Is the nursery being unreasonable? - EpiPen related(43 Posts)
Dd (aged 3) has a severe egg allergy, of which his nursery are obviously aware.
It's currently about 17 months since she was diagnosed, and the two epipens we were given at the time will soon be past their expiry date (18 months).
I've called up the GP multiple times asking for new epipens, but have been told that they're currently unavailable and they have no idea when we'll be able to get them.
Dd's nursery say that she can't attend without an in-date epipen.
Are the nursery being unreasonable to be so inflexible when it's quite literally impossible to get hold of an EpiPen within the UK at the moment?
*her nursery, obviously (not sure how that happened)
I had the same problem with epipens being unavailable. DS is 18. I was given a private prescription for £140 and they suddenly became available.
That sucks. Could you get a note from your GP?
There’s a national shortage of epipens. I was advised at hospital this week, that an extra 6 months is being given as a ‘grace period’ on all epipens.
I’m advised that children are getting priority with any epipens which become available (because small people’s lives are more valuable?!) so sure you’ll get at least one new one soon, if you put a prescription into a pharmacist.
I'm really sorry this is happening, but I don't think they're being unreasonable. Mixing with so many children, being exposed to egg is a real risk. All it takes is another child to foist some food into your DD's mouth while the staff aren't looking, which can happen easily.
I don't think they are BU. If the allergy is that severe then they are doing what is safest for the child.
If god forbid your DC were to have a reaction and an ambulance couldn't get there in time, can you imagine the absolute nightmare for the nursery?
I don't think they are being unreasonable, I have just googled and you can buy them online.
If her allergy is that severe, it is not reasonable to expect the nursey to shoulder the burden of knowing that should the worst happen and she come into contact with egg, they can't do anything to treat her.
Is the allergy life threatening? If so, YAB even more U.
The nursery is a business and has to protect itself. Should your DD become severely ill or, god forbid, die, blame would be apportioned to them. It is much MUCH harder for them to guarantee an egg free environment than it is you at home.
Sadly they're not. They can't take the risk of something happening at nursery. They simply won't have the man power to deal with it amongst other things. I've no easy answer though, all you can do is keep trying to get the pens. Do they come through pharmacies at all? Can you contact all the ones you can get to and ask to be told if there's any news?
When do the epipens expire ? I've got this situation at the moment and I've asked parents to get a letter from their GP stating that the EpiPen is still OK to use and to state for how many months.
The nursery is being guided by the LEA, Ofsted and their insurance company and cannot just decide to 'break' the guidelines. They need written advice from a reliable source.
My son also has allergies. Epi pens are difficult to get hold of at the mo, but my GP has been prescribing, I then take the script to the chemist, who fax it to the suppliers. They are then sent the Epi pens. I don’t think any chemists have them on the shelves ‘just in case’ at the moment. They have to prove they have a prescription, hence faxing.
If you really can’t get hold of Epi pens in your area, there is an alternative, which is very similar. Sorry I can’t remember the name but I had a letter from my GP explaining the shortage and that there was an alternative.
I think you should call your GP back and ask what they suggest, investigate alternatives.
Contact your CCG pharmacist as there is guidance on this- some pens are safe to use beyond stated use by date
Plus there are alternatives to epipen like jext and emerade your GP may need to explore
I feel for you but they are acting responsibly.
We had a similar problem back in September. The pharmacist advised us to ask for a prescription for either a jext pen or an emerade pen. It took a bit of a wait but we got them and nursery were happy with the change as we also ordered a new trainer pen for them.
Lots of sympathy though. I remember the worry at the time.
This is happening in schools too and has been an issue for a while. I would second previous poster re change to jext/emerade “brand” first. My understanding as an HCP is that using out of date epipen is not necessarily harmful but may be less effective, so better than nothing in life threatening situation. If your GP could authorise in writing that old pen may be administered that could satisfy all parties in the interim. Good luck!
I suppose they really cannot take the risk as, another poster said, another child could easily give your child some egg.
Is there a possibility that you could ask the nursery to ban all egg products until you get an epi pen? They might be willing to help and I'm sure other parents would be happy to comply. I would.
There as a letter to parents of Epi pen users detailing the arrangements for EPi-pens and making recomendations linked below. You can check the batch numbers of exptended expiry dates on the Epi-pen website.
There is guidance to pharmacists about getting them on a named patietn basis ( hence faxing the script)
Jext and Emerade seem to be quite short as well.
I second the advice about seaking to the CCG pharmacy team- they might do a general letter to all nurseries in your area advising what they need to do. ( It appears to be give the out of date one and dial 999)
The nursery are totally correct here . There are other brands of pen available. Jext and Emerade . Why not ask your GP to prescribe an alternative ?
They officially extended the Epipen sell by date by 6 months due to the shortage.
What my GP said to do was go to my pharmacy and ask them which ‘auto-injector’ they were currently able to source and then tell the GP and they would write a prescription for. We switched to Emerade by doing this and the pharmacy had them in stock no problem.
The nursery will be following advice from their insurance company
Medication has to be in date
Nurseries are under no obligation to give any medication whatsoever
The responsibility rests with you to provide the correct medication, whether that means a private prescription or another brand of pen
The EpiPen jr hasn't been issued with an extension according to the manufacturers. My GP was unable to fulfill the prescription, nor could Boots. I have since found a chemist who was able to try outside their usual suppliers and who have managed to get it filled.
