Illness policy in schools

What governs a school's illness policy

Two sets of guidance govern a school illness policy in England: the UK Health Security Agency's Health protection in children and young people settings, including education, which sets how long people with an infection should stay away, and the Department for Education's statutory guidance Working together to improve school attendance (July 2026), which sets how the absence is reported, recorded and evidenced. The illness policy itself is good practice: it is not on the DfE's list of statutory policies for schools and academy trusts.

UKHSA's Public health exclusion periods in children and young people's settings, updated on 7 September 2026, is “A guide for staff in early years and education settings which include nurseries, childminders, preschools and schools.” It starts from attendance: “Where there's no public health exclusion period, infected people can come to the setting and interact with others as usual.” UKHSA's collection page adds that the guidance “is not intended to be used as a tool for the diagnosis of infections”.

Exclusion here is not the disciplinary kind. UKHSA's Managing outbreaks and incidents says a public health exclusion is “the time period an individual should not attend a setting to reduce the risk of transmission during the infectious stage. This is different to ‘exclusion’ as used in an educational sense.” The process in our school exclusion records guide plays no part.

Two statutory duties sit beside the illness policy. Section 100 of the Children and Families Act 2014 requires maintained schools, academies and pupil referral units in England to make arrangements for supporting pupils with medical conditions, having regard to the DfE's December 2015 guidance, which stays in force after a consultation from 5 March to 15 May 2026, until the DfE updates it “in due course”. And since 1 September 2026, section 100A of the Children and Families Act 2014, inserted by section 34 of the Children's Wellbeing and Schools Act 2026, has required those schools to include an allergy safety policy in their medical conditions arrangements, review it at least once every year and publish it on the school's website, with the DfE's statutory guidance Allergy safety in schools (July 2026) setting out how. Neither duty yet applies to independent schools. Medicines, long-term conditions and allergy belong in those policies, not the illness policy.

UKHSA's guidance covers England. Scotland, Wales and Northern Ireland publish their own.

How long a child should be off school: the UKHSA exclusion periods

How long a child should be off school depends on the infection, and UKHSA's table gives a period for each. It speaks of “infected people”, so the same periods apply to staff. The rows schools are asked about most:

• No exclusion. Conjunctivitis, hand, foot and mouth disease, head lice, slapped cheek and threadworms: “No exclusion required”.
• Diarrhoea and vomiting: 2 days. “Infected people should stay away from the setting until 2 days after diarrhoea and vomiting has stopped.” Norovirus, rotavirus and food poisoning take the same 2 days: this is the “48-hour rule”.
• Rash illnesses. Chickenpox “until 5 days after the rash first appears”; measles “until 4 days after their rash started”, with a call to the health protection team; rubella 5 days after the rash started; mumps “until 5 days after onset of swelling”.
• After antibiotics. Scarlet fever and group A strep “until 24 hours after they started antibiotics treatment”; impetigo “until all blisters have formed scabs or 2 days after starting antibiotics”; whooping cough “until they have taken antibiotics for 2 days, or for 21 days from onset of symptoms if no antibiotics”.
• Respiratory infections. COVID-19, RSV and other respiratory infections: stay away “if they have more than mild symptoms, for example, a high temperature”. Flu: “until they are better and no longer have a temperature”.
• Scabies. Those “aged 5 and under, or cannot follow the guidance, should stay away from setting until 24 hours after their first treatment”.
• Specialist rows. Hepatitis A until 7 days after symptoms started; E. coli STEC for 2 days, with children under 6 away until a healthcare professional confirms it is safe; active tuberculosis until 2 weeks after starting antibiotics; typhoid until 2 days after diarrhoea and vomiting stop. The table says to contact the health protection team for STEC, TB and typhoid, and for hepatitis A only if 2 or more linked people are infected.

Brothers, sisters and classmates usually stay in school. UKHSA says close contacts “do not usually need to be excluded from the setting”, and that the health protection team will advise if they do.

Use the table, not the poster. UKHSA's parent-facing How long should you keep your child off school poster was last updated on 27 April 2022 and differs from the current table on chickenpox (“until all blisters have crusted over”), whooping cough (“48 hours after they started taking antibiotics”, with no 21-day rule), scabies (after first treatment, at any age) and impetigo. The whooping cough period without antibiotics changed from 14 to 21 days on 21 May 2026, and UKHSA's collection page records eight updates between April and September 2026. Summarise the common rows and link to the live table rather than copying it.

