Nursery Sickness Policy Guide | UK Illness & Exclusion Rules
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Nursery Sickness Policy Guide

Understand when a child should stay home from nursery, common illness exclusion periods, medicine procedures, parent notification, return requirements and whether nursery fees may still be charged.

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Nursery Sickness And Exclusion Checker

Select the main symptom or diagnosed condition to see general attendance guidance. Always check the nursery’s policy and seek medical advice when your child appears seriously unwell.

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This tool provides general UK guidance only. A nursery may need to follow case-specific advice during an outbreak or after contact with a health-protection team.

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Select your child’s general condition, symptom and timing to see the usual next step and questions to ask the nursery.

Your Nursery Sickness Guidance

General Attendance Position Check Nursery Policy Confirm the individual circumstances before attendance.
Selected Condition
Usual Exclusion Guidance
Return Requirement
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Your answers suggest that the child may need urgent medical assessment. Do not use an online nursery guide to delay emergency help. Follow NHS emergency advice or call 999 where appropriate.
This tool does not diagnose illness. Nursery policies may include additional operational rules, but public-health or medical advice may take priority during outbreaks or individual cases.

Nursery Sickness Policy Essentials

A clear sickness policy should explain attendance, parent contact, exclusion, medicine administration and return-to-nursery arrangements.

48H
Stomach Bugs Vomiting and diarrhoea commonly require 48 symptom-free hours before returning.
°C
High Temperature Keep an unwell child home until the high temperature has gone and they can participate normally.
CALL
Parent Contact The policy should explain when parents are called and how quickly a sick child must be collected.
RX
Medicine Rules Medicine should follow written consent, safe storage and recording procedures.
Read The Complete Sickness Guide

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Parent caring for a young child who is unwell at home
A child may be free from a formal exclusion period but still need to remain home when they are too unwell to join normal nursery life.

Exclusion Time Is Only One Part Of The Decision

A condition may not require formal exclusion, but the child still needs to be well enough for nursery. Consider their energy, breathing, hydration, comfort and ability to participate.

Nursery staff cannot normally provide one-to-one sick-child care while also maintaining safe supervision for the wider group.

  • The child is alert and responsive
  • They can drink enough fluids
  • They can take part in ordinary activities
  • They do not need constant adult comfort or monitoring
  • They no longer meet the relevant exclusion rule
  • Required treatment has started where applicable
  • The nursery has received important health information
  • Any outbreak-specific instructions have been followed
Check Return-To-Nursery Steps

What Is A Nursery Sickness Policy?

A nursery sickness policy explains how the setting responds when a child is ill, infectious or becomes unwell during a session. It should help parents understand when attendance is unsuitable and how the nursery limits infection.

The policy should be available before a child starts. Families should read it alongside the nursery contract because illness can affect attendance, collection arrangements, medication and fees.

Keep a copy of the sickness policy with the nursery contract. Check whether the document uses current public-health guidance and how the setting communicates temporary outbreak rules.

What Should The Policy Cover?

  • Symptoms or illnesses requiring exclusion
  • Usual minimum exclusion periods
  • When parents must notify the nursery
  • What happens when a child becomes ill during the day
  • Who can collect the child
  • Medicine consent, administration and storage
  • Recording of symptoms, accidents and medication
  • Emergency action and medical assistance
  • Infection-control procedures
  • Rules during an outbreak
  • Return-to-nursery requirements
  • Fees during sickness and exclusion

Why Do Nurseries Exclude Sick Children?

Exclusion can reduce infection risk, protect vulnerable children and staff, and ensure an unwell child receives appropriate care. Young children often play closely together and may not consistently cover coughs or wash their hands.

Can A Nursery Set Its Own Rules?

A nursery can have operational policies that reflect its setting, but it should also follow current public-health, regulatory and medical guidance. During an outbreak, case-specific advice may change normal arrangements.

Should Parents Report Every Illness?

Parents should report conditions covered by the nursery policy and any diagnosed or suspected infection that could affect others. Give accurate information about symptoms, diagnosis, treatment and the last relevant episode.

Early years and childcare settings can use the official UKHSA health-protection guidance for children’s settings when developing infection-control and exclusion procedures.

Common Nursery Sickness Exclusion Periods

The table below summarises common situations. It is not a diagnosis tool and cannot cover every infection, outbreak or individual medical circumstance.

