Letter to school leaders on mild illness and school attendance

Published 5 September 2023

Applies to England

Dear headteachers and trust leaders,

As you begin to welcome children and young people back for a new school year, we have been asked by the Department for Education (DfE) to provide you with a clinical and public health perspective on mild illnesses and school attendance.

We are aware that the COVID-19 pandemic may have caused some parents to feel less confident with assessing whether their child is well enough to be in school so we have laid out some information which we hope you will find helpful.

There is wide agreement among health professionals and educational professionals that school attendance is vital to the life chances of children and young people. Being in school improves health, wellbeing and socialisation throughout the life course. The greatest benefits come from children and young people attending school regularly.

It is usually appropriate for parents and carers to send their children to school with mild respiratory illnesses. This would include general cold symptoms: a minor cough, runny nose or sore throat. However, children should not be sent to school if they have a temperature of 38°C or above. We would encourage you to share the NHS ‘Is my child too ill for school?’ guidance with parents and carers in your schools and communities which has further information.

In addition to respiratory illnesses, we are aware that more children may be absent from school due to symptoms of anxiety than before the pandemic. Worry and mild or moderate anxiety, whilst sometimes difficult emotions, can be a normal part of growing up for many children and young people. Being in school can often help alleviate the underlying issues. A prolonged period of absence is likely to heighten a child’s anxiety about attending in the future, rather than reduce it. DfE has published useful guidance on mental health issues affecting a pupil’s attendance and those who are experiencing persistent symptoms can be encouraged to access additional support.

Thank you for your efforts so far to facilitate immunisation sessions within schools. As we head into winter, encouraging high uptake of seasonal flu vaccination and routine immunisations for eligible children and young people will help to reduce absences and the disruption they cause.

You, and the teachers you lead, are already supporting families to build up children’s confidence to attend school regularly. The Royal College of General Practitioners (RCGP) recently approved 5 principles to promote school attendance. We hope this guidance will support GPs in having sensitive and reassuring conversations with parents, carers and pupils.

Thank you and your colleagues for your continued commitment to supporting the health and wellbeing of children and young people.

Yours sincerely,

Professor Chris Whitty, Chief Medical Officer, England

Pat Cullen, General Secretary, Royal College of Nursing

Professor Kamila Hawthorne, Chair, Royal College of General Practitioners

Dr Camilla Kingdon, President, Royal College of Paediatrics and Child Health

William Roberts, Chief Executive, Royal Society for Public Health

Dr Lade Smith, President, Royal College of Psychiatrists