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Absence for medical reasons
All parents have a duty to make sure their child attends school regularly. All children are likely to have short absences from school when they are ill, but some children with a disability or health condition will have lengthy or repeated periods off school.
Lengthy absences could be for a variety of reasons, such as surgery or other treatment, or conditions such as ME/Chronic fatigue syndrome.
Short, repeated absences could be due to having frequent hospital appointments or because of a condition involving intermittent crises or flare ups between periods of being reasonably well. Children with an impaired immune system may have more absences with coughs and colds than other children. Mental health conditions can be a reason for both lengthy and recurrent absences, and some children and young people develop school phobia or refusal.
Keeping the school informed
It is important to keep closely in touch with the school about your child’s health. You should inform them in advance of any medical appointments or planned treatment.
If your child is unable to go to school because of a mental health condition, such as severe anxiety, let the school know in writing, rather than just keeping them at home. A GP’s note may help in such cases.
What help is available if my child is off school for medical reasons?
Your child might not be well enough to do much work, but continuity and maintaining a sense of normality is good.
For short absences, your child’s school should keep in touch and send work home if they are off for more than a day or two. Some schools have a bank of activities available to download from their website. Others may provide some outreach support, for instance the child’s support assistant coming and doing some work with them at home. While your child is off, the school should help them keep in touch with classmates, for example by writing, over the phone, through photos or class newsletters, over skype, and so on.
If your child is admitted to hospital they will attend the hospital’s school, where they’ll have lessons on the ward or in a separate schoolroom. The hospital education team should liaise with your child’s school.
The local authority must provide alternative education for children aged five to 16 who are at home sick for more than 15 school days. This should be either full time or as much as the child can manage. It can be provided in a number of different ways, including:
- A home tutor.
- Online learning.
- A small unit for children with medical needs.
Before arranging alternative education, the local authority may need a referral from your child’s school or a letter from a consultant stating that your child is not well enough to attend school. The teams coordinating alternative education have different names in different areas. Common names are ‘home and hospital tuition’ or ‘EOTAS’ (education otherwise than at school).
There is no duty on local authorities to make provision for children below or above compulsory school age, though some may do. If your child has an Education, Health and Care (EHC) plan, you can insist that the plan makes provision for school absences. In some cases an EHC plan may specify home-based education.
Going back to school after absence
It is important to have a reintegration plan for when your child goes back to school. You should discuss this with the school, the home or hospital tuition service and any medical professionals involved in the child’s care. It may be possible to have a gradual return, for instance through part-time attendance for a limited time.
The school will need to look sensitively at what information is shared and how. Some children may not want to answer questions about why they were off or for people to make a fuss. They may overstretch themselves because they do not want to appear different. It is also important to guard against potential bullying or isolation, for example if the child has mental health issues or if they can’t do what they used to be able to.
The school could look at providing some extra help for your child, either one-to-one or in a small group. The school may also provide additional pastoral support via a learning mentor or an in-school counselling project. The focus should be on your child’s reintegration into school, not just academic ‘catching up’.
If your child is doing public exams, the school should look at what access arrangements, such as rest breaks, are required. The school might be able to make special consideration if your child has missed an exam due to illness.
All schools have a duty to support children with medical needs and must publish a policy. Find out about help at school if your child has medical needs.
If your child has a special educational need, the return to school can be a good time to review their support plan or to ask for a formal review of the EHC plan. For instance, you can ask if more or different support is needed. It may also be worth looking at whether mental health difficulties, such as anxiety or school phobia, are the result of an unidentified learning difficulty.
Can I be fined or prosecuted if my child is off sick?
No. You cannot be penalised for a genuine medical absence. Schools must authorise an absence where a child is ill or has a medical appointment.
Government guidance recommends that schools should authorise medical absences unless they have reasons to doubt that they are genuine, and that schools should not ask for unnecessary medical evidence. You shouldn’t be asked for a doctor’s note for every single absence, but it will be helpful to share information with the school about your child’s condition and the likely effect on attendance.
How schools deal with attendance issues varies in practice. Some schools send out automated letters when attendance drops below a certain level. This can be alarming and distressing, but there’s nothing to worry about if the absence is authorised. Always ask for a copy of the attendance record and check the status of individual absences.
If you are being fined or threatened with prosecution, please call our helpline.
Can my child be excluded from school completely if they are too ill to attend?
No. The school cannot exclude your child, or simply take their name off the register, for health reasons. Your child can only be removed from the register for health reasons if:
- A doctor has confirmed that they will not be well enough to go back to school before the end of year 11. and
- You or your child agree that they will not be returning to school in the future.
You should not be put under pressure to remove your child from school or to home educate them.
Government guidance and external resources
- Ensuring a good education for children who cannot attend school because of health needs.
- Supporting pupils at school with medical conditions.
- School attendance.
Support for mental health:
- Young minds – support for children and young people’s mental health.
Extra support in school
Read about the extra support provided in mainstream schools for children with special educational needs in England.Read more
Is your child having difficulty meeting certain milestones? We can help.Read more
Mental health services (CAMHS)
CAMHS stands for child and adolescent mental health services, which support children and young people with their emotional or behavioural wellbeing.Read more