OBJECTIVE To examine the policy, administration, and supervision of medicine administration in primary schools within the Greater London area (GLA). METHODS A prospective survey using postal questionnaires sent to 172 randomly selected primary schools within the GLA. METHODS Head teachers of primary schools. RESULTS Some 65% of head teachers replied. Less than 50% of responding head teachers had actually read the national guidelines Supporting Pupils with Medical Needs and only 30% of respondents were aware of other members of staff who had read the document. A total of 95% of respondents followed a policy/procedure in caring for the medical needs of pupils. Over 80% of respondents had staff handling the pupils' medical needs, staff handling access to stored medicines, and prior arrangements for staff training. However, it is worrying that a quarter of the schools did not keep a written record of medicines given to children in schools. The majority of staff with responsibility for medicine administration in schools are support staff. The most encouraging findings were that for the majority of schools with children using the EpiPen and rectal diazepam, there were trained staff to administer these medicines. CONCLUSIONS The majority of schools had a policy in place to deal with medicine administration, although further work should be conducted to analyse the content of such policies. It is very important that training is directed at staff responsible for medicine administration and not just at teachers. Most schools were willing to administer rectal diazepam and EpiPen treatment in an emergency.