National Quality Framework
Children with medical conditions
attending education and care services
Fact sheet | September 2013
Last updated March 2015
An important objective of the National Quality Framework is to ensure the safety, health and wellbeing of all
children attending education and care services. When a child who has a diagnosed health care need 1, allergy or
relevant medical condition is enrolled at an education and care service additional requirements must be met to
ensure that the child’s safety, health and wellbeing is protected.
Once the enrolment record has been completed it should be reviewed to identify whether the child has a diagnosed
health care need, allergy or relevant medical condition. Where a child is identified with a diagnosed health care
need, allergy or relevant medical condition the service will need to obtain a copy of the medical management plan
from the child’s parent and prepare a risk minimisation plan with the parent of the child. These plans should be in
place prior to the child commencing at the service and stored on the enrolment record for that child.
It is important that services have procedures in place for carefully considering enrolment records as part of the
enrolment and orientation policy and procedure (regulation 168(2)(k)). Once enrolled, each child’s parents should
be regularly consulted regarding any diagnosed health care needs, allergies or relevant medical conditions a child
may have developed since enrolment.
When a child with a diagnosed health care need, allergy or relevant medical condition is enrolled at the
service
A number of issues must be considered when a child with a diagnosed health care need, allergy or relevant medical
condition is enrolled at the service. Critically, key requirements must be in place before the child commences
attending the service, with several other issues requiring consideration:

Has the child’s parent provided a medical management plan for the child? Has a risk minimisation plan been
developed in consultation with the parents of the child?

Will it be necessary to adjust any of the usual practices of the service in order to be fully inclusive of the child?
An education and care program must be delivered to all children being educated and cared for that is designed to take into
account the individual differences of each child (section 168(1)(d)). All aspects of the service’s operation should be
considered in relation to the child’s inclusion at the program and to ensure that their safety, health and wellbeing is
protected at all times.

What precautions may be necessary in order to protect the safety, health and wellbeing of the child?
The nature of diagnosed health care needs, allergies and medical conditions varies significantly. Every reasonable
precaution must be taken to protect children from harm and from any hazard likely to cause injury (section 167). For
example, in some cases it may be necessary for one or more staff members to access additional professional
development or training to assist in meeting a child’s needs.
If a child has a food preference or dietary restriction, for example not drinking cow’s milk as the parents do not
want them to, this would not be considered a diagnosed health care need. Instead, this information would be
included in the child enrolment record (regulation 160) in accordance with the health information to be kept in the
enrolment record (regulation 162).
1
Each education and care service must have in place policies and procedures for dealing with medical conditions
(regulations 168 and 90). This fact sheet presents the relevant requirements of the Education and Care Services National
Regulations 2011.
Medical conditions policy
The medical conditions policy must (regulation 168) set out requirements for:

the management of medical conditions including asthma, diabetes or a diagnosis that a child is at risk of
anaphylaxis

informing the nominated supervisor, staff members and volunteers of practices in relation to managing those
medical conditions

a communications plan that provides information about how the service will ensure that staff members and
volunteers are aware of how the service manages any diagnosed health care needs, allergies or medical
conditions of children at the education and care service; and how parents can communicate any changes to the
service

the practices in relation to self-administration of medication by children over preschool age if the service permits
self-administration and any practices relating to recording in the medication records where medication has been
self-administered

a child enrolled at the service who has a diagnosed health care need, allergy or relevant medical condition, to
have in place:

a medical management plan provided by the parents of the child and for the medical management plan to be
followed in the event of a related incident; and

a risk minimisation plan developed between the service and the parents of the child (regulation 90).
This policy applies at any time that a child with diagnosed health care need, allergy or relevant medical condition is
being educated and cared for by an education and care service, including during excursions. Preparations for high
risk scenarios, including establishing clear decision making processes for calling an ambulance, should be
addressed in the medical conditions policy.
The medical conditions policy must provide for the management of any medical condition that an enrolled child may
have, which may not be limited to asthma, diabetes and a diagnosis that a child is at risk of anaphylaxis. Diagnosed
health care needs, allergies or relevant medical conditions may be ongoing or acute/short term in nature.
The medical conditions policy must be followed (regulation 170) and be readily accessible and available for
inspection at all times the service is educating and caring for children or on request (regulation 171). A copy of the
medical conditions policy must be provided to the parent of a child enrolled at the service who has a diagnosed
health care need, allergy or relevant medical condition (regulation 91).
When a child is enrolled who has a diagnosed health care need, allergy or relevant medical
condition
A medical management plan and risk minimisation plan must be prepared for every child who is enrolled who
has a diagnosed health care need, allergy or relevant medical condition (regulation 90(1)(c)). Generally, a
registered medical practitioner will have been consulted in the diagnosis and management of a diagnosed health
care need, allergy or relevant medical condition.
Medical management plan
A parent of the child must provide a medical management plan for the child. This medical management plan must
be followed in the event of an incident relating to the child's diagnosed health care need, allergy or relevant medical
condition (regulation 90(1)(c)(i) and (ii)).
Best practice is that the child’s registered medical practitioner is consulted by parents in the development of the
medical management plan and that the advice from the medical practitioner is documented in the medical
management plan. The medical management plan should detail the following:

