Medical needs

The Government guidance ‘Supporting pupils at school with medical conditions‘ says:

Schools, local authorities, health professionals, commissioners and other support services should work together to ensure that children with medical conditions receive a full education. In some cases this will require flexibility and involve, for example, programmes of study that rely on part-time attendance at school in combination with alternative provision arranged by the local authority6 . Consideration may also be given to how children will be reintegrated back into school after periods of absence.

6 All children must receive a full-time education, unless this would not be in their best interests because of their health needs

(Page 7, Further advice point 5 and footnote 6)

Individual healthcare plans (not to be confused with Education, Health and Care or EHC plans!)

For children with complex health needs.

• An individual plan may not be appropriate for your child. Talk to school if you are not sure.
• An individual healthcare plan will help a school to effectively plan what your child needs, and can provide reassurance about the support plan i.e. who will do what, and when.
• You will be able to share your views and those of your child. Let school know of any changes to your childs needs so the plan can be amended
• This plan can also include your child’s Special Educational Needs (where an EHC plan is not in place).
• Though school will be responsible for finalising and maintaining the plan, healthcare and social care or other professionals should be involved in the process
• Annexe A on page 28 of the guidance for schools (PDF) includes a helpful flowchart of what the process should look like.

Children of compulsory school age have the right to a full-time education unless, due to health needs, it would not be in their best interests.

A part-time timetable must not be treated as a long-term solution. This should only be in place in exceptional circumstances and for a temporary period, with an agreed date for when the reduced timetable will end.  

If you are feeling under pressure to agree to a reduced timetable, talk to school about whether there are other appropriate support options, for example…

• an Early Help Assessment – a way of working with families and assessing needs
• referral to the Specialist Education Services or to the Psychology and Therapeutic Service (for an Educational Psychologist or Inclusion Facilitator)
• Referral to a health service.
• a request to the local authority to carry out an EHC needs assessment or, where an EHC plan is already in place, requesting an early review

The Government guidance ‘Supporting pupils at school with medical conditions‘ says:

Part-time timetables

65. All pupils of compulsory school age are entitled to a full-time education suitable to their age, aptitude and any special educational needs they may have. In some circumstances their education may be provided partially at school and partially at another educational setting or through education otherwise than at a school in line with section 19 of the Education Act 1996 or section 42 or 61 of the Children and Families Act 2014. Time away from school to receive education in other ways must be recorded in the attendance register using the appropriate codes (see chapter 8).
66. In very exceptional circumstances, where it is in a pupil’s best interests, there may be a need for a school to provide a pupil of compulsory school age with less than full-time education through a temporary part-time timetable to meet their individual needs. For example, where a medical condition prevents a pupil from attending school or another setting full-time and a part-time timetable is used to help the pupil access as much education as possible. A part-time timetable should not be used to manage a pupil’s behaviour.

Sometimes a child’s anxiety prevents attendance at school – and this is sometimes referred to as ‘school-refusal’.

Here are a few commonly used support strategies to help with anxiety about school:

• asking your child to tell you what would need to change for them to feel happier about school – this can help identify specific worries
• help to understand and manage their feelings and emotions
• meet and greet by a trusted member of staff at the start (sometimes during or at the end) of the day
• adult-led approaches – checking in with a child that they are okay
• positive praise (for getting through a lesson – instead of sanctions)
• time-out card for when a child feels overwhelmed in lessons
• lesson breaks (to allow some calm down time)
• changes to timetable if particular lessons are a trigger
• allowing a child to learn away from the classroom, in a dedicated area or room sometimes known as a ‘safe space’
• lunching away from the dinner hall, ask whether any lunchtime clubs available. (crowded dinner halls can cause anxiety)
• 1:1 or small group interventions, support programmes and friendship groups
• leaving lessons or school 5 minutes early to avoid crowded corridors
• school counselling

You can speak to a school nurse or your child’s GP for advice, recommendations or a possible referral to specialist services. Share this information with school so they have the full picture, and you can discuss next steps together.

Talk to school about whether there are other options, for example…

• Early Help Assessment (EHA) – a way of working with families and assessing needs
• referral to the Specialist Education Services or to the Psychology and Therapeutic Service (for an Educational Psychologist or Inclusion Facilitator)
• Referral to a specialist health service.
• a request to the local authority to carry out an EHC needs assessment or, where an EHC plan is already in place, requesting an early review 

See also our information ‘Reduced or part-time timetables’.

---

Useful links

Wellbeing in education

Emotional Wellbeing Hub (access advice and support if you are worried about your child’s mental health)

Suffolk information around anxiety based school avoidance (EBSA)

Young Minds guide to School Anxiety and Refusal

If your child is unwell and regular attendance at school is going to be difficult, contact school as soon as possible and share any relevant information from health professionals.

Sometimes, a child may need a part-time timetable – for example, where a medical condition prevents a pupil from attending school or another setting full-time and a part-time timetable is used to help the child access as much education as possible.

See also our information ‘Reduced or part-time timetables’.

The Department for Education guidance ‘Working together to improve school attendance‘ says:

Schools are not expected to routinely request that parents provide medical evidence to support illness absences.