When to call the health protection team, and refusing a child

A school should contact its UKHSA health protection team when an outbreak may be forming or a serious infection appears, not for every case of a common illness. Managing outbreaks and incidents says to “Contact the relevant UKHSA HPT for advice if you're concerned or have seen”:

• “a higher than previously experienced and/or rapidly increasing number of absences due to the same infection”, which “may look like a doubling of absences across the setting or in a year group in a short space of time”
• “evidence of severe disease due to an infection, for example if an individual is admitted to hospital”, generally meaning at least an overnight stay
• “more than one infection circulating in the same group of people, for example chicken pox and scarlet fever”
• a serious or unusual illness such as measles, mumps, rubella, meningococcal disease, E. coli STEC, hepatitis, tuberculosis, typhoid or whooping cough

Spotting a cluster depends on knowing why children are off, so UKHSA suggests “requesting that parents, carers or students inform the setting of a diagnosis of any infectious disease”.

A school can refuse a child who is ill with an infection. UKHSA says: “If a parent or carer insists on a child with symptoms attending the setting, where they have a confirmed or suspected case of an infectious illness, you can take the decision to refuse the child if, in your reasonable judgement, it is necessary to protect other children and staff from possible infection.” Where a child is already known to be vulnerable to neglect, abuse or exploitation and staying at home may increase that, UKHSA says to “notify the appropriate agencies or individuals involved in safeguarding the child”.

Outbreak messages never name a child. UKHSA says information from health protection teams “will never name cases or give out any personal details”, and that “Organisations where cases are identified are also bound to manage personal case details in strict confidence.”

Closing a class is a separate decision. UKHSA says any decision “to temporarily limit attendance for business continuity reasons, such as staff shortages, is for the setting management and local authority”, and communications should make clear it is not a public health decision.

Recording illness absence: code I, medical evidence and the sickness return

Illness absence is recorded with code I, “The pupil is unable to attend because of sickness”, under regulation 10 of the School Attendance (Pupil Registration) (England) Regulations 2024. Working together to improve school attendance says the code covers illness “both physical and mental health related”, that “Schools should advise parents to notify them on the first day the child is unable to attend due to illness” (paragraph 373), and that the code “is classified for statistical purposes as authorised absence” (paragraph 376).

Schools should not demand a doctor's note for every absence. Paragraph 374 says: “Schools are not expected to routinely request that parents provide medical evidence to support illness absences, and should not have blanket rules requiring this.” A school “may request reasonable evidence where they have genuine and reasonable doubt about the authenticity of the illness, or when they are seeking to support pupils with prolonged or repeated patterns of illness”, and paragraph 375 says a conversation with the parent may itself be enough. A GP letter after a set number of days is the blanket rule paragraph 374 rules out.

Long-term or recurring illness needs support, not just a code: paragraph 373 says schools “should work with families and other agencies to identify barriers to attendance and put support in place to address them”, and paragraph 293 says remote education “should only be used as a last resort, where the school has considered reasonable adjustments first, and as part of a wider plan to support the pupil's return to school”, with the pupil still marked absent. For a pupil with a medical condition, that support belongs in the medical conditions arrangements and, where needed, an individual healthcare plan.

A school must tell the local authority about a long illness. Under regulation 13(9) of the 2024 Regulations, a school must make a sickness return to the local authority, giving the pupil's full name and address, for a pupil of compulsory school age recorded with code I where it has reasonable grounds to believe the pupil will be unable to attend because of sickness for at least 15 consecutive school days, or for at least 15 school days in total in the school year. The return is due “as soon as possible” once those conditions are met, and one return covers a continuous period of absence.

Local authorities then have their own duty under section 19 of the Education Act 1996. The DfE's statutory guidance Arranging education for children who cannot attend school because of health needs says there is “no absolute legal deadline”, but “as soon as it is clear that a child will be away from school for 15 days or more because of their health needs, the local authority should arrange suitable alternative provision”, beginning “at the latest by the sixth day of the child's absence from school”.

What the illness policy should say, and who is told

A short policy that staff and parents can follow beats a long one. It should cover:

1. Reporting. The route, the time by which the school should hear, and notification on the first day.
2. What to tell the school. Symptoms or a diagnosis of an infectious disease, so a cluster shows early.
3. How long to stay away. The common periods, the 2-day rule for diarrhoea and vomiting, and a link to UKHSA's live table.
4. A child who becomes unwell at school. Who decides to send them home and how parents are reached.
5. Back to school. Once the exclusion period has passed, with no routine note.
6. Evidence. When the school may ask for it, in the words of paragraphs 374 and 375.
7. Longer illness. Support, the sickness return and links to the medical conditions and allergy safety policies.
8. Outbreaks. When the health protection team is called and how parents are told without naming anyone.
9. Records. What is written down, who sees it and how long it is kept.

