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Overview

The purpose of this document is to provide additional bespoke advice and guidance for leaders and staff working in:

  • special schools
  • specialist post-16 providers
  • independent special and residential schools
  • specialist resource bases or units catering for learners of higher clinical risk

In recognition of the specific context that these education settings operate within, this advice provides additional information on the following areas:

  • children and young people with higher clinical risks and clinically extremely vulnerable adults
  • testing and self-isolation

Introduction

The specific nature of the provision available in our special schools and other education settings identified in this document means that the many challenges they face on a day-to-day basis can often be unique to them. We also know that they are experienced in dealing with various communicable diseases within their setting, are very familiar with the specific needs of their learners, and have worked extremely hard throughout the pandemic to ensure their settings remain as safe as possible for staff and learners.

Given the specific nature of special schools and other education settings set out in this document, we recognise there is a need to provide a degree of flexibility and autonomy to enable COVID-19 measures to be tailored in discussion with local authorities and public health advisors to address specific risks. With this in mind, we acknowledge that headteachers and leaders in these settings may need to make decisions quickly to maintain the health and safety in their schools/education settings.

This guidance includes public health advice in relation to COVID-19 and should be read alongside the following documents:

The statutory duties and obligations of local authorities and schools/settings relating to SEN remain unchanged and in force, including the duty to arrange provision as set out in a statement. This will remain the case as the implementation of the ALN Act continues, until a child has moved to the new system. Children with statements are not transitioning to the ALN system in the first year of implementation.

Schools/setting should continue to consult parents and carers about specific support needs, and use their discretion in agreeing the way forward for specific learners.

Guiding principles

The fundamental principle remains that the most effective way to prevent transmission of COVID-19 in our schools/settings is to stop infection being brought into the school/setting. The best way to manage personal risks is to take up the offer of vaccination, and we encourage those eligible for vaccination to take up this offer. If anyone tests positive for COVID-19 they must self-isolate and not attend school.

Workplace risk assessments

In Wales the person or persons responsible for any premises, or the work activity being undertaken on the premises, are under a specific duty to take all reasonable measures based on a risk assessment to minimise the risk of exposure to, and the spread of, COVID-19. As part of this, schools/settings will need to ensure that regular COVID-19 risk assessments continue to be undertaken. The assessment should directly address risks associated with COVID-19, to enable measures to be put in place to control those risks.

Children and young people with higher clinical risks

The situation is now very different in comparison to when shielding was first introduced at the start of the pandemic. We know a lot more about the virus and what makes someone more or less vulnerable to serious illness when infected with  COVID-19, the vaccine programme continues to be successfully implemented, and other treatments and interventions are becoming available.

Children and young people are no longer on the Shielding Patient List. A Written Statement published on 25 August 2021 provides further details about this.

The Royal College of Paediatrics and Child Health (RCPCH) has been very clear that children and young people, including the vast majority with underlying health problems, are not at high risk from COVID-19 - that’s why they have advised the removal of children and young people from the Shielding Patient List.

The decision to remove children and young people from the shielding patient list has come as a result of studies commissioned by the UK Government into the effects of COVID-19 infection on children and young people. These studies found that children and young people, including those originally considered to be clinically extremely vulnerable to the disease, are at very low risk of becoming seriously unwell or dying from infection with the virus. This information was subsequently discussed at a UK expert medical panel who recommended that all children and young people should no longer be considered clinically extremely vulnerable to COVID-19 and therefore be removed from the shielding patient list. This recommendation was agreed by the Chief Medical Officers of the UK.

Whilst all children and young people are being removed from the shielding patient list, there remains a small number in this group who may have been advised by their own specialists to self-isolate or reduce their social contact, due to the nature of their medical condition or treatment, rather than because of the pandemic. Where this is the case, children and young people are advised to continue to follow the advice of their own clinician. We also recognise that schools/settings will already have processes and systems in place to ensure they are informed of and understand their learners’ individual needs, including their medical needs.

