Guidance to practices following requests from schools
Practices are often asked to provide letters to schools to support the organisations request, the LMC has provided some guidance to support practices on the most popular requests to inform practices of their responsibility.
We have covered the following areas:
a. School letters
- School fit note template letter
- Requests for information about medical conditions
- Requests for sick notes for absence from school
- Requests for sick notes for missing exams
- Requests for authorisation to give medications
- Inhalers in School
- Medical Diet - School Meals Request Form
- Maintaining a good relationship with schools
a. School Letters
School fit note template letter
Schools frequently request information from GPs regarding a child’s health conditions, their absence from school, or to certify that they were ill when sitting an exam. Parents often are put under pressure from schools to get this information from practices, even though they themselves would be happy to write to the school on their child’s behalf. This information sheet is aimed at reducing the workload burden for practices of these requests, and we recommend that practices use this as a resource for this purpose.
Requests for information about medical conditions
Schools have a duty to reduce non-attendance by pupils, as there is good evidence of the correlation between non-attendance and reduced academic achievement. In the document “Supporting pupils at school with medical conditions”[1] there is guidance for school governing bodies on how they can best support pupils who have medical conditions to attend school. For schools to comply with this guidance it is important for them to understand the nature of a child’s medical condition. The guidance states that GPs and other healthcare professionals should
“notify the school nurse when a child has been identified as having a medical condition that will require support at school. They may provide advice on developing healthcare plans.”
Thus, requests from schools for information about a child’s health conditions should be provided, as long as there is consent from the parents and child. There is no fee applicable to this information. These requests should be made by the school, and not the parents.
Requests for sick notes for absence from school
GPs do not provide “fit notes” for adults until they have been unable to work for seven days. The “fit note” is also “designed to help you provide fitness for work advice to your patients”[2] so is not just a way to evidence that they are ill. These rules should also apply to children who are absent from school. Thus if a parent or school requests a sick note for a period of absence shorter than this we should decline. There is a template letter available on the LMC website by clicking here which can be used to inform schools that this is the case.
If a child is absent from school for longer than seven days, the child may have a condition which may affect their long term ability to attend school, and thus more information may be needed by the school in accordance with the guidance above. In this circumstance it would be advisable to discuss with the child, the parents, and the school, whether a “sick note” will best achieve the aim of supporting the child in returning to regular school attendance.
Requests for sick notes for missing exams
As a result of a number of practices and LMCs querying whether GPs are required to provide evidence that children were unwell and thus missed exams, the GPC wrote to Ofqual to get the official stance. The response from Ofqual states:
“Awarding Organisations make no requirement for pupils to obtain a medical certificate in support of an application for special consideration. Students are asked for information in support of their application, but this may take the form of a statement by the school. The Joint Council of Qualifications (JCQ) has confirmed that as far as they are concerned, if a student was absent from an examination as a result of illness and has the support of the school or centre to be absent, special consideration will be granted in that basis. Awarding Organisations do not insist that medical proof is provided”
Requests for authorisation to give medications
The “Supporting pupils at school with medical conditions” guidance states “no child under 16 should be given prescription or non-prescription medications without their parents’ written consent”.
This statement implies two things:
- that GPs do not need to provide authorisation for medications to be administered by school staff, as this is the role of the parent
- that GPs do not need to prescribe medications which are available over-the-counter so that the medication can be administered in school, as non-prescription medication can be given with parental consent.
Requests from parents or schools to provide authorisation or prescriptions should be declined.
Inhalers in School
Children should have their own reliever inhaler at school to treat symptoms and for use in the event of an asthma attack. If they are able to manage their asthma themselves, they should keep their inhaler on them, and if not, it should be easily accessible to them. This is not an “extra” inhaler for schools to keep for each individual child.
From 1st October 2014 the Human Medicines (Amendment) (No. 2) Regulations 2014 allowed schools to buy salbutamol inhalers, without a prescription, for use in emergencies.
The emergency salbutamol inhaler should only be used by children, for whom written parental consent for use of the emergency inhaler has been given, who have either been diagnosed with asthma and prescribed an inhaler, or who have been prescribed an inhaler as reliever medication.
Medical Diet - School Meals Request Form
It has been brought to the attention of the LMC by our members, that GPs are receiving letters of request from Local Authority and school dietitians which are being requested to sign by a health professional, particularly around the start of a new term The LMC view is that these requests are not part of GMS services, hence the GP is within their rights to refuse to sign these forms.
We have attached a sample copy of the letter.
If the GP feels that they can sign the form then this type of work is non-contractual and attracts a fee.
The LMC would urge any GP challenged on this matter, to signpost the relevant person to the LMC.
Maintaining good relationships with schools
The LMC recommends that practices endeavour to have good relationships with the schools in their catchment areas. To this end we recommend that this guidance is discussed with school head teachers and school nurses so that they are aware of this advice.
If you have any further questions relating to the matter, please email enquiries@llrlmc.co.uk or call the LMC office on 0116 2962950.