GPs should advise families that pupils should not stay off school with upper respiratory tract infection symptoms or anxiety, according to both the RCGP and the chief medical officer.
Yesterday, the College co-signed a letter to healthcare professionals along with CMO Professor Chris Whitty, the Royal College of Paediatrics and Child Health, as well as other royal colleges.
It said GPs need to work alongside colleagues in education to ‘address health-related barriers to school attendance and maximise the short and longer-term benefits of being in school’.
Last month, the RCGP approved ‘five principles to promote school attendance’ which sought to raise awareness among GPs ‘about their vital role in promoting school attendance’.
The College’s Wales chair Dr Rowena Christmas said it is ‘a significant concern’ that school absence has notably increased since the pandemic.
The Department for Education therefore asked the RCGP and other royal colleges to give parents and carers a clinical perspective on mild illness and attendance as pupils return to school this week.
The letter said that ‘in most cases’ GPs should reassure families that children with upper respiratory infection symptoms can go to school if they do not have a temperature.
It also highlighted that while mild or moderate anxiety can sometimes be ‘difficult’, it can also be ‘a normal part of growing up’.
The letter said: ‘Being in school can often help alleviate the underlying issues. A prolonged period of absence is likely to heighten their children’s anxiety about attending in the future, rather than reduce it.
‘We ask you to continue supporting families to build up children’s confidence to attend school regularly and to encourage those who are experiencing persistent symptoms to access additional support.’
GPs were also encouraged to share with patients the NHS guidance on deciding whether a child attends school, especially since the pandemic may have ‘caused some parents to feel less confident’ with this.
Last month, Dr Christmas said: ‘GPs have close and trusted relationships with children and their families, who will often turn to their doctor first when they have concerns.
‘GPs can use this opportunity to reinforce the health and wellbeing benefits gained from good school attendance.’
She added: ‘GPs may feel that their focus is their patients’ health, not their education. But this issue is also about safeguarding and addressing societal inequalities. It will become a national disaster if it is not turned around.
‘Trusted family practitioners have a role to play doing what they do best — practising curiously, asking the right questions, and supporting parents to make the best decision for their child. Education is crucial for individual children but also for the future of our country.’
Five principles for GPs to promote school attendance
- Be alert to when it is better to encourage a child to attend school rather than take time off. Consistently promote school attendance, emphasising the importance of attendance for every child’s long-term outcome, while continuing to support the child and their family.
- Reassure and have sensitive conversations with pupils and parents about anxiety, particularly at the start of new school terms, recognising the importance of minimising time missed during the first week of school.
- Remind ourselves that some schools have mental health support teams, and most have a range of self-help resources and organisations to which we can signpost.
- Encourage parents and carers to speak to school staff about any worries their child may have, enabling them to work together to support their child and improve attendance.
- Make it practice policy to try and schedule routine appointments to minimise time taken off school. Although broader in scope than just GP appointments, in 2020/2021 there were 4.6 million school sessions interrupted due to medical appointments.
Source: RCGP
After it emerged last week that unsafe concrete had forced the full or partial closure of more than 100 schools in England, NHSE said it is now seeking assurance over the state of the primary care estate.
If the parents aren’t on boars, this is hopeless. Why is this also the GPs responsibility??
school refusal can take hold of some children and the longer it goes on the worse it gets. Over the decades a useful tool to encourage reluctant pupils who claim they feel to ill to go to school is to say ‘ lets give it a week and if you are still missing school I will organise a set of blood tests’. It works 90% of the timel I think some poor parents dont have their children under adequate control. A certain old fashioned firmness done kindly works better than endless discussion/counselling in my experience,
There is rarely a need for school age children with anxiety to see the GP as most tier 2 Camhs and general mental health support are based in school, so are the support structures and knowledge of the child.
This is completely contrary to the Medical Ethical maxim of ‘First, do no harm’.
To send children with colds to school unwell causes illness (ie harm ) to other children. It may also breed in a culture of disrespect and lack of consideration for others, which is not helpful developmentally, harmful to good social relationship development, and harmful to a the goal of bilding a strong society.
If there is school refusal because of anxiety – we need to consider removing the cause of anxiety and if the anxiety is justified. The child has a right to decide on their own approach to risk-taking in respect of themselves (but not necessarily in respect of others!), and their wishes in terms of risk avoidance must be respected – especially if they are more right than some bigotted Health Minister.