Children and young people previously considered clinically extremely vulnerable should attend school or college and should follow the same guidance as the rest of the population. However, if a child or young person has been advised to self-isolate or reduce their social contact by their specialist, due to the nature of their medical condition or treatment, rather than because of the pandemic, they should continue to follow the advice of their specialist. We recognise that for some this may be a significant change and they may be anxious about attending face-to-face education. It will be important for headteachers and college principals to work collaboratively with families to reassure them and to help their child return to their everyday activities.

Where a learner is unable to attend their school/setting because they are complying with clinical or public health advice, the individual and/or their parent/carer should discuss how the school/setting can continue to support them. This may be through online learning or through regular communication. However the school/setting will know their learners and how best to effectively support them during this time.

Clinically extremely vulnerable adults

Staff who are identified as clinically extremely vulnerable should follow the published guidance. These members of staff should continue to discuss with their schools how they will be supported.

Those living with someone who is clinically extremely vulnerable can still attend work where home-working is not possible. Guidance for adults who are clinically extremely vulnerable to developing serious illness if they are exposed to coronavirus because they have a particular serious underlying health condition is available.

Staff who are at increased risk

Staff who are at increased risk from COVID-19 can continue to attend school. While in school they should follow the interventions to minimise the risks of transmission - including taking particular care to observe good hand and respiratory hygiene - and should have an individual workplace assessment.

People who live with those who are at increased risk can attend the workplace but should ensure they maintain good prevention practice in the workplace and home settings.

Employers should be able to explain the measures they have in place to keep clinically extremely vulnerable staff safe at work. The Health and Safety Executive (HSE) has published guidance on protecting vulnerable workers, including advice for employers and employees on how to talk about reducing risks in the workplace.

Allied Health Professionals

There are many examples where local authorities, schools and settings, and partner agencies have worked creatively to provide practical and flexible approaches, including providing services remotely. This should continue wherever possible and appropriate.

Allied health professionals, such as speech and language therapists, physiotherapists and occupational therapists, may have been using the NHS Wales Video Consulting Service rather than meeting clients face-to-face during the pandemic. The learner’s school or setting will be able to provide specific information on the provision of teaching/support assistants and therapists. 

Where learners benefit from using hydrotherapy pools, an individual risk assessment should be undertaken to determine if any additional interventions are necessary.

Multi-agency working

The importance of multi-agency working and partnership at this time cannot be underestimated. It is especially the case in terms of the effective support of vulnerable and disadvantaged learners, for example where there may be a role for social care or specialist services in supporting the learner. 

As a result of COVID-19, health practitioners may have been redeployed to other areas of work within the health board and this could feature more acutely if there is a significant increase in transmission rates in the future. Wherever possible, contact should be maintained between learners, schools/settings and local authorities, and alternative support arrangements discussed and agreed as appropriate.

Residential settings

For residential special schools, local authorities should maintain a register of all learners who have been sent home due to COVID-19. The local authority or independent school or college should also contact the family frequently to ensure that risks are being managed and to establish whether additional support is necessary and how that will be delivered.

Schools/settings should continue to provide any necessary health and therapy support (including access to medical supplies) if the child or young person returns to their family home.

All learners can travel between their residential provision and home, including those who attend weekly residential provision.

Schools/settings should ensure that appropriate arrangements are in place to allow children and young people to remain in contact with their parents and carers. Visits should be face-to-face wherever possible. The use of virtual visits can be offered when it is not practicable to have a face-to-face visit because of COVID-19 due to:

  • self-isolation due to public health advice
  • any local or national restrictions

Use of personal protective equipment (PPE)

Most staff in schools and colleges will not require PPE beyond what they would normally need for their work. If a learner already has routine care needs that involve the use of PPE, the same PPE should continue to be used. However, additional PPE for COVID-19 may be recommended in a very limited number of scenarios, for example, when performing aerosol generating procedures (AGPs).

