INSIGHTS: Medical Management Plans for children and your system of governance

October 7, 2021


Georgina Odell

Approved providers and nominated supervisors will be aware that as part of ensuring the health, safety and wellbeing of children, a medical conditions policy must be in place which complies with Regulation 90 of the Education and Care National Regulations (National Regulations).

This means that the medical conditions policy must set out the practices of the service in:

  1. the management of medical conditions, including asthma, diabetes or a diagnosis that a child is at risk of anaphylaxis;
  2. informing nominated supervisors and staff members of, and volunteers at, the service of practices in relation to managing those medical conditions;
  3. the requirements arising if a child enrolled at the education and care service has a specific health care need, allergy or relevant medical condition, including –
    • requiring a parent of the child to provide a medical management plan for the child;
    • requiring the medical management plan to be followed in the event of an incident relating to the child’s specific health care need, allergy or relevant medical condition;
    • requiring the development of a risk-minimisation plan in consultation with the parents of the child;
    • requiring the development of a communications plan to ensure that;
      • relevant staff members and volunteers are informed about the medical conditions policy and the medical management plan and risk minimisation plan for the child; and
      • a child’s parent can communicate any changes to the medical management plan and risk minimisation plan for the child, setting out how that communication can occur.

The medical conditions policy must also set out practices in relation to self-administration of medication by children over preschool age if the service permits that self-administration. 

Managing medical management plans

Meridian’s legal team works with child care and family day care operators to guide their understanding of, and assist them to comply with, legislative obligations. We also assist clients on the stringent regulations relating to care programs, quality of care, and compliance with the Family Assistance Law. In advising clients on the subject of managing medical management plans we recommend that:

  • Approved providers and nominated supervisors develop and document a system to ensure that the parents of children with a medical condition provide a medical management plan as soon as possible upon enrolment. It is not enough to request parents provide the plan but then fail to follow up on this. The Regulator expects that a service promptly follows up requests for medical management plans with parents. It is recommended that you consider insisting that a child’s GP provides a letter setting out the way in which a child’s medical condition should be managed within the service.
  • Medical conditions policies are regularly reviewed and discussed within a service, and evidence kept that this has been done, such as minutes and attendance records for policy review meetings.
  • Detailed consideration is given to where children’s medication is located within a service, to ensure that it is readily accessible at all times should there be a medical episode. For example, if children spend part of the day outdoors, would medicines located in the room they start the day in in the morning still be readily accessible if they are needed in the outdoor play area? Does the flow of a child’s day, or upcoming excursions, suggest that a medical rapid access buddy bag might assist with accessibility of medicines as children move around a centre or outside a centre? It goes without saying that medicines be kept secure at all times, and should not be accessible to children.
  • All staff members (including new or casual staff members) know which children have a medical management plan, what that plan is, and where medicine is located.
  • Documenting the details of the staff with the responsibility for checking whether children’s medications are approaching their expiry date, and the frequency medications are   The Regulator will take a dim view if they find that an approved provider or nominated supervisor has allowed children’s medications to expire, and the consequences of this for a child needing their medication while attending education and care could, in certain circumstances, be fatal.

The importance of an effective and well documented system

It is important for every approved provider to have effective and well documented systems for dealing with medical conditions. Having a well-documented and thoroughly thought through system can drastically reduce risks to the safety, health and welfare of children by ensuring that planning and preparation takes place and the right medicine is in the right place whenever it may be needed. Having a well-documented system (which is demonstrably implemented within the service) may also assist in the defence of any compliance action by the Regulator, should there be a medical episode at the service.

For example, if your policy says that all new educators will be trained and inducted in the medical conditions policy and the medical management plans in place at the service on their first day of work, how could you prove that this actually takes place? Do you have an induction checklist that you run through with educators as you train and induct them? Is this dated and signed by the trainer and the new educator?

You may wish to consider developing an online learning platform which provides consistent video training to educators as part of their ongoing training and development. Such training can be monitored by the nominated supervisor, and, particularly where educators have to achieve 100% accuracy in an end of video test, can provide really good assurance that educators understand the policies and procedures of a service, and the practice which is expected of them on a day to day basis.

One of the definitions of “system” in the Cambridge Dictionary is “a way of doing things; a particular method”. Having a good “system” of governance for the operation of an education and care service is essential to ensure the safety, health and wellbeing of children, and clearly and effectively documenting that system for staff and parents is essential to ensuring that your “system” is implemented at the service.

Approved providers and nominated supervisors should also have a system for regularly checking, verifying and recording that key systems are being implemented at their service.

This article was written by Principal Georgina Odell. For further information or advice on any Child Care related matters please contact Georgina Odell.

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Disclaimer: This information is current as of October 2021. This article does not constitute legal advice and does not give rise to any solicitor/client relationship between Meridian Lawyers and the reader. Professional legal advice should be sought before acting or relying upon the content of this article.