Managing sickness in school children 

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.

If a school is concerned about a pupil’s attendance at school, this should be managed as an attendance issue via the education system and should not fall within the remit of GPs.

BMA – Managing workload

Cambs LMC – Managing Inappropriate Workload – Template Letters

Cambs LMC – Emergency Guidance – School Absence Requests

Missing exams

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:

Ofqual response to GPC

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.

Cambridgeshire County Council – Education Welfare Officers

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 of Education – supporting pupils at school

Non-prescription our the counter (OTC) medication in Early Years Foundation Stage (EYFS)

The LMC is aware that practices have received requests from parents to prescribe over the counter medications for their young children in EYFS because schools/nurseries/childcare settings say they need to have ‘child specific’ bottles with prescription labels on them.

The revised ‘The Early Years Foundation Stage Statutory Framework’ (published 3rd March 2017) which governs the standards of institutions looking after and educating children, includes a paragraph entitled – Medicines (3.45 & 3.46) that states:

3.45. Providers must have and implement a policy, and procedures, for administering medicines. It must include systems for obtaining information about a child’s needs for medicines, and for keeping this information up-to-date. Training must be provided for staff where the administration of medicine requires medical or technical knowledge. Prescription medicines must not be administered unless they have been prescribed for a child by a doctor, dentist, nurse or pharmacist (medicines containing aspirin should only be given if prescribed by a doctor).

3.46. Medicine (both prescription and non-prescription) must only be administered to a child where written permission for that particular medicine has been obtained from the child’s parent and/or carer. Providers must keep a written record each time a medicine is administered to a child, and inform the child’s parents and/or carers on the same day, or as soon as reasonably practicable.

OFSTED has also produced a very useful factsheet that confirms that written permission from parents to administer over the counter medications is sufficient.

BMA – Prescribing Over the Counter Medication in Nurseries & Schools

Department for Education – Statutory Framework for EYFS
Ofsted – Giving medication to children in registered childcare

Infectious diseases

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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