Advice for Schools
Requests for medical certificates to validate pupils’ absences from school
Increasingly, GPs receive requests to provide medical certificates, letters or evidence to present to a school to verify a pupil’s absence from school due to illness or to excuse them from exams or other activities.
GPs are not contractually obliged to undertake this work as it does not form part of the NHS General Medical Services (GMS) contract therefore an appropriate charge can be made.
While practices are entitled make a charge, it should be noted that medical certificates, letters or evidence are rarely appropriate or necessary; a parent’s explanation of the absence is generally sufficient.
School Absence Requests
School Absence Requests
School Absence Requests
Return to play following head (or other) injury
Can a GP verify that my child is safe to return to sports following a head (or other) injury? Many traumatic injuries are initially best assessed by a minor injuries unit rather than the GP practice, though some practice offer this service. It is ok to check by calling 111 or the practice reception team if you are unsure.
GPs are, of course, happy to assess any person who thinks they are unwell – especially if the recovery is not going as predicted. However, GPs are normally unable to provide medical opinion on safety to return to sports following an injury. This is for the following reasons:
- Decisions to return to sport may sometimes be complex and require specialist training. Many GPs are not formally trained nor have appropriate medical insurance to make these medical assessments.
- Medical assessments for sport are not something GPs are contracted by the NHS to do.
Pressures on General Practice are significant. Practices must use their limited time wisely, and this normally includes declining to take on work for which they are not trained nor commissioned to do because this could jeopardise their core duty to deliver the services the NHS contracts them to
Who should provide return to play assessments? The verification of the fact that a child is symptom free and sanctioning of return to play is a function that should be fulfilled by the school / club / parent.
Alternatively, there are organisations that provide Return to Play assessments for a fee.
Another request that practices often receive is in relation to a pupil missing an exam as a result of illness. As a result of these requests, the GPC wrote to Ofqual and they confirmed that awarding organisations make no requirement for pupils to obtain a medical certificate in support of an application for special consideration and that medical proof is not required. A copy of this letter is available below:
Response to GPC
The obligations of schools in supporting pupils with health conditions
The Department for Education have produced some guidance to ensure that schools have regularly reviewed policies that are readily available to ensure they can support pupils at school with medical conditions.
The DfE has also produced various templates to help schools create individual health care plans and ensure they obtain written parental agreement to administer medicines to their child.
Department for Education
Supporting Pupils at School
Education Welfare Officers (EWOs)
The role of an Education Welfare Officer is to support schools to work with parents and children of statutory school age to improve regular school attendance. Schools will make a referral when non-school attendance reaches the threshold of 90% or below over the previous 6 weeks, mostly unauthorised.
EWOs are employed by the local authority and part of their role is to prepare the case if an authority is considering taking legal action against parents or guardians for failing to send children to school.
There is no obligation on practices to provide information to EWOs and no information should be shared without the consent of the parents unless there is an immediate safeguarding concern.
GPs should always consider the possibility that a safeguarding issue exists and take appropriate action when necessary.
Non-prescription over the counter (OTC) medication
GP practices often receive requests from parents to prescribe over the counter medications for their children because schools/nurseries/childcare settings say they need to have ‘child specific’ bottles with prescription labels on them.
Can a school give a child an over-the-counter (OTC) medicine? The MHRA (Medicines and Healthcare products Regulatory Agency) licenses medicines and classifies them as over-the-counter, based on their safety profiles. A medicine being made available over the counter enables access to those medicines without a GP. This applies in the educational setting as well as in the home.
GPs would therefore not normally prescribe simple OTC medications for any patient, including children, and a doctor’s prescription should not therefore be required before administering such medicines to a child.
It is appropriate for OTC medicines to be administered by a member of staff in the nursery or school, or self-administered by the pupil during school hours, following written permission by the parents. However, schools should not give pupils under 16 years old a medicine containing aspirin, unless prescribed by a doctor.
Medication should never be administered without first checking maximum dosages and when the previous dose was taken. Parents should be informed when the school give a child a medicine, and how much was given.
Can a school give a child a prescribed medicine? Does it need an additional GP letter of authorisation? Giving a child a medicine that has been prescribed for them does not normally require an additional letter from the GP. Rather, the statutory guidance for schools says that written permission for that particular medicine should be obtained from the child’s parent and/or carer.
Where a medicine has been recommended for a child to take at school, the instructions on the prescription label, or as described by the parent (in the case of over-the-counter medications), are usually sufficient.
OTC Medicines request
Over the counter medicines
Public Health England has published ‘Guidance on Infection Control in Schools and other Childcare Settings’ that is designed to prevent the spread of infections such as rashes and skin infections, diarrhoea and vomiting, and respiratory infections. This is a useful reference document in the event that practices receive enquiries from schools that suddenly find themselves facing such a situation.
Public Health England
Guidance on infection control
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