13-Year-Old Gets Access to Medication on Transport to School

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Sarah Woosey

Interim Head of Education Law

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Our specialist team of Education Law Solicitors previously assisted in a case concerning a complex transport policy issue which led to a Judicial Review. The case concerned a 13-year-old boy who will be referred to as ‘A’ throughout this article. A was in Year 8 and had an Education Health and Care Plan (EHCP) in place.

The child we represented, ‘A’, had a diagnosis of severe haemophilia and cerebral palsy due to a brain injury which was sustained at birth. As a result of this, A has very significant medical and physical needs and severe learning difficulties, as well as a gastrostomy PEG where most of his fluids and medications are given.

A gastrostomy PEG is formally known as a Percutaneous Endoscopic Gastrostomy. It is a type of feeding tube which is inserted through the skin of the abdomen into the stomach during an endoscopy. A person may need a PEG if food, drink and medications cannot properly reach their stomach. For example, they may be unable to swallow properly.

Part of the medical needs concerning A was that he started to have epileptic seizures around 10 years ago which are controlled by medication. Despite this, he remains at risk of suffering from further seizures.

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A's Situation

A had recently started a new school placement at an independent special school on a weekly residential basis. Shortly after this however, the Local Authority changed its transport policy to stop allowing transport escorts and passenger assistants (PAs) to administer emergency epilepsy medication to children transported by the Local Authority’s Special Educational Needs (SEN) transport.

The SEN Transport Policy for the years 2019 to 2020 stated that:

“… passenger assistants are not authorised to administer emergency rescue medication. Emergency services will be called if a pupil has a medical emergency whilst on the vehicle.”

Because of this, in the event that A had an epileptic seizure while travelling on SEN transport taking him to and from school and back home again, his passenger assistant would not be  allowed to provide him with his epilepsy medication, Buccal (Oromucosal) Midazolam .

This medication was prescribed to A and was to be administered in seizures lasting longer than five minutes. This is because a seizure could be difficult to stop after this time period unless treatment is given. It is therefore important that rapid treatment is given to stop the seizures and therefore prevent status epilepticus.

Status epilepticus is a condition where a person has a seizure or a series of seizures that last for 30 minutes or more, without a complete recovery of consciousness. It is not overly common but can happen in any type of seizure. As such, medication can be helpful in a situation where this could arise.

The midazolam solution should be placed against the sides of the gums and cheek so that the medicine is absorbed directly into the bloodstream. Carers need training in giving emergency medication. It is important for the person to have an individualised written plan about when to give it for the carer to follow.

Instead of being able to administer this medication to A however, his passenger assistant was expected to simply wait for the emergency services to arrive at the scene.

This caused concern as the journey from A’s new school to his home was  60 miles one way and took a total of 2 hours by school transport via the M25 motorway. As part of the additional support that A requires, he travels by mini bus and he is the only child travelling on the minibus. The only other people on the bus would be the driver and a passenger assistant. His medication was kept in a bag that A would have both to and from school.

Due to this, his mother was extremely concerned that due to the high volume of traffic on the M25 on Monday mornings and Friday afternoons when A would be travelling, emergency services would be unlikely to reach A in a short amount time. It may take at least 30 minutes or longer for an ambulance to arrive.

A delay like this his would ultimately cause significant harm as there would be a delay in providing A with the emergency rescue medication he needs.

It was confirmed by A’s consultant paediatrician that the administering of medication should not be delayed for any more than five minutes as cessation of a seizure as soon as possible is an essential part of management. Given this, it is highly likely that if he were to have a seizure, emergency services wouldn’t be able to arrive in time to administer the medication before further harm was caused to A.

Of even more concern was the fact that A had experienced 2 previous seizures in his lifetime that have led to him being in a coma. A delay in administering the prescribed medication could result in Status Epilepticus which could ultimately cause brain damage or even death. It’s considered to be a medical emergency where urgent medical help would be required.

Due to this, A’s mother had tried to resolve the issue via the SEN Transport Complaint Procedure without any success. Given the urgency and imminent danger posed to A, his mother thought that it wasn’t appropriate to make a complaint to the Local Government and Social Care Ombudsman which can take considerable time to resolve.