details of the diagnosed health care need, allergy or relevant medical condition including the severity of the
condition

any current medication prescribed for the child

the response required from the service in relation to the emergence of symptoms

any medication required to be administered in an emergency

the response required if the child does not respond to initial treatment

when to call an ambulance for assistance.
Risk minimisation plan
A risk-minimisation plan must be developed in consultation with the parents of a child and ensure:

that the risks relating to the child's diagnosed health care need, allergy or relevant medical condition are assessed
and minimised

if relevant, that practices and procedures are in place including the safe handling, preparation, consumption and
serving of food are developed and implemented

that the parents are notified of any known allergens that pose a risk to a child and strategies for minimising the risk
are developed and implemented

that all staff members and volunteers can identify the child, the child's medical management plan and the location
of the child's medication are developed and implemented

if relevant, to ensure that practices and procedures ensuring that the child does not attend the service unless the
child has at the service their relevant medications if this would pose a significant risk (regulation 90(1)(c)(iii)).
Communications plan
A communications plan must be prepared for the service as part of the medical conditions policy (regulation
90(1)(c)(iv)) to set out how:

relevant staff members and volunteers are informed about the medical conditions policy; and, the medical
management and risk minimisation plans for children at the service who have a diagnosed health care need,
allergy or relevant medical condition

a parent of the child can communicate any changes to the medical management plan and risk minimisation plan
for their child.
The communications plan must set out how the above communication will occur. This document can be an
overarching communications plan for managing all diagnosed health care needs, allergies or relevant medical
conditions of children in the service and it is not required to be developed for each individual child. Further
information
can
be
found
in
the
fact
sheet
Meeting
children’s
health
needs
available
at:
www.education.vic.gov.au/childhood/providers/regulation/Pages/nqffactsheets.aspx
Child enrolment records
For a child enrolled at the service who has a diagnosed health care need, allergy or relevant medical condition, the
health information kept in the enrolment record must include:

details of any diagnosed healthcare needs of the child, including any medical condition and allergies, including
whether the child has been diagnosed as at risk of anaphylaxis

any medical management plan, anaphylaxis medical management plan or risk minimisation plan to be followed
with respect to a diagnosed healthcare need, medical condition or allergy and details of any dietary restrictions for
the child (regulation 162).
Meeting the requirements for regulation 90 Medical conditions policy
Education and care services must:
All
education
and care
services
Prior to
enrolment
of each
child
Parents should be asked to:
 have a medical conditions policy in place that meets the
requirements of regulation 90
 ensure that the nominated supervisor, staff members
(including family day care educators, where applicable) and
volunteers understand and implement the medical
conditions policy
 review enrolment records and identify any children with
medical conditions as part of the enrolment and orientation
procedures for the service
 monitor the safety, health and wellbeing of all children being
educated and cared for
 ensure all parents are regularly asked if their child has
developed any diagnosed health care need, allergy or
relevant medical condition.
□
□
 seek information from parents about any diagnosed health
care need, allergy or relevant medical condition in relation to
individual children, including whether a medical practitioner
has been consulted in relation to the diagnosed health care
need, allergy or relevant medical condition
□
□
 inform the service at any
time of any diagnosed
health care needs,
allergies or relevant
medical conditions for
their child
□
 inform the service of any
diagnosed health care
need, allergy or relevant
medical condition for their
child prior to enrolment
□
□
□
For each child enrolled who has a diagnosed health care need, allergy or relevant medical condition
Before the
first day of
attendance
at the
service
 require a parent to provide a medical management plan for
the child
 in consultation with the child’s parents, develop a risk
minimisation plan in relation to the child
 record any prescribed health information and keep the
medical
management
plan,
anaphylaxis
medical
management plan (if applicable) and risk minimisation plan
on the enrolment record
 ensure any relevant authorisations for the administration of
medication are recorded on the enrolment record.
□
□
□
□
□
 provide a medical
management plan to the
service for their child
 participate in the
development of a risk
minimisation plan in relation
to their child’s diagnosed
health care need, allergy or
relevant medical condition
□
During the
attendance
of the child
at the
service
 monitor the safety, health and wellbeing of the child
 regularly review the risk minimisation plan for the child
 ensure that parents are regularly asked to provide any
updated information relating to the nature of, or
management of, their child’s diagnosed health care need,
allergies or relevant medical condition
 if necessary, ensure an updated medical management plan
is provided by the child’s parents
 ensure the practices and procedures of the service are
inclusive of the child.
□
□
□
 inform the service of any
relevant changes relating
to the nature of, or
management of, the
child’s diagnosed health
care need, allergies or
relevant medical condition
 if necessary, provide an
updated medical
management plan for the
child
□
□
□
□
Other considerations
 Every reasonable precaution must be taken to protect children from harm and from any hazard likely to cause injury (section
167). What precautions may be necessary in order to protect the safety, health and wellbeing of a child who has a diagnosed
health care need, allergy or relevant medical condition?
 An education and care program must be delivered to all children being educated and cared for that is designed to take into
account the individual differences of each child (section 168(1)(d). Will it be necessary to adjust any of the usual practices of
the service in order to be fully inclusive of the child?
Notification of changes to the medical conditions policy
Parents of children enrolled at the service must be notified at least 14 days before making any change to the
medical conditions policy, if the change may have a significant impact on the service's provision of education and
care to any child enrolled at the service, or the family's ability to utilise the service (regulation 172).
If the notice period would pose a risk to the safety, health or wellbeing of any child enrolled at the service, the
parents of children enrolled at the service must be notified as soon as practicable after making a change to a
relevant policy (regulation 172(3)).
Medication
In most cases, medication must not be administered to a child being educated and cared for unless the
administration is authorised. The enrolment record kept for each child must include details of any person who is
authorised to consent to medical treatment or administration of medication to the child (regulations 160 and 161).
A medication record is kept for each child to whom medication is to be administered by the service. The record
must include the authorisation to administer medication (including, if applicable, self -administration, regulation
96), signed by a parent or a person named in the child's enrolment record as authorised to consent to
administration of medication (regulation 92).
The medical conditions policy of the education and care service must set out practices in relation to self administration of medication by children over preschool age if the service permits self -administration (regulation
90(2)).
In the case of an emergency, authorisation may be given verbally by a parent or a person named in the child's
enrolment record as authorised to consent to administration of medication or, if such a person cannot reasonably
be contacted in the circumstances, a registered medical practitioner or an emergency service (regulation 93).
Medication may be administered to a child without an authorisation in case of an anaphylaxis or asthma
emergency (regulation 94).
Incidents, injuries, trauma and illness
The incident, injury, trauma and illness policies and procedures must include procedures to be followed in the
event that a child is injured, becomes ill or suffers a trauma (regulation 85).
An incident, injury, trauma and illness record must be kept that includes details of any illness which becomes
apparent while a child is being educated and cared for and details of any medication administered or first aid
provided and any medical personnel contacted.
First aid, anaphylaxis management and emergency asthma management training
Centre-based education and care services
At least one educator who holds the following qualifications must be in attendance at any place where children
are being educated and cared for by the service, and must be immediately available in an emergency, at all times
that children are being educated and cared for by the service:

