Medical needs

Some children may not be able to attend school for health reasons, for long term or intermittent periods.

For children with SEND, anxiety or sensory overload are common factors affecting attendance, which are sometimes not immediately identified. If you think there may be underlying needs affecting your child's attendance, discuss and explore with school how these might be supported.

Browse through our dropdowns below to find out what you can expect in different circumstances.

School Anxiety

Read our information about School anxiety

Supporting children with medical conditions in school

The government guidance 'Supporting pupils at school with medical conditions' says

Governing bodies should ensure that school leaders consult health and social care professionals, pupils and parents to ensure that the needs of children with medical conditions are properly understood and effectively supported. (Key points, page 4)

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 ie. 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.

Watch our video presentation exploring how children with medical conditions may be supported in education:

Reduced or part-time timetables

Children of compulsory school age have the right to a full-time education, and reduced timetables are unlawful (unless following medical opinion that this would be in the child's best interests).

However, a reduced timetable can be an effective temporary measure to support some children. There should be a plan to support an increase to full-time, regular reviews and only with parental agreement and involvement of appropriate services.

If you are feeling pressured to accept a reduced timetable talk to school about whether there are other appropriate support options, for example...

a CAF – a way of working with families and assessing needs
an Inclusion Service referral - a universal referral for alternative provision and tuition; specialist placements; outreach services; and for the multi-agency assessment programme
Referral to a health service.
where support options in school have been exhausted, a request to the local authority to carry out an EHC needs assessment
where an EHC plan is already in place, requesting an early review (opens PDF)

The Department for Education guidance about Attendance says

All pupils of compulsory school age are entitled to a full-time education. In very exceptional circumstances there may be a need for a temporary part-time timetable to meet a pupil’s individual needs. For example where a medical condition prevents a pupil from attending full-time education and a part-time timetable is considered as part of a re-integration package. A part-time timetable must not be treated as a long-term solution. Any pastoral support programme or other agreement must have a time limit by which point the pupil is expected to attend full-time or be provided with alternative provision. In agreeing to a part-time timetable a school has agreed to a pupil being absent from school for part of the week or day and therefore must record it as authorised absence. (page 17, FAQ no.1)

Anxiety & school refusal

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 for challenging behaviour)
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 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...

CAF – a way of working with families and assessing needs
an Inclusion Service referral - a universal referral for alternative provision* and tuition; specialist placements; outreach services; and for the for multi-agency assessment programme
Referral to a specialist health service.
where support options in school have been exhausted, a request to the local authority to carry out an EHC needs assessment

*Alternative provision

This term is used to describe the education arrangements made for excluded pupils to continue to have a suitable, full-time education whilst they are excluded from school or cannot attend school for another reason.

In some circumstances, alternative provision can be used where a child has not been excluded, including alongside mainstream or special education, where there are medical needs.

Read the government guidance around Alternative Provision (PDF)

You can contact the local authority directly with any questions or concerns about alternative provision.

The Suffolk County Council Inclusion Service & how to contact them.

Take a look at this online directory of alternative provision (PDF) (via the Suffolk local offer).

Useful links

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

Developing effective support systems for young people experiencing anxiety based school avoidance

Unity Research School - Blog about helping children to be fine in school

Young Minds guide to school-refusal

Young Mings guide to Anxiety

Children unable to attend school for health reasons

If your child is unable to attend school, there will be alternatives available from the local authority - this is known as alternative provision. You can discuss with school if you believe you need to explore this for your child.

Share any relevant information from health professionals with school and the local authority, particularly if this indicates attendance at school is going to be difficult.

Alternative provision

This term is used to describe the education arrangements made for pupils to continue to have a suitable, full-time education whilst they are excluded from school or cannot attend school for another reason.

Read the government guidance around Alternative Provision (PDF)

You can contact the local authority directly with any questions about alternative provision.

The Suffolk County Council Inclusion Service & how to contact them.

Take a look at this online directory of alternative provision (PDF) (via the Suffolk local offer).

The Department for Education health needs guidance says:

...Local Authorities (LA's) should ensure that it is arranged as quickly as possible and that it appropriately meets the needs of the child. LAs should make every effort to minimise the disruption to a child’s education. For example, where specific medical evidence, such as that provided by a medical consultant, is not quickly available, LAs should consider liaising with other medical professionals, such as the child’s GP, and consider looking at other evidence to ensure minimal delay in arranging appropriate provision for the child. (Page 8)

Watch our video presentation which explains arrangements for education:

Where an Education, Health and Care (EHC) plan is in place

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 (opens PDF).

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, where the local authority decide to amend the plan following review.

Penalty notices (for unauthorised absence)

A Head Teacher or the local authority may issue a penalty notice for unauthorised absence.

If you believe you have been incorrectly issued with a penalty notice you should raise your concerns with Governing body.

If you believe school are recording illness as 'unauthorised absence' it might be helpful to look at the following guidance:

The Department for Education guidance to schools around recording attendance says:

schools should authorise absences due to illness unless they have genuine cause for concern about the veracity of an illness.

schools can request parents to provide medical evidence to support illness.

Schools can record the absence as unauthorised if not satisfied of the authenticity of the illness but should advise parents of their intention.

Schools are advised not to request medical evidence unnecessarily. Medical evidence can take the form of prescriptions, appointment cards, etc. rather than doctors’ notes. (Code I illness, page 11)