Consultation on schools holding Adrenaline Nasal Sprays for anaphylaxis

Anaphylaxis is a life-threatening severe allergic reaction that is usually sudden in onset and progresses rapidly. Prompt treatment with adrenaline is essential. Schools in England are currently permitted to purchase and hold spare Adrenaline Auto-Injectors (AAIs) for use in emergencies involving pupils known to be at risk of anaphylaxis. Following the authorisation of Adrenaline Nasal Spray (ANS) in July 2025, there is an opportunity to consider whether schools should also be permitted to purchase and hold this alternative adrenaline product.

This consultation seeks views on proposals to amend the Human Medicines Regulations 2012 to allow schools to purchase and hold spare Adrenaline Nasal Sprays alongside Adrenaline Auto-Injectors. The proposed changes would extend the existing legal exemptions for AAIs to ANS, enabling schools to obtain and use it in emergencies without a prescription for a named individual. The aim is to ensure that legislation keeps pace with clinical developments and removes barriers to accessing approved, safe and effective treatments for anaphylaxis in school settings.

The proposal would maintain the existing safeguards that apply to school-held adrenaline products. Spare adrenaline supplies could only be used for pupils known to be at risk of anaphylaxis and administered by appropriately trained school staff. Schools would be able to choose whether to stock Adrenaline Auto-Injectors, Adrenaline Nasal Sprays, or both, and either product could be used in an emergency regardless of which type of adrenaline device the pupil has been prescribed. Updated guidance would support implementation and training, while reinforcing that school-held supplies are a backup measure and not a replacement for pupils carrying their own prescribed medication.