Ofsted Health Declaration

Statement of declaration

We will use the information that you and your GP give on this form to make a decision about your medical suitability to look after or be in contact with children and/or young people. We may seek further information from your doctor or another doctor by telephone or in writing. Our medical adviser may also ask you to attend an interview or consultation.

I understand Ofsted will obtain and use information about my health in the way set out above. I understand that my doctor may charge a fee for providing a report and I agree to pay any such fee directly to my doctor.

I consent to my GP sharing my health information with Ofsted for the purpose of making a decision about my medical suitability to look after or be in regular contact with children and/ or young people.

I declare that to the best of my knowledge the answers given to the questions above are full and correct. I agree to notify Ofsted of any significant changes to my health.

I want to see a copy of the medical report before my GP sends it to Ofsted
Yes No

C Explanatory note for the general practitioner

Your patient is applying to register as a childminder on the Early Years Register, registering as the manager of childcare on domestic premises, applying to register as a social care establishment, agency or manager, or required to complete this form because we need more information.

We have a duty to ensure that such people are suitable to look after or be in regular contact with children and/or young people. Part of this process is to establish the person’s physical and mental suitability. We treat all medical information confidentially.

Ofsted’s medical adviser will use the information in this booklet to provide advice about your patient’s medical suitability. If necessary, we seek further information from other medical practitioners or form an independent medical examination.

To help us reach a decision, you are asked to complete the section of this form marked 'GP verification'.

Notes for general practitioners on completing section C

1. Before completing the form please check section B carefully, compare the information provided against your medical records and check that your patient has signed the statement of declaration at the end of section B.

2. No physical examination is required. Ofsted requires only factual information from your patient’s records.

3. Please charge any fee you make for this service directly to your patient.

Thank you for your help.

Should there be any change to your patient’s health that gives you cause for concern about their ability to care for children and/or young people, please do not hesitate to contact the Ofsted helpline on 0300 123 1231.

C1 If the health declaration form omits significant information, please give brief details of the omission (use a separate sheet of paper if necessary).

C2 Please provide the details of any significant medical condition(s) that your patient has or that may recur, and the severity of the condition.

C3 Please complete this table by placing a tick in the appropriate box to show if your patient is affected on a functional level (Only necessary if your patient has completed section B1)

C4 Are you aware of any illegal drug use or inappropriate alcohol use by your patient? If 'yes', please give details.

Yes No

C5 Please include any additional information that will help us to reach a fair and balanced judgement about your patient’s ability to look after or be in contact with children and/or young people.

C6 Do you have your patient’s records from birth? Yes No

Are your patient’s records for a continuous period? Yes No

If 'no', please state from what date the records commence and/or please give a reason, if known, for any gaps in the records.

C7 Please provide the name and address of any consultant/specialist to whom your patient has been referred.

Address

Postcode

I confirm that the patient’s health declaration is a true reflection of their health. Yes No

Practice stamp (This is mandatory and required to validate form)

D For Ofsted use only

URN

Explanatory note for applicants

Ofsted’s powers for registration and inspection are set out in the Childcare Act 2006 for childminders and childcare providers and the Care Standards Act 2000 for social care provision for children and young people.

This information remains valid for six months from the date of your doctor’s signature. Please send this to Ofsted without delay.

Why does Ofsted need information about my health?

Ofsted must be satisfied that you are able to care for, or be in regular contact with, children and young people if you are applying to register as a childminder, registering as the manager of childcare on domestic premises, applying to register as a social care establishment, agency or manager, or have been asked to provide information.

Who will see this information? We and any qualified medical advisers store all records securely and use the information provided to make a decision about your medical suitability to look after children and/or young people.

What if Ofsted needs more information?

If we need more information, we may telephone or write to you, ask you to attend an interview or consultation, or ask for more information from your doctor or another practitioner.

You will not be charged for any additional information that is needed.

What happens next?

Ofsted makes a decision about whether you are suitable to work or be in regular contact with children and/or young people. We may decide to repeat checks on your health if necessary.