Supporting a pupil with cancer during the Covid-19 pandemic recovery phase – a guide for schools

This page was last checked and updated on 27th September 2021.

School attendance for young cancer patients is important. It can make an enormous difference to their mental health, how they cope with cancer treatment, their resilience, and their ability to get on with life after treatment ends. Supporting pupils with cancer often causes anxiety and concern amongst school staff, which is likely to be heightened since the coronavirus pandemic.

CCLG and Young Lives vs Cancer

Are children and young people on cancer treatment more at risk from Covid-19?

Children and young people with cancer are at no greater risk of getting coronavirus than other children and young people. They do not appear to get severe forms of Covid-19 even if they become affected with it during treatment. Often they’ll show no signs or symptoms of it at all. This is the rationale for allowing children with cancer to return to school when it is clinically appropriate for the individual child to do so.

How do we know this?

At the start of the pandemic all young cancer patients were advised to shield. This is because little was known about the virus and its effects. Cancer and public health researchers across the world have monitored and analysed data throughout the pandemic, and shared their findings. These have informed the UK’s approach to lift shielding from groups who have been found to be at significantly less risk of severe Covid-19 infections than first predicted.

Statement from UK Chief Medical Officers on schools and childcare re-opening

Childhood Cancer and Leukaemia Group (CCLG) – Coronavirus advice 

World Health Organisation – Schools and COVID-19

Is it safe for a child on cancer treatment to attend school while the coronavirus is still in the community?

Most children and young people with cancer will be able to return to school during treatment. The clinical team will advise the family on the right time for the child to return.

Ultimately COVID-19 is just another infection that families of a child with cancer must be mindful of. This is alongside chicken pox, measles, herpes, diarrhoea, vomiting bugs, and flu. All these can have extreme consequences for children with cancer. The measures advised by the Government to reduce the risks of spreading coronavirus in schools will also help prevent the spread of these other infections. So it’s possibly safer than ever for children on cancer treatment to attend school now.

Across children’s cancer centres in the UK, there has been a reduction in admissions for infection (including febrile neutropenia), and this is thought to be due to a greater public awareness of infection prevention measures such as handwashing and coughing/sneezing into the elbow crease rather than the hands.

We understand that as the UK population attempts to return to a more normal life with less social distancing, fewer people opting to wear face coverings, and ‘school bubbles’ stopping, you may be feeling more anxious again about the risks of infection. Here are some points that might help you to think about this in a balanced way:

  • In the UK we have always encouraged children with cancer to attend school when it’s clinically appropriate in line with their treatment phase. This has been safely managed for the last 40 years.
  • Your clinical team will advise you about when it’s not the right time for your child to attend school (see below).
  • If children miss a lot of school during treatment it can make it harder for them to maintain
    friendships and catch up with what they missed.
  • School is a great distraction from the abnormal world of hospitals and treatment.
  • Parents become experts in their child’s care and you will get to know the pattern of when your child is fit for school and when they’re not, linked to the phases of their treatment.
  • Children with cancer are not at greater risk of severe infection with Covid-19 than other children.
  • Your specialist nurse or social worker can help liaise with school about adjustments your child needs to manage their cancer related needs at school.

Government guidance for schools on coronavirus 

Government campaign to get children back to school safely

What would prevent a child with cancer returning to school?

There has always been a small number of children who, at certain points in their treatment, are advised not to attend school. In these cases it’s likely that the child wouldn’t feel well enough to attend school anyway.

Terms like ‘shielding’ and ‘extremely vulnerable’ hadn’t been used in cancer services before Covid-19. But it’s this small group of children who would have been shielded as extremely vulnerable during the pandemic, who would also not be advised to attend school by their clinical teams because of their cancer treatment. For them, returning to school is still not appropriate. This is ‘normal’ cancer care, rather than a reaction to Covid-19.

Clinicians will guide the family on whether their child can return to school. This will be based on individual assessments of the child and the impact of the treatment on their immune system and general health.

The educational needs of these children still needs consideration and action. This may include support from hospital schools or home tuition and remote learning technologies.

How can schools support pupils with cancer returning to school?

Once the child is able to return to school, an Individual Health Care Plan (IHCP) is a helpful tool to support the process. For many children, an IHCP will only be needed for the short-term. Some children, including those with brain tumours, may have longer term physical and cognitive difficulties. These pupils may need longer term plans and/or special educational needs assessments.

A staged return can be helpful as the child rebuilds their energy levels. Flexible adjustments may be needed as fatigue is a known consequence of treatment. You’ll find further advice on how to support a pupil to return in our My student has cancer article, or CCLG’s booklet Supporting your pupil after a cancer diagnosis.  

Once the child is back it’s important to develop effective communication channels with the child’s parents or carers. If the child becomes unwell at school or comes into contact with a pupil with an infectious illness, the parents/carers need to be contacted as soon as possible. This is so they can manage the situation with support of their healthcare team.

Childhood Cancer and Leukaemia Group – Information for schools

Brain Tumour Charity – Supporting your child’s return to school