Only where the school has genuine and reasonable doubt about the authenticity of the illness should medical evidence be requested to support the absence.

Where medical evidence is deemed necessary, schools should not be rigid about the form of evidence requested.

Where a parent cannot provide evidence in the form requested but can provide other evidence, schools should take this into account. Where a parent cannot provide any written evidence the school should have a conversation with the parent and pupil, if appropriate, which may in itself serve as the necessary evidence to record the absence. (365 and 366).

What is alternative provision?

The term ‘Alternative Provision’ is used to describe the education arrangements for pupils to continue to have a suitable, full-time education whilst they are excluded from school or cannot attend school for illness or another reason (or where directed by schools to off-site provision to improve their behaviour).

Read the Government guide ‘Arranging Alternative Provision’ for local authorities and schools

Can I ask for alternative provision?

If you child is unable to attend school due to illness or for other reasons, you can discuss with your child’s school, the option of alternative provision.  

The Government guidance ‘Supporting pupils at school with medical conditions‘ says:

All pupils of compulsory school age are entitled to a full-time education suitable to their age, aptitude and any special educational needs they may have. In some circumstances their education may be provided partially at school and partially at another educational setting or through education otherwise than at a school in line with section 19 of the Education Act 1996 or section 42 or 61 of the Children and Families Act 2014. Time away from school to receive education in other ways must be recorded in the attendance register using the appropriate codes (see chapter 8).

Section 19 of the Education Act 1996 sets out the legal duty for a local authority to provide a suitable full-time education for compulsory school-age children who are unable to attend due to ‘illness, exclusion or otherwise’.

You can contact the local authority directly with any questions about alternative provision for medical or health needs: Students with health or medical needs.

IPSEA have a template letter ‘asking the local authority to arrange alternative education‘.

The Department for Education health needs guidance says:

….‘Local authorities, working closely with the child’s home school, medical practitioners (such as a GP or consultant) and the child’s family, should make every effort to minimise the disruption to a child’s education by identifying the most suitable provision.

Where specific medical evidence, such as that provided by a medical practitioner, is not readily available, the child’s home school or the local authority should consider liaising with other medical practitioners and consider other evidence to ensure appropriate provision can be arranged as soon as possible.’ (Page 8)

If your child is too unwell, or refusing, to attend a school named in an Education, Health and Care plan you could contact the local authority to request an early annual review.

Annual reviews provide the opportunity to update circumstances, discuss progress being made towards outcomes, and ask for any amendments you would like to make to the plan. 

You will also have an opportunity to request a particular school to be named, if the local authority decides to amend the plan. 

A headteacher, or the local authority, may issue a penalty notice when they are concerned about attendance. They are an alternative to prosecution and aim to improve attendance.

It would usually be issued for unauthorised absence and they must follow the national threshold (10 sessions of unauthorised absence in a rolling period of 10 school weeks). A penalty notice might also be issued if a child is found in a public place (during school hours) in the 5 days following a suspension or permanent exclusion.

The statutory guidance says that schools must record absence using codes set out in Regulation 10 of The School Attendance (Pupil Registration) (England) Regulations 2024.

Unauthorised absence codes are for very limited circumstances including holidays taken in term-time, for a short term period to allow time to check the exact reason for absence, or where the school is not satisfied they can classify the absence as authorised (where they doubt the genuineness of the illness).

If you have any questions or concerns about how your child’s absence has been recorded on their attendance record, talk to school as soon as possible.

You can also raise your concerns (or make a complaint) with the Governing Body.

Read more about Suffolk School Attendance Penalty Notices 

Can I appeal against a penalty notice?

There is no right of appeal against a penalty notice, however, you can make your representations to the school to request they reconsider. Include relevant background information and reasons which lead to the absence.

Any time you raise concerns, it can help to include information about the impact to your child and what they have expressed (about a decision, or around any delays/barriers to support).

You may also make a complaint to school and Governing Body. We explain the routes of complaint here, including a section around Disability Discrimination (if you believe your disabled child has been discriminated against): Raising concerns

The Suffolk County Council Family Services team and how to contact them.

Specialist Education in Suffolk

Government guidance around Alternative Provision

Guidance around anxiety based school avoidance

DFE Guidance Ensuring a Good Education for Pupils who cannot attend school because of health needs

DFE Guidance for pupils with medical needs (PDF)  

DFE School Attendance Guidance (PDF)

‘Not fine in school’ – Action and support for school-refusal and attendance difficulties (PDF)

Medical Conditions and School Partnerships (Health Conditions in Schools Alliance) – Includes Individual Healthcare Plan templates for particular conditions.

Equality Act guidance for schools 2014 (PDF)

Equality & Human Rights Commission guidance for schools 2014

NHS ‘Is my child too ill for school?

Ombudsman Report ‘Out of School, Out of Mind’ (PDF)

Care and Education Treatment Reviews (for children and young people with Autism and/or a learning disability who are at risk of being admitted to or are currently being detained in an in-patient psychiatric service)

School Attendance (Suffolk Local Offer information)