Due to this, A’s mother approached our expert team here at Simpson Millar to assist. Having assessed the case, we determined that it would be appropriate to judicially review the Local Authority’s decision and refusal to provide ‘A’ with a suitably trained escort who could administer his epilepsy medication.

How We Helped

The main part of the argument that our expert Education Law Solicitor put forward was  that failing to provide A with passenger assistants who are authorised to administer emergency rescue medication makes the travel arrangements for A both unsafe and unsuitable. As such, this failure was unlawful in accordance with Section 508B of the Education Act 1996.

Section 508B of the Education Act 1996 concerns travel arrangements for eligible children in England. It states that a Local Authority must make necessary travel arrangements in order to secure that suitable home to school travel arrangements are made and provided for free of charge.

Given that A is clearly is a disabled pupil according to the definition set out in Section 6 of the Equality Act 2010 and therefore an ‘eligible child’, we argued that the Local Authority’s implementation of this policy  breached the Equality Act 2010.

Given this, it was therefore clear that the Local Authority had applied a policy that discriminated against a disabled pupil.

Due to this, we proceeded to outline our argument to the Local Authority who initially failed to respond. After some prompting, the Local Authority maintained their position and refused to make any further accommodations for A.

Because of this, we had to get significant additional medical evidence and clarification from  the epilepsy doctor who treated A in order to show that the transport decision in place was not safe or suitable for ‘A’ to travel to and from school.

The Outcome

Following this, we were pleased that the Local Authority reversed their decision which means that A went on to have  a suitably trained PA escorting him on his home to school transport who can administer his emergency and lifesaving medication if needed. His mother is relieved that her son now has the support he needs to keep him safe on his journey to and from school.

If you feel like the Local Authority haven’t put the appropriate transport measures in place for your child or any other measures that you feel are required, our team of expert Education Solicitors would be happy to help

Our team of Education Lawyers have years of experience in dealing with cases such as this and achieving a positive outcome. We want to help you get what’s best for your child. You can contact us to find out more information on 0808 239 9764 or requesting a call back.

References:

Leeds Teaching Hospitals NHS Trust. (n.d.). Therapeutic Endoscopy and Colonoscopy. Retrieved from https://www.leedsth.nhs.uk/a-z-of-services/endoscopy/about-your-procedure/therapeutic-endoscopy-and-colonoscopy/peg-and-feeding-tubes/ (Accessed: 14/12/2023)

(n.d.). What to do if someone has a seizure (fit). Retrieved from https://www.nhs.uk/conditions/what-to-do-if-someone-has-a-seizure-fit/ (Accessed: 14/12/2023)

Epilepsy Society. (n.d.). Seizure First Aid. Retrieved from https://epilepsysociety.org.uk/about-epilepsy/first-aid-epileptic-seizures/seizure-first-aid (Accessed: 14/12/2023)

Great Ormond Street Hospital. (n.d.). Buccal (Oromucosal) Midazolam. Retrieved from https://www.gosh.nhs.uk/conditions-and-treatments/medicines-information/buccal-oromucosal-midazolam/ (Accessed: 14/12/2023)

Local Government Ombudsman. (n.d.). Frequently Asked Questions. Retrieved from https://www.lgo.org.uk/make-a-complaint/faqs (Accessed: 14/12/2023)

gov.uk. (1996). Education Act 1996, Section 508B. Retrieved from https://www.legislation.gov.uk/ukpga/1996/56/section/508B (Accessed: 14/12/2023)

gov.uk. (2010). Equality Act 2010, Section 6. Retrieved from https://www.legislation.gov.uk/ukpga/2010/15/section/6 (Accessed: 14/12/2023)

UK. (n.d.). Extra SEN help. Retrieved from https://www.gov.uk/children-with-special-educational-needs/extra-SEN-help (Accessed: 14/12/2023)

Sarah Woosey Profile Picture

Sarah Woosey

Interim Head of Education Law

Areas of Expertise:
Education Law

Sarah re-joined Simpson Millar in 2018 having previously trained at the firm before spending a number of years working for a different national firm. She has a number of years’ experience in a range of Education Law and Social Care issues and has focused particularly on getting suitable education and/or services for children and young adults with a wide range of Special Educational Needs and/or disabilities.

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