Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the adequacy of the availability of EpiPens in (a) schools, (b) shopping centres, (c) sports venues, (d) transport hubs and (e) other public places.

Since October 2017, the Human Medicines (Amendment) Regulations 2017 has allowed all schools to buy adrenaline auto-injectors (AAIs) without a prescription, for emergency use on children who are at risk of anaphylaxis but whose own device is not available or not working. The Department has published non-statutory guidance to accompany this legislative change, which is available at the following link:

https://www.gov.uk/government/publications/using-emergency-adrenaline-auto-injectors-in-schools

This guidance advises schools on the recognition and management of an allergic reaction and anaphylaxis, and outlines when and how an AAI should be administered for pupils. The guidance makes clear that any AAIs held by a school should be considered as a spare device and not a replacement for a pupil’s own AAI. It also states that children at risk of anaphylaxis should have their own prescribed AAIs at school for use in an emergency, and that they should carry two devices at all times.

There are many implications that would need to be given careful consideration if AAIs were to be located in public places such as shopping centres, sports venues, or transport hubs. For example, we would need to consider the impacts on the supplies of AAIs for patients who are currently prescribed them.

In June 2023, the Medicines and Healthcare products Regulatory Agency (MHRA), with the support of allergy awareness advocates, launched a safety campaign to raise awareness of anaphylaxis and to provide advice on the use of AAIs. The MHRA produced a toolkit of resources for health and social care professionals to support the safe and effective use of AAIs.

Ambulance staff are trained in how to treat a range of conditions, including anaphylaxis. Treatment options may include a dose of adrenalin via a syringe or use of AAIs. The Community First Responder (CFR) programme enables volunteers trained by the ambulance service to attend certain types of emergency calls in the area where they live or work. CFRs have had first aid training but are not medically trained. CFRs are trained in the administration of a patient’s own AAI, which would ensure the correct medication and dose for that patient. In general, CFRs do not carry medication.