Illness information is health data, which Article 9 of the UK GDPR makes special category data, so it is shared on a need-to-know basis: the class teacher needs to know a pupil is off and when they return, not the whole staff group why. The parent-facing part can be one page: report on the first day, the common periods, the link to UKHSA's table, and NHS advice for the child's own health; the parent communication policy guide covers the channels it should name.

Where illness is actually reported

The policy names a phone line. Illness is reported by message. A parent texts the class teacher at 07:30 that their son was sick in the night. Another asks in the class parents' group whether anyone else's child has spots. A teaching assistant tells the office in a direct message that three Year 1 children went home pale after lunch. By nine o'clock the first signs of a norovirus outbreak are spread across four phones, two apps and an inbox.

Those messages are the cluster signal UKHSA asks schools to look out for and the first record of when the school knew. They are also health data about named children, held on personal phones and in groups the school does not run, where nobody can produce them if the health protection team asks for a timeline.

ComplyChat is built for that kind of conversation. Parents join a channel the school runs with a mobile number verified by SMS, so they need no school account; everyone added is told the channel is on the record; and messages are recorded on the server as they are sent. On paid plans, once the school's Microsoft 365 tenant is connected, the lasting record files into the school's own Microsoft 365 under its retention rules. ComplyChat is not an attendance register or management information system, it does not mark code I or make a sickness return, and it does not judge whether a child is too ill for school: the UKHSA table and NHS advice do that.

A question for the next leadership meeting: if the health protection team asked for a timeline of when the school first heard about each case in its last outbreak, where would the answer come from?

Questions people ask

What is the 48 hour sickness rule in UK schools?

The 48-hour rule is UKHSA's exclusion period for diarrhoea and vomiting: people with diarrhoea and vomiting should stay away from school until 2 days after it has stopped. It is public health guidance for England, not a statute, and it applies to diarrhoea and vomiting and infections such as norovirus, rotavirus and food poisoning, not to every illness.

Is there a 24 hour sickness rule for school?

No: for sickness and diarrhoea UKHSA's exclusion period is 2 days after symptoms stop, not 24 hours. Twenty-four hours is UKHSA's period for scarlet fever and group A strep after starting antibiotics, and for scabies after first treatment in people aged 5 and under or who cannot follow the guidance.

What are the government guidelines for sickness in schools?

In England, UKHSA's health protection guidance for schools sets exclusion periods for each infection and says when to call the health protection team, and the DfE's Working together to improve school attendance says parents should notify the school on the first day, illness absence is recorded with code I, and schools should not routinely demand medical evidence.

How long should a child be off school with sickness?

How long a child should be off school depends on the infection: UKHSA's table gives 2 days after diarrhoea and vomiting stop, 5 days after the rash first appears for chickenpox, 4 days after the rash started for measles and 5 days after swelling begins for mumps. Conjunctivitis, head lice and hand, foot and mouth disease need no exclusion at all.

Can a school ask for proof of illness?

A school can ask for proof of illness only in limited cases: the DfE's Working together to improve school attendance says schools should not routinely request medical evidence or have blanket rules requiring it, but may ask where they have genuine and reasonable doubt or are supporting a pupil with prolonged or repeated illness. Paragraph 375 says to start with a conversation with the parent, which may itself be enough, and names prescriptions, medication and evidence of appointments as wider evidence.

Can a school refuse to accept a child who is ill?

Yes: UKHSA says that if a parent insists on a child with symptoms of a confirmed or suspected infectious illness attending, the school can refuse the child if, in its reasonable judgement, that is necessary to protect other children and staff from possible infection.

Official guidance and your next step

UKHSA's public health exclusion periods and managing outbreaks and incidents pages sit in its health protection collection, whose change history shows each update. The DfE's Working together to improve school attendance covers code I and evidence, regulation 13 of the 2024 Regulations the sickness return, and Allergy safety in schools the new allergy policy. Quotations are from those pages as published on 8 October 2026.

This guide summarises public health guidance and attendance law for schools in England. It is not legal or medical advice: for a child's health, follow NHS advice or a health professional, and for an outbreak, your local health protection team.

Then do one thing: take down any copy of the 2022 poster in the school, and check the illness page of the school website against UKHSA's live table for chickenpox, whooping cough, scabies and impetigo.