer than a week.

Children should be encouraged to take small sips of diluted juice to prevent dehydration, have plenty of rest and eat small amounts of plain food if they are hungry.

They can take paracetamol if they experience fever or aches and pains. Sometimes rehydration drinks are needed where children become dehydrated.⁷ 

Pharmacy First

Under the Pharmacy First scheme community pharmacists can offer patients aged one to 17 years assessment, advice, and, where appropriate, prescription medication for otitis media without the need for them to see a GP.

Community pharmacists can engage with their local GP practices to encourage them to refer patients to their local pharmacy. Posters in the pharmacy and leafleting can help advertise the service.

GPs and patients can be reassured that pharmacists follow a robust clinical pathway, which includes self-care and safety-netting advice and, only if appropriate, supplying a restricted set of prescription only medicines without the need to visit a GP.

NHS England explains that pharmacists now train for five years in the use of medicines and managing minor illnesses “so they are well equipped to provide health and wellbeing advice to help people stay well. They are also experienced in spotting warning signs, otherwise known as red flag symptoms, which may warrant a referral to another healthcare provider”.⁸

Information on community pharmacy websites about services offered as part of Pharmacy First can also give patients and other healthcare professionals confidence in the service community pharmacists can offer.⁹

Tonsillitis is another condition that community pharmacists are well placed to help with.

For people aged five years and over who meet the criteria under the Pharmacy First clinical pathway for acute sore throat, pharmacists can assess symptoms to exclude conditions that need referral and judge the level of pain experienced and recommend self-care.

That includes keeping well hydrated, along with analgesics if needed. Patients should be reassessed after three to five days and referred where necessary. For more severe symptoms pharmacists may prescribe a short course antibiotic and refer to a GP if symptoms do not improve.¹⁰ 

References 

1. Gov.UK. Top tips on how to keep your child healthy at school (https://educationhub.blog.gov.uk/2025/10/top-tips-how-child-healthy-school; accessed July 2026).

2. e-Bug Evidence-based teaching resources (www.e-bug.eu/teachers; accessed July 2026)

3. Gov.UK. A to Z of infectious diseases in children and young people's settings (www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/a-to-z-of-infectious-diseases-in-children-and-young-peoples-settings#headlicenits; accessed July 2026).

4. NHS. Head lice and nits (www.nhs.uk/conditions/head-lice-and-nits accessed July 2026).

5. NHS. Is my child too ill for school? (www.nhs.uk/live-well/is-my-child-too-ill-for-school; accessed July 2026).

6. Gov.UK. Public health exclusion periods in children and young people’s settings (www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/public-health-exclusion-periods-in-children-and-young-peoples-settings; accessed July 2026).

7. NHS Inform. Gastroenteritis in children and babies (www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/gastroenteritis-in-children-and-babies; accessed July 2026).

8. NHS England. Pharmacy First (www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first; accessed July 2026).

9. Batley Pharmacy. Earache explained: how the NHS Pharmacy First service can work (https://batleypharmacy.co.uk/earache-explained-how-the-nhs-pharmacy-first-service-can-help; accessed July 2026).

10. clinicalpathways.uk. Acute sore throat (https://clinicalpathways.uk/pharmacy/acute-sore-throat; accessed July 2026).