Illness Or Symptom Usual Nursery Exclusion Position Return Guidance Important Notes
Mild Cough Or Cold Exclusion is not usually required when the child is otherwise well and has no high temperature. Attendance may continue when the child can participate normally. Keep the child home if they are clearly unwell, struggling to breathe or need more care than nursery can provide.
High Temperature An unwell child with a high temperature should remain at home. Return when the high temperature has gone and the child is well enough to attend. Seek advice if symptoms are concerning, persistent or affect a young baby.
Vomiting Or Diarrhoea Exclude while symptoms continue and for 48 hours after the last episode. Return after a complete 48-hour symptom-free period, when the child is well. Longer or different advice can apply to some infections or outbreaks.
Chickenpox Exclude until the spots have formed scabs. This is commonly around five days after the spots first appear. Extra caution is important around pregnancy and weakened immune systems.
Hand, Foot And Mouth Disease Formal exclusion is not usually required once the child is well enough to attend. The child does not normally need to wait for every blister to heal. Follow nursery or public-health instructions during unusual clusters or outbreaks.
Scarlet Fever Exclude for at least 24 hours after the first antibiotic dose. Return after that period if the child is well enough. Contact a health professional when scarlet fever is suspected.
Conjunctivitis Routine exclusion is not usually required. The child may attend when well enough unless specific advice says otherwise. Outbreak-control advice may differ, particularly where many cases occur.
Impetigo Exclusion is normally required until treatment has been effective for the stated period or lesions are healed. Common guidance is 48 hours after starting appropriate antibiotics or once lesions are crusted and healed. Confirm the current instruction with the nursery or health professional.
Measles Exclusion is required and suspected cases should receive prompt medical advice. Follow the current public-health exclusion period and case-specific instructions. Contact the healthcare service before attending in person because measles spreads easily.
Whooping Cough Exclusion applies for a defined period after antibiotics or from the onset of symptoms when untreated. Follow the current public-health period given for the case. Tell the nursery promptly because vulnerable contacts may need advice.
Threadworms Routine exclusion is not normally required. Treatment and careful household hygiene should begin. Follow pharmacist or health-professional advice.
Head Lice Routine exclusion is not normally required. Start appropriate detection and treatment. Notify the nursery according to its policy without blaming individual children.
Use the latest official exclusion table for precise condition-based periods. Do not rely on an old nursery poster or a screenshot saved from an earlier year.
Current minimum periods are published in the public-health exclusion guide for children and young people’s settings.

What Happens If A Child Becomes Ill At Nursery?

A nursery sickness policy should explain how staff assess a child, provide comfort, contact parents and arrange collection without exposing other children unnecessarily.

Staff Observe And Record Symptoms

Practitioners may record the child’s temperature, behaviour, vomiting, diarrhoea, rash, pain or other symptoms. The record should include relevant times and action taken.

The Child Is Comforted And Supervised

The child should remain appropriately supervised while awaiting collection. The nursery may move them away from close group contact where this can be done safely and sensitively.

Parents Or Carers Are Contacted

The nursery normally calls the main contact first and then other authorised contacts if necessary. Keep telephone numbers current and make sure contacts can collect the child.

Collection May Be Required

Parents may be asked to collect when a child meets an exclusion rule, cannot participate, needs one-to-one sick care or may expose others to infection.

Emergency Action May Be Taken

Staff should follow emergency procedures where symptoms indicate serious illness. This can include first aid, contacting emergency services and informing parents.

Medicine Is Not Automatically Given

Staff should administer medicine only under the nursery’s policy, with the required consent, instructions, packaging and records.

Parents Receive Handover Information

Ask what staff observed, the symptom timing, any temperature readings, fluids taken and medicine or first aid provided.

Nominate more than one reliable emergency contact and tell them that the nursery may call. A contact who cannot collect offers limited practical backup.

Nursery Medication Policy

Medicine should never be left unnoticed in a nursery bag, coat pocket or lunchbox. Hand it directly to an authorised member of staff and complete the required consent procedure.

Original Packaging

Prescription medicine will normally need to remain in its original container with the child’s name, instructions, dosage and expiry information clearly visible.

Written Consent

The nursery should obtain the required parental permission before administration. The consent should identify the medicine, dose, timing and relevant instructions.

Administration Record

Staff should document what was given, when it was given, the dose and who administered or witnessed it. Parents should receive the information at collection.

Safe Storage

Medicine must be stored securely and, where necessary, at the correct temperature. Emergency medication should remain accessible to trained staff while protected from children.

Non-Prescription Medicine

Policies differ for pain relief, antihistamines, nappy cream and other non-prescription products. Ask what consent and instructions the nursery requires.

Long-Term Medical Conditions

Children with asthma, allergies, epilepsy, diabetes or another ongoing condition may need an individual healthcare or care plan, staff training and accessible emergency medicine.

Medicine Does Not Make An Unwell Child Fit For Nursery

Reducing a temperature with medicine does not necessarily mean a child is ready to attend. Consider their underlying illness and ability to manage an ordinary session.

Never hide medicine inside a child’s belongings. Staff need to know immediately that it is present and how it must be stored.

