Pharmacists can provide advice on a back-to-school health checklist to support parents and children at the start of the new school term. Kathy Oxtoby explains…

Community pharmacies need to get ready to support the health needs of children as they start the new school year.

In making decisions about the support they provide, “schools should fully consider advice from healthcare professionals, including pharmacists, and value the views of parents, carers and pupils”, says Royal Pharmaceutical Society practice and policy lead Laura Wilson.

Ade Williams, lead pharmacist at Bedminster Pharmacy in Bristol, describes a pharmacy as “the centre of the health and wellbeing journey for families. It’s also a hub for self-care information, empowering families to be able to make choices that are right for them.”

“Back to school is a time we know parents will be under pressure, so it will be good for them to know there’s the reassuring presence of their local pharmacy team,” he says.

Here some topics which should appear on a pharmacy’s back-to-school checklist.

How to manage medicines and health emergencies

When it comes to managing medicines and health emergencies, every school will have its own policy. Pharmacists should advise parents to make sure they understand what that policy is when term starts, advises Lindsey Fairbrother, owner and superintendent pharmacist at Goodlife Pharmacy, Hatton. For example, parents need to check whether children can carry their inhalers and EpiPens, or whether these are held by the school nurse.

With asthma and anaphylactic reactions “it’s important to act quickly”, says Lila Thakerar, superintendent pharmacist at Shaftesbury Pharmacy in Harrow. Ms Thakerar recommends that inhalers and EpiPens are readily to hand at all times, and that a ‘spare’ should always be separately available and accessible.

Before term starts, parents are advised to check the expiry dates on any of their children’s medicines that might be kept at school.

Some pharmacies provide schools with emergency medicine supplies. “It’s a good way to build relationships with schools. We should reach out to schools, and let them know we’re there to help,” says Mr Williams.

Managing allergies and long-term conditions in school

OTC allergy medicines should be available for purchase as children prepare for the first day of school.

With asthma management, Ms Thakerar says pharmacists should be ready to provide information and advice to children on correct inhaler techniques, if they are having to self-administer at school.

Children with long-term conditions like diabetes should have an individual healthcare plan (IHP) in place which should be drawn up with the school, advises Diabetes UK.¹ Insulin should be stored in a medical fridge, and glucose should be readily available in case the child has hypoglycaemia.

Parents should understand what medication teachers can give and when children can self-medicate.

If a child needs medication at school, parents should find out what the school guidelines are on how medications are administered, and follow those rules.

Mr Williams says pharmacy can build relationships with schools by understanding medications policies, helping with medicines management, and providing support on how medicines can be used effectively and safely.

Check children’s vaccinations are up to date

Pharmacists can remind parents that Covid-19 vaccines are now approved for use in children from the age of five, and flu vaccinations are available in nasal form for children from the age of two.

But with vaccination programmes disrupted during the pandemic, pharmacy can also support parents to ensure their child is up to date with all their immunisations.

“It’s worth paying attention to local vaccination data and having conversations with parents asking if their child has had their immunisations,” advises Mr Williams. “You can also promote vaccinations in your pharmacy and support local initiatives to help address the low uptake of vaccines.”

Eye tests and hearing checks

“Having a health MOT is a good idea at any age, and school holidays can provide the breathing space to get some check-ups in place,” says Ms Wilson.

Poor eyesight and hearing can both have a knock-on effect on learning. “Not being able to hear or see well can affect children’s learning, so it’s crucial they have regular checks,” says Ms Thakerar. Parents should be alerted to simple signs that can indicate problems, such as a child sitting close to the TV.

Mr Williams says pharmacists need to be alert to potential problems with children’s eyesight or hearing. “When a parent says their child has dry eyes, we should be clinically curious, and ask when the child last had an eye test,” he says.

With hearing, what can be seen by a parent as a lack of attention from a child could be a sign of hearing problems and a prompt for a hearing check.

Visit to the dentist

Tooth decay remains the leading reason for hospitals admissions among five to nine-year-olds, according to data published by NHS Digital.² _. “It’s vital that children get regular dental checks – particularly as many missed appointments during the Covid pandemic,” says Ms Fairbrother.

Pharmacies can help parents to encourage good oral hygiene in their children, for example, by reminding them of the need to change toothbrushes regularly, and by stocking a wide choice of dental products. And they can also take part in education campaigns to promote oral health.

Tackling headlice and the latest innovations

Advising parents to check their child’s hair on a frequent basis using a nit comb “can help in the early detection of the lice and ensure treatment can be started at the earliest opportunity to eradicate them”, says Ms Wilson.

Pharmacists need to keep abreast of the latest innovations in tackling headlice and be aware of local prevention policies. “Back to school time is a good time for us to refresh our knowledge and that of pharmacy teams,” says Mr Williams.

Many parents are looking for all-natural remedies, so pharmacies should stock up on both traditional and alternative choices. Some products can be left on for 15 minutes, others overnight, so when it comes to advising parents about which products to use, it’s about offering the product that is the most convenient for them, advises Ms Fairbrother.

Footcare

School changing rooms and swimming lessons can lead to problems such as athlete’s foot or verrucas. As well as stocking foot sprays and verruca treatments, pharmacists can advise on good foot hygiene, such as drying between toes thoroughly and not sharing towels and footwear, says Ms Thakerar.

Pharmacies can also offer advice on wearing in new school shoes, as well as stocking insoles and foot protectors as part of their footcare range, suggests Mr Williams.

Putting a sleep schedule in place

Making sure children get enough sleep is an essential part of keeping them healthy. Young children should get nine to 12 hours of sleep a night, and teenagers should aim for eight to 10 hours ³.

Ahead of the new school year, parents are advised to set a regular bedtime and wake-up times in their house, gradually easing children into earlier times by 5-10 minutes a day.

Pharmacists can signpost parents to resources about good sleep hygiene. It is also important for children not to be using their phones or the internet for at least an hour before bedtime, otherwise they will be too alert to sleep properly, advises Ms Fairbrother. Parents can be encouraged to be good role models by trying to do the same.

Supporting children’s mental health

Poor sleep in children could be a sign they are anxious, which may be a particular issue just before they are due to start school again. “Anxiety is very common in children, but it’s often ignored and neglected,” says Ms Thakerar.

As well as directing parents to resources and support, such as mental health charity Mind, Mr Williams says children should be “equipped from a young age on how to manage and talk about their emotions. In doing that we can help create healthier adults too,” he says.

References

1. Diabetes UK (2022) Diabetes in schools – the IHP - a child's individual healthcare plan. https://www.diabetes.org.uk/guide-to-diabetes/your-child-and-diabetes/schools/ihp-a-childs-individual-healthcare-plan
2. Royal College of Surgeons of England (2019) Hospital admissions for 5-9 year olds with tooth decay more than double those for tonsillitis. https://www.rcseng.ac.uk/news-and-events/media-centre/press-releases/dental-decay-hosp-admissions/#:~:text=Tooth%20decay%20remains%20the%20leading,5%20to%209%20year%20olds.)
3. Great Ormond Street Hospital for Children NHS Foundation Trust (2020) Sleep hygiene in children and young people. https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/sleep-hygiene-children/