When your child is too unwell to attend school and what the system should do instead
For many families, attendance stops being a routine school matter and becomes a source of constant anxiety.
Parents are warned about attendance percentages, penalty notices, and court action. What is often missing from these conversations is a basic but crucial point:
Attendance law does not override a child’s health.
Welsh Government guidance is clear that where health affects attendance, the response should be supportive, flexible and planned. It should not be punitive.
This article explains what parents are expected to do, what they are not required to do, and how families can push back safely when pressure is being applied inappropriately.
Do parents need a doctor’s note every time a child is off sick?
No.
There is no requirement in Wales for parents to obtain a GP or medical note for every illness related absence.
Welsh Government attendance definitions confirm that illness is an authorised absence where a satisfactory explanation has been provided by the parent. GP practices are not expected to provide letters for routine sickness, and parents are not required to seek medical appointments purely to justify absence.
Medical evidence can take many forms and GP notes are not the default expectation.
Key point: Schools should not require medical evidence as a condition of authorising absence where illness is genuine and explained. If a school intends to mark illness as unauthorised, it should tell parents this and explain why.
Suggested parent wording:
“Please record today’s absence as illness. I am providing a satisfactory explanation. If you intend to mark this as unauthorised, please confirm in writing and explain what evidence you require.”
What about fluctuating conditions and sporadic attendance?
Many children live with health conditions that do not follow a predictable pattern. This includes:
chronic fatigue and pain conditions
mental health difficulties
neurodevelopmental burnout
post-viral illness, including Long Covid
Welsh Government guidance on supporting learners with healthcare needs exists specifically because some learners cannot reliably access education in the usual way. It recognises that health conditions may fluctuate, worsen after activity, and affect attendance inconsistently.
This means:
a child coping one week does not prove capacity the next
uneven attendance does not equal avoidance
pressure to push through can worsen outcomes
Attendance affected by healthcare needs should trigger planning and flexibility, not assumptions of non-compliance.
Suggested parent wording:
“Our child has healthcare needs that affect capacity. We are asking for a planned approach to access and support, not assumptions based on short periods of improvement.”
Is there a percentage absence rate that triggers enforcement?
There is no legal attendance percentage at which fines or court action automatically apply.
In practice, attendance below 90 percent is often labelled persistent absence. This is a monitoring category, not an enforcement threshold. It is used to identify learners who may need additional support, not to mandate punishment.
Attendance figures must always be interpreted in context, particularly where illness or disability is involved.
What is the role of the school nurse and why are they important?
School nurses in Wales are Specialist Community Public Health Nurses working under the Healthy Child Wales Programme. Their role is not limited to vaccinations.
They support physical and emotional health, identify barriers to education, work with families and schools, and contribute to planning where health affects learning.
They are one of the few professionals whose remit explicitly bridges health and education.
School nurse involvement can be particularly valuable when:
attendance is affected by health
conditions fluctuate or are misunderstood
schools focus solely on attendance figures
families are being pressured without health being properly considered
Parents do not need school permission to request school nurse involvement.
Suggested parent wording:
“I am requesting input from the school nursing service, as Welsh Government describes school nursing as assessing and monitoring health needs and working with families to promote wellbeing.”
The school nurse is also very useful where a child requires ongoing healthcare support. They can help draw up an Individual Health Care Plan (IHCP/IHP) to support chronic healthcare needs while a child is attending school. This can include continence support, medication, or other day-to-day health requirements.
You can find out more about what an Individual Health Care Plan is, and how it differs from the much better known Individual Development Plan (IDP), here:
https://learnwithoutlimitscic.blogspot.com/2026/01/idp-vs-ihp-in-wales.html
What if an Education Welfare Officer becomes involved?
Education Welfare Officers are not intended to be enforcement-only roles.
Where health is the reason for absence, it is reasonable to expect a support-first approach. Parents are entitled to request that healthcare needs are considered before escalation.
Parents can also request communication in writing and ask for meetings to include health professionals.
Suggested parent wording:
“Our child’s absences relate to healthcare needs. Before any enforcement action is considered, please confirm what support and planning steps have been taken to ensure access to education.”
Penalty notices and enforcement as a last resort
Penalty notices exist, but Welsh Government guidance frames them as one option among several interventions. Decision-makers are expected to have regard to the guidance and follow it unless there is good reason to depart.
This reinforces an important principle: enforcement should not be the first response, particularly where health needs are clearly in play.
Being encouraged to deregister because of attendance
Some families report being advised that deregistration would “solve” attendance problems where a child is too unwell to attend school.
It is important to be clear:
Deregistration is a parental choice.
It should not be presented as a response to health related absence.
Welsh Government guidance is built around access, planning and working together. Families are entitled to expect consideration of:
authorised absence
healthcare informed planning
reasonable adjustments
alternative provision where attendance is not currently suitable
Suggested parent wording:
“We are not seeking deregistration. We are asking how education can be accessed appropriately while healthcare needs are managed, in line with Welsh Government guidance.”
When does EOTAS become relevant?
Education Otherwise Than At School (EOTAS) may be appropriate where:
a child cannot reasonably attend school due to health
attendance pressure worsens their condition
school-based adjustments have not resolved access
EOTAS is a lawful education route, not a failure by parents.
If you need more information about EOTAS and whether it might be applicable to your situtation, then part 1 of our 5-part EOTAS series can be found here:- https://learnwithoutlimitscic.blogspot.com/2025/12/eotas-in-wales-part-1.html
What Welsh Government guidance consistently supports
Across attendance guidance, healthcare needs frameworks and school nursing policy, the message is consistent:
illness can be an authorised absence
attendance must be interpreted in context
support should precede enforcement
health and education must work together
Parents are not expected to compromise a child’s health to meet attendance targets.
If you are reading this as a parent
If you are exhausted, frightened or feeling pressured, please hear this clearly:
Protecting your child’s health is responsible parenting. It is not neglect.
Coming next
Later this month we will publish a two-part series on Long Covid and education in Wales, building directly on the issues raised here.
Sources and references (Welsh Government unless stated)
Supporting learners with healthcare needs
https://www.gov.wales/supporting-learners-healthcare-needs-0
Direct PDF:
https://www.gov.wales/sites/default/files/publications/2018-12/supporting-learners-with-healthcare-needs.pdfSupporting learners with healthcare needs: a quick guide for parents (PDF)
https://www.gov.wales/sites/default/files/publications/2018-12/supporting-learners-with-healthcare-needs-a-quick-guide-for-parents.pdfSchool attendance and absence: definitions of authorised and unauthorised absence
https://www.gov.wales/school-attendance-and-absence-quality-report-htmlGuidance on school attendance codes (PDF)
https://www.gov.wales/sites/default/files/publications/2018-03/guidance-on-school-attendance-codes.pdfGuidance on penalty notices for regular non-attendance at school (PDF)
https://www.gov.wales/sites/default/files/publications/2018-03/guidance-on-penalty-notices-for-regular-non-attendance-at-school.pdfHealthy Child Wales Programme for school-aged children
https://www.gov.wales/healthy-child-wales-programme-school-aged-children-introduction-htmlImproving learner engagement and attendance (PDF, October 2023)
https://www.gov.wales/sites/default/files/publications/2023-10/improving-school-attendance-guidance_0.pdf
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Learn Without Limits CIC provides general information and guidance only. We do not provide legal or medical advice. Families should seek advice from appropriate qualified professionals where needed
