School Absence and Requests for Medical Evidence

In 2012, Doncaster Local Medical Committee (LMC) and Doncaster Council reached a shared agreement that letters from GPs should not be used as evidence to validate a pupil’s absence from school.

This approach recognises that school attendance is primarily an educational matter rather than a healthcare function. It also supports the effective use of NHS resources by ensuring that valuable clinical and administrative time is reserved for patients who require assessment, treatment, and ongoing care.

As a result, practices across Doncaster are advised not to provide letters, certificates, appointment attendance confirmations, sick notes, or other forms of medical evidence for the purpose of school absence verification.

Maintaining a consistent approach across all practices helps reduce unnecessary demand on general practice and ensures that NHS capacity remains available for those who are unwell.

We remain grateful to Doncaster Council for its continued support of this position and for recognising the importance of protecting frontline NHS resources.

GPs Should Not Provide Sick Notes for School Absence

GPs should not issue sick notes, medical certificates, or supporting letters for school-aged children who are absent from school due to illness. This applies to short-term illnesses and the vast majority of longer-term attendance concerns.

Why GPs Should Not Issue Sick Notes for Children

There are several reasons why requests of this nature should not be managed by general practice:

• School attendance is governed by education legislation rather than healthcare legislation.
• There is no contractual or statutory requirement for GPs to authorise or certify school absence.
• Most childhood illnesses are self-limiting and do not require medical assessment.
• Requests for absence letters add unnecessary workload to general practice without providing additional clinical value.
• Requiring GP letters can create the misconception that school absence must be approved or authorised by a doctor.

Parents and carers are responsible for notifying schools when a child is unwell. Schools should not routinely require medical evidence for short periods of absence, and GPs should not be expected to validate these absences.

Avoiding the Misconception That GPs “Sign Off” Children

It is important that children, families, schools, and healthcare professionals share a clear understanding of the role of general practice.

Where a child is experiencing difficulties attending school, the issue is often multifactorial and may involve educational, social, emotional, family, or health-related factors. In these circumstances, GPs should not be expected to act as arbiters of attendance.

Accordingly:

• GPs should not issue letters to support non-attendance at school.
• GPs should not be asked to determine whether a child is “fit for school”.
• GPs should not become intermediaries in attendance disputes between families and schools.
• GPs should not be expected to provide administrative validation where no clinical intervention is required.

General practice must remain focused on delivering healthcare rather than administering attendance processes.

Where Families Should Be Directed

If a child has ongoing health concerns that may be affecting school attendance, the appropriate source of support is often the Doncaster School Nursing Service, rather than a GP letter.

School nurses are specifically placed to:

• Assess health needs in the context of education and attendance.
• Support children and families with longer-term health concerns.
• Advise schools regarding appropriate support and reasonable adjustments.
• Work collaboratively with education services and other agencies where required.

This ensures that children receive the most appropriate support while avoiding unnecessary GP appointments and paperwork.

What Practices Should Do

To maintain a consistent approach across Doncaster, practices are encouraged to:

• Decline requests for sick notes, attendance certificates, or medical evidence for school absence.
• Avoid issuing generic “to whom it may concern” letters relating to attendance.
• Direct parents and carers to the School Nursing Service where health-related attendance concerns exist.
• Reinforce that parental notification is generally sufficient for short-term illnesses.
• Signpost schools and families to this guidance where appropriate.

Why This Matters

General practice is facing unprecedented demand. Every unnecessary request for a non-clinical letter or certificate consumes administrative and clinical time that could otherwise be used to care for patients.

Maintaining clear professional boundaries helps to:

• Protect NHS clinical capacity.
• Reduce inappropriate demand on general practice.
• Ensure children and families are supported by the services best equipped to help them.
• Promote a consistent and equitable approach across Doncaster.
• Prevent the normalisation of GPs as certifiers of school attendance.

By working together, schools, families, local authority partners, school nursing services, and general practice can ensure that children receive appropriate support while preserving valuable NHS resources for patient care.