The Department for Education has issued new statutory guidance and non-statutory advice on the roles and responsibilities of GPs in supporting pupils with medical conditions at school.
This new guidance came into force 1 September 2014 and replaces previous guidance on 'Managing medicines in schools and early years settings' (March 2005).
Its aim is to ensure that all children with medical conditions, in terms of both physical and mental health, are properly supported in school so that they can play a full and active role in school life, remain healthy and achieve their academic potential. This guidance is for England only.
- Pupils at school with medical conditions should be properly supported so that they have full access to education, including school trips and physical education.
- Governing bodies must ensure that arrangements are in place in schools to support pupils at school with medical conditions.
- 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 effectively supported.
The role of GPs
The guidance from the DoE sets out that supporting a child with a medical condition is not the sole responsibility of one person and the school's ability to provide effective support will depend on working co-operatively with other agencies.
It suggests that GPs should notify the school nurse when a child has been identified as having a medical condition that will require support at school. The Department has not issued a list of conditions, but acknowledges that not all children will require an individual healthcare plan.
GPs should note the confidentiality requirements in doing so, although there is a presumption that information can be disclosed to fellow health professionals. General Practitioners are recommended to advise the child and, in usual circumstances, their parent(s), that it would be in their best interests to share such information with the school nurse and that you would intend to do so unless consent is refused.
GPs may also provide advice on developing healthcare plans. Specialist local health teams may be able to provide support in schools for children with particular conditions (e.g. asthma, diabetes).
Examinations and sickness certificates
It should be noted that GPs do not provide sick notes for schoolchildren. When children are absent from school owing to illness, schools may request a letter from a parent or guardian, and this is no different during an exam period. However, children who have missed exams due to illness are frequently told by schools that a note from a doctor is required; but this cannot be provided by a GP. Aside from the fact that parents/guardians are responsible for excusing their children from school, GPs cannot provide retrospective sickness certification. When a child suffers from a long-term condition, any certification will be provided by the responsible specialist.
GPC has sought and received confirmation from the Office of the Qualifications and Examinations Regulator that Awarding Organisations make no requirement for pupils to obtain a medical certificate in support of their 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 for Qualifications 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 on that basis. Awarding organisations do not insist that medical proof is provided.
Any work involved in providing advice to other agencies and not directly concerned with the specific treatment of the patient, is not covered by GMS or PMS essential services and is therefore chargeable.
Part 3 of the NHS Act 2006 places a statutory duty on the NHS to make available to local authorities services to enable them to discharge their functions relating to social services, education and public health.
The view of the BMA is that any work commissioned from a GP to enable local authorities to discharge their functions relating to social services, education and public health, should constitute work under the collaborative arrangements.
Therefore if it is the local authority requesting this work, then it would fall under collaborative arrangements and the NHS England Area Team would be responsible for payment (unless it has entered into an arrangement with and passed funding to the CCG).
However, even in those circumstances, a practice would be under no contractual obligation to provide a service, though clearly there may be professional reasons why such information should be shared if requested, as in practice only a child's registered General Practitioner may be in a position to provide it.
Any work carried out for bodies other than the local authority is directly chargeable to the organisation requesting it.
Guidance from the Department of Education
Read the full government guidance
Supporting pupils at school with medical conditions
We provide detailed guidance on how and when GPs can charge fees for certain aspects of work including collaborative arrangements
Check our Fees section