When Can A Child Return To Nursery?

A child can normally return when the relevant minimum exclusion period has ended, they are well enough to participate and any treatment or case-specific requirement has been met.

Complete The Full Exclusion Period

Count the period from the correct event, such as the last vomiting episode, first antibiotic dose or appearance of a rash. Ask the nursery when the return date is unclear.

Check The Child’s General Condition

The child should be alert enough for normal activities, able to drink, reasonably comfortable and not dependent on continuous one-to-one care.

Tell Nursery About Treatment

Share the diagnosis, treatment start time and relevant professional advice. Do not disclose another person’s private medical information unnecessarily.

Provide Medicine Properly

Complete medicine forms and hand over original labelled packaging where treatment must continue during nursery hours.

Ask Whether An Outbreak Rule Applies

A nursery may receive temporary public-health advice that changes ordinary return arrangements for identified contacts or cases.

Medical Certificates

A nursery should explain whether it requests evidence in particular circumstances. Parents should ask why documentation is needed and what type is acceptable.

Return Gradually Where Appropriate

After a significant illness, a shorter first day may help when the nursery agrees and the child no longer requires exclusion.

Meeting the minimum exclusion period does not automatically mean the child is ready. They should also be well enough for the normal nursery day.

Do Parents Pay Nursery Fees When A Child Is Sick?

Many nurseries continue charging normal fees when a child is absent because the place, staffing and operating costs remain reserved. The exact position depends on the nursery contract.

Child Illness

Contracts commonly state that fees remain payable when a child is absent through illness, including when the nursery’s exclusion policy prevents attendance.

Public-Health Exclusion

Fees may still continue when a child must stay home under public-health guidance. Check whether the contract distinguishes ordinary sickness from a wider outbreak.

Nursery Closure

The fee position may differ when the provider closes the setting or cannot offer the contracted service. Read clauses covering emergencies, outbreaks and circumstances outside the nursery’s control.

Funded Childcare

Funded-hour attendance and provider funding rules are separate from private fee clauses. Ask how an extended absence affects the funded-place arrangement.

Insurance Or Sickness Credits

Some providers offer limited sickness credits or optional nursery fee insurance. Check conditions, waiting periods, evidence and maximum claims.

Ask For The Written Clause

Request the sickness, closure and absence sections before signing. Verbal assurances are difficult to rely on when the invoice later follows the written contract.

Challenge An Unclear Charge

Ask the nursery to identify the contract term supporting the charge. Use the provider’s complaints procedure if the explanation remains unclear.

Read the full guide to nursery fees when a child is sick for additional contract questions.

Before accepting a place, compare illness charges together with closure fees, bank holidays, notice periods and funded-hour rules.

Nursery Outbreak Procedures

An outbreak may involve more cases than normally expected or a disease requiring coordinated public-health action. The nursery may need advice from its local health-protection team.

Temporary Changes To Exclusion Rules

Public-health professionals may recommend additional exclusions, testing, cleaning, contact management or communication during an outbreak.

Information For Parents

The nursery should provide useful information without identifying individual children or families. Communications may explain symptoms, action taken and when parents should seek advice.

Enhanced Cleaning

The setting may increase cleaning of frequently touched surfaces, toys, toilets, changing areas and shared equipment.

Hand Hygiene

Regular handwashing with soap and water is especially important for infections causing diarrhoea or vomiting and for respiratory illness.

Food And Nappy-Changing Procedures

Staff should follow safe preparation, personal-protective equipment, waste disposal and cleaning procedures relevant to the setting.

Vulnerable Children, Staff And Family Members

Some infections create greater risk during pregnancy or for people with weakened immune systems. Parents should follow professional advice appropriate to their circumstances.

Closure Is Not Automatic

A cluster of illness does not automatically require the whole nursery to close. Decisions should reflect the infection, staffing, risk and public-health advice.

Follow the nursery’s outbreak communication rather than social-media rumours. Ask the setting for the source and date of temporary instructions.
Settings can consult official guidance on managing outbreaks and incidents in children’s settings.

How Nurseries Reduce The Spread Of Infection

No nursery can prevent every childhood infection, but consistent hygiene, ventilation, safe care and appropriate exclusion can reduce transmission.

Handwashing

Children and staff should wash hands at appropriate times, including after toileting and before food.

Cleaning

Frequently touched surfaces, toys and care areas need suitable routine and incident-based cleaning.

Ventilation

Fresh air and sensible ventilation can support respiratory infection control.

Safe Personal Care

Nappy changing, toileting, bodily-fluid spills and waste need clear procedures.

Respiratory Hygiene

Nurseries can encourage tissues, safe disposal, handwashing and age-appropriate cough and sneeze habits.