I suggest getting the prescription and trying all the independents if you haven't already, and there is also guidance on www.epipen.co.uk regarding sourcing pens.
And the alternatives advice from above. Good luck. x
YABU. The #1 reason people die from anaphylaxis is that they did not get epinephrine in time. The nursery are being totally reasonable in saying they won't take her without epinephrine. It's a HUGE liability for them.
I agree with the PPs - see if there's an alternative you can get.
I would try a different pharmacy to see if they can obtain them for you. As a previous poster said they are in short supply but if a pharmacy has a valid prescription they can fax it through (anonymising your sons details) to Alliance the wholesaler and they arrive about 2 days later. It might be the Pharmacy you use doesn't have a contract with Alliance, or more likely, they haven't tried to order it other than putting it onto their ordering system on the computer
Of course they're not being unreasonable. You're basically asking them to possibly administer out of date medication. would you honestly give your child out of date Calpol.
Can you get a different prescription for adrenaline - we were prescribed Emerade only last week without any problems. And to be honest I prefer it as there is only one cap, so you can't stab yourself in the hand!
As far as I am aware, they are all adrenaline shots, just different brands that make them.
Do you have a pair at home - could you give one to them, or alternatively give your home set to them each day and bring it home each day until you have something more permanent sorted?
I know someone who should have two epipens due to the severity and speed of her reactions and she can only get hold of one due to the shortage, and that one is rapidly approaching it's date.
If you can not get hold of an up to date epi pen or equivilent, surely it is discrimination to exclude a child because the health service cannot provide them with the optimal medication?
It isn't discrimination.They are looking at the best interests of the child. The child has a severe allergy and they are concerned that they would not be able to offer the best care for the OPs child in their setting without up to date adrenaline shots - I think that is fair enough.
It’s not discrimination
They would not be following their own policy and procedures if they accepted out of date medicine
I work in a hospital. The other brand is Jext
A bit inflexible I think. I am a school First Aider, I have several pupils with Epipens affected by this. I consulted with the the NHS and parents and was told epipens could be used after their advisory date, they have a “window “ on them where you can see if the contents are still clear, there are instructions regarding this. Approximately 6 months. We can’t tell secondary pupils they can’t come to school, common sense has to prevail. In the end they were all quite quickly replaced by Emerade injectors and the problem was solved.
I carry an Epipen for a life threatening allergy and know the frustration.
There is an alternative i've been prescribed called a Jextpen, apparently it's the same ingredients etc but just a different brand. I had to get my GP to specifically prescribe these though as the Chemist couldn't just give them out.
There's information on the extended use by dates for epipens here:- www.anaphylaxis.org.uk/2019/01/22/statement-from-mylan-on-the-availability-of-epipen-0-3mg-and-0-15mg-adrenaline-auto-injectors
It seems to say that 0.3mg and 0.15mg epipens are now available - though from your experience that's not true.
I really sympathise with you. It took me two months from last September to get epipens for my daughter and ,even then, the pharmacist could only get epipens that expired at the end of February so I've just had to request another prescription.No idea if I'll actually be able to get them.
Of course nursery are not being unreasonable.
I was told last year by boots that there was a worldwide shortage of epipens.
Today at work I was told that we no longer have access to pre-filled adrenaline syringes so when we run out we are onto ampoules of drug which have to be drawn up.
All very scary. The pharmacist in boots told me that manufacturers were advising all GPs to tell their patients that epipens could be used after their expiry dates.
🤞 we are ok for now. DS has 3 and all are in date up until July. Touch wood he won’t need to use one but he is off to West Virginia in July and I am shitting it really as he won’t be with us. I will be sending him with large amounts of antihistamines though and advising him to take them every day symptoms or not.
We are a little more edgy though as we don’t know what triggered his reactions.
I would urge you to ask for a prescription for either Jext or Emerade. They are actually far easier to use as you’re less likely to accidentally stab yourself when administering them. That said, as others have said, some pens have their dates extended due to the shortage so you may be ok. We had issues replacing our general EpiPen at school and now have a Jext instead.
Yabu they need to be confident that in event of your dd grabbing food off another child that they can administer the medication. I've heard of nurseries even refusing kids with allergies because can you imagine what would happen if the child is harmed? They are simply not equipped to deal with severe allergies - and they are wide ranging so they would basically have to ban food to accommodate every possible allergy (the nursery at work as a kid allergic to carrots, and one allergic to bananas)
Nursery has policies and procedures that have to followed and they cannot be flexible.
I work in a school. And we have to send kids home if their medications aren't right. A recent example was an out of date inhaler, parents sent them in every day, we sent them home because we cannot have a child in school without the correct medication.
The nursery might accept a letter from your doctor to say the pen will be ok for 6 months after the date.
Get a different brand. I had a prescription for epi but pharmacy could only get jextpen - same thing and very similar to use.
As for nursery, i imagine if they are inspected they'd have to have in date meds. I can understand their side.
Provide them with syringes, needles and Adrenalin ampules then. It’s the same thing.
@Nothinglefttochoose - seriously? Do you honestly think a nursery will be willing to use a needle to inject adrenalin into a child?! They're not nurses!!!!
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