at least one educator who holds a current approved first aid qualification

at least one educator who has undertaken current approved anaphylaxis management training

at least one educator who has undertaken approved emergency asthma management training (regulation
136(1)).
A person may hold one or more of the above qualifications. Where children are being educated and cared for on a
school site this requirement may be met if the educator(s) or at least one staff member of the school are in
attendance at the school site and are immediately available in an emergency.
Family day care services
A family day care service must ensure that each family day care educator and family day care assistant engaged
or registered with the service:

holds a current approved first aid qualification; and

has undertaken current approved anaphylaxis management training; and

has undertaken current approved emergency asthma management training (regulation 136(3)).
Health, hygiene and safe food practices
The service must implement adequate health and hygiene practices, and safe practices for handling, preparing
and storing food to minimise risks to children being educated and cared for by the service (regulation 77).
Any food provided by the service must be nutritious, adequate in quantity and be chos en having regard to the
dietary requirements of individual children including any health requirements (regulation 79).
Specialist advice regarding medical conditions
Below are links to organisations that provide specialist advice, medical management templates or training in the
management of diagnosed health care needs, allergies or medical conditions, including asthma, diabetes or a
diagnosis that a child is at risk of anaphylaxis.
Diabetes

Diabetes Australia (Victoria) www.diabetesvic.org.au

Diabetes Australia www.diabetesaustralia.com.au

Australian Diabetes Society www.diabetessociety.com.au
Anaphylaxis and allergies

Australian Society of Clinical Immunology and Allergy www.allergy.org.au

Allergy and Anaphylaxis Australia www.allergyfacts.org.au

Royal Children’s Hospital, Department of Allergy and Immunology www.rch.org.au/allergy
Asthma

National Asthma Council Australia www.nationalasthma.org.au

Asthma Foundation Victoria www.asthmafoundation.org.au

Asthma Australia www.asthmaaustralia.org.au
Other

Royal Children’s Hospital fact sheets www.rch.org.au/kidsinfo

Emergencies - when to call an ambulance fact sheet

Epilepsy Foundation of Victoria www.epinet.org.au
Further information
The Australian Children’s Education and Care Quality Authority (ACECQA) is the national statutory authority
governing the National Quality Framework.
Phone: 1300 422 327
Email: enquiries@acecqa.gov.au
Web: www.acecqa.gov.au
The Department of Education and Training is the Regulatory Authority in Victoria.
Phone: 1300 307 415
Email: licensed.childrens.services@edumail.vic.gov.au
Web: www.education.vic.gov.au/childhood/providers/regulation/pages