Food Hygiene

Food preparation, storage and serving should prevent contamination. Children and staff with relevant gastrointestinal symptoms should follow exclusion guidance.

Personal Protective Equipment

Staff may use gloves or aprons for particular care and cleaning tasks. Equipment should be used correctly rather than as a substitute for hand hygiene.

Immunisation Information

Families can follow NHS vaccination advice. Nurseries should handle any health information lawfully and sensitively.

Clear Parent Communication

Parents need current information about symptoms, exclusion periods and outbreaks without unnecessary disclosure of another child’s identity.

UKHSA states that hand hygiene is one of the most important ways of reducing infections, particularly those involving diarrhoea, vomiting and respiratory symptoms. Read the official infection-prevention guidance.

When To Seek Medical Help For A Sick Child

A nursery exclusion guide cannot assess a child’s health. Seek professional advice when symptoms are severe, unusual, worsening or concerning for the child’s age.

Urgent Warning Signs

Seek urgent help where a child has serious breathing difficulty, becomes difficult to wake, has a seizure, appears blue or very pale, develops a rash that does not fade under pressure, or shows another sign of a medical emergency.

Young Babies

Fever and illness in a young baby require particular caution. Follow NHS guidance and obtain professional advice promptly.

Dehydration

Seek advice if a child cannot keep fluids down, passes much less urine, has a very dry mouth, lacks tears or becomes unusually sleepy.

Breathing Problems

Rapid, difficult or noisy breathing, chest recession or struggling to speak, cry, feed or drink needs prompt assessment.

Persistent Or Worsening Fever

Obtain advice when fever persists, the child becomes more unwell or you are concerned despite home care.

Possible Measles Or Another Highly Infectious Disease

Contact the healthcare service before arriving so it can reduce exposure to other patients.

Call 999 for a medical emergency. Use NHS 111 or another appropriate urgent service when you need prompt advice but the situation is not immediately life-threatening.

Related Nursery Health Guides

Continue reading about sick-day fees, medicine, safeguarding, nursery absence and preparing emergency contact information.

Do You Pay Nursery Fees When A Child Is Sick?

Understand common contract terms for illness, exclusion, absence and nursery closure.

Read Sick-Day Fee Guide →

Nursery Medication Policy

Review parental consent, original packaging, staff records, storage and emergency medication.

Read Medication Guide →

Nursery Safeguarding

Understand reporting, designated safeguarding leads, safe collection and staff responsibilities.

Read Safeguarding Guide →

Nursery Absence Policy

Learn how to report illness, holidays, unexpected absence and extended non-attendance.

Read Absence Guide →

Employer Childcare Support

Check emergency childcare, flexible working and family policies when ordinary nursery care is unavailable.

Explore Employer Support →

Nursery Sickness Policy FAQs

Answers to common questions about temperatures, vomiting, diarrhoea, colds, rashes, medicine, return dates and nursery fees.

A mild cough, runny nose or minor sore throat does not normally require exclusion when the child is otherwise well and has no high temperature. Keep them home if they are clearly unwell or unable to participate.
An unwell child with a high temperature should stay home. They can usually return when the temperature has gone and they are well enough for normal nursery activities.
It normally means a child should remain away from nursery until 48 hours have passed after the last episode of vomiting or diarrhoea.
Nursery and public-health policies commonly apply the 48-hour rule after vomiting or diarrhoea because the cause may be infectious. Contact the nursery with the circumstances rather than assuming the child can return.
A child should normally stay away until the spots have formed scabs, commonly about five days after the spots first appear.
Formal exclusion is not usually required once the child feels well enough to attend. They do not normally need to wait until every blister has healed.
A child with scarlet fever should normally remain away for at least 24 hours after taking the first antibiotic dose and until they are well enough to return.
Routine exclusion is not normally required, although a nursery may receive different instructions during an outbreak. The child should still be well enough to attend.
A nursery may administer medicine under its policy with appropriate consent, instructions, safe storage and records. Medicine should be handed directly to staff.
Medicine temporarily reducing a temperature does not necessarily make a child fit for nursery. Consider the underlying illness, nursery policy and whether the child can manage a normal session.
Many nurseries continue charging because the place remains reserved. The exact position depends on the written contract and any sickness credit or insurance arrangement.
A nursery may require collection when a child meets an exclusion rule, is too unwell to participate, needs more care than staff can safely provide or may expose others to infection.
Ask the nursery why evidence is required and what type is acceptable. A doctor’s note is not automatically needed after every ordinary childhood illness.
Yes. A nursery may receive temporary case-specific instructions from a health-protection team. Parents should follow the current dated communication for that outbreak.

Check Your Nursery’s Sickness Rules

Review the usual exclusion period, your child’s general condition, medicine requirements, nursery notification and the written fee policy before planning their return.

Use Nursery Sickness Checker