Exclusive GPs could see a spike in requests to provide reports, medical letters or certificates for schools as a result of new legislation, passed without consultation with GP bodies.
The Children and Families Act 2014 – due to come into force in September – places a statutory duty on schools to have formal arrangements in place for pupils with medical conditions, and supporting guidance for schools highlights GPs as an example of a health professional to approach in developing medical arrangements and training staff.
A Department for Education consultation on the guidance reveals that no GP representatives were consulted about the potential impact of the regulation, and the BMA have expressed their ‘disappointment’ that the changes have been so poorly communicated.
The GPC will now write to the DfE to clarify any additional work implications, and have warned that the legislation has the potential to exacerbate problems in the relationship between parents and GPs.
The legislation was highlighted by YORLMCs ltd – Airedale, Bradford, North Yorkshire and the City of Yorkshire – who posted in their newsletter that GPs should not take on any work unpaid following concerns from members.
The legislation states: ‘The appropriate authority for a school to which this section applies must make arrangements for supporting pupils at the school with medical conditions.’
The supporting guidance, which directs schools on how they should interpret the regulations, says: ‘Healthcare professionals, including GPs and paediatricians – should notify the school nurse when a child has been identified as having a medical condition that will require support at school. They may provide advice on developing healthcare plans.’
It adds: ‘School nurses can liaise with lead clinicians locally on appropriate support for the child and associated staff training needs.’
YORLMCS Ltd advise that practices have no statutory obligation to provide supporting information to schools, and where they do so, they are entitled to charge the individual or organisation making the request.
GPC deputy chair Dr Richard Vautrey told Pulse that for GPs their patients’ welfare is the chief concern, but that expectations to provide extra work should not go unresourced.
Dr Vautrey said: ‘GPs have always put children’s welfare at the top of their priorities and regularly work with other professionals in the community to make sure vulnerable children are properly supported.’
‘However, these new arrangements appear to have been poorly communicated to GPs and I suspect many will be unaware that they are coming into force in September. It is disappointing that GP representative bodies were not proactively consulted about these proposals.’
‘While we are keen to improve the care of children, we will be writing to the Department for Education for greater clarity on what work GPs will be expected to undertake and then seek to issue guidance to GPs.’
Dr Robert Morley, chair of the GPC’s contracts and regulation subcommittee, said: ‘It’s always been a problem anyway, with schools asking GPs to police the absences of their pupils from schools, and provide medical certification.‘
‘The old issues apply; firstly, it’s not NHS work, it’s extra-contractual. It takes away appointments from people who genuinely need them for medical reasons. It causes difficult consultations between GPs and patients, if GPs don’t feel it’s appropriate to issue certificates.’
‘And clearly they are chargeable as well, so there’s all sorts of issues and clearly it would seem that this legislation might make the problem worse.’
The DfE was unable to identify any GP bodies consulted in the proposals, and a spokesperson told Pulse: ‘Schools already have a legal duty to support pupils with medical needs and can work with health experts as part of this.’
‘From September, school governing bodies must make arrangements to support pupils with medical conditions and schools will continue to work with healthcare professionals to do this.’
‘It is for schools to decide how they put these arrangements in place, in consultation with health professionals and parents.’
A recent House of Commons work and pensions committee report said that GPs should not be relied upon for providing supporting evidence to benefits appellants, after Pulse found GPs were being asked for evidence to support one third of claims.