When someone develops COVID-19 symptoms or has a positive test

If anyone in your setting develops COVID-19 symptoms, however mild, you should send them home and they should follow public health guidance on self-isolation.

If a learner in a residential setting shows symptoms, they should usually self-isolate in their residential setting so that their usual support can continue, while others may benefit from self-isolating in their family home.

For everyone with symptoms, they should avoid using public transport and, wherever possible, be collected by a member of their family or household.

If a learner is awaiting collection, where possible a window should be opened for fresh air ventilation if possible. Appropriate PPE should also be used if close contact is necessary. Any rooms they use should be cleaned after they have left.

Confirmatory PCR tests

Staff and learners with a positive LFD test result should self-isolate in line with the guidance. They will no longer need to get a PCR confirmatory test.

Tailored testing to support children and young people with higher clinical risks

Our approach to testing in schools, post-16 and higher education settings is set out in turn in the documents listed earlier in this advice. However, we acknowledge that a tailored approach to testing will support children and young people with higher clinical risks as well as those who work with them.

We therefore recommend the following approach is adopted:

  • All staff (working in any of the settings listed in the overview section, including transport providers/school escorts) are strongly encouraged to undertake a lateral flow test every day before they go to work. Staff, regardless of vaccination status or previous infection of COVID-19, should test at home and the test should be carried out in good time before starting work to allow the work to be covered by alternative staff if the test is positive. All results (positive/negative/invalid) should be reported online.
  • Schools should continue to distribute LFTs to support all staff who wish to test regularly and staff should contact their employer to order LFTs. Staff should not order tests online or collect from pharmacies unless in an emergency.
  • All fully vaccinated staff (working in any of the settings listed in the overview section, including transport providers/school escorts) identified as a contact of a confirmed case by TTP, should be offered to take part in the test to return to work scheme. Subject to an informed discussion based on the individual and the school context the member of staff will be required to receive a negative PCR test before attending work and then undertake daily lateral flow tests for 7 days.  
  • Schools/settings will be provided with a return to work checklist template link to assist with the process. In considering the criteria for returning to work the headteacher should consider the context of the contact, the regular roles and duties of the member of staff, workforce pressures and possible infection risks on a case-by-case basis. Schools/settings may want to consider temporarily redeploying those who work with the small proportion of learners who are still considered to have a higher clinical risk, or where a member of staff is a household member of a positive case, to a suitable alternative role. If redeployment is not possible, schools/settings may wish to consider asking them to work from home.
  • Staff should not attend the setting until a negative result is confirmed.
  • There is no need for a fully vaccinated individual to self-isolate at home unless they:
    1. are advised to do so by TTP, or
    2. are identified as a close contact (household or otherwise) and required to receive a negative PCR test before returning to work
    3. develop the main symptoms of COVID-19, or
    4. test positive via LFD or PCR
  • If repeat contact with community/household cases is identified, the testing protocol for the member of staff is reset to point of last contact with a confirmed case. If repeat contact with school based contacts are identified then incident and outbreak actions will take precedent.
  • Unvaccinated staff or those fully vaccinated outside the UK must self-isolate in line with national self-isolation guidance.
  • If any LFD result is positive, the individual should self-isolate and follow national guidance.
  • If any staff member has tested positive for COVID-19 within the last 90 days they should not take a PCR test and should instead use the repeated LFDs part of the testing scheme.

Asymptomatic testing for learners

Asymptomatic testing for learners in special schools will be in line with the wider advice for testing in mainstream schools and the community.

We recognise schools/settings will need to take additional considerations into account for asymptomatic testing, and that self-swabbing may cause significant concerns for some children and young people with SEN/ALN.

Testing is voluntary and no child or young person will be tested unless informed consent has been given by the appropriate person.

Welsh Government and PHW are exploring viable alternative swabbing methods and will make these available to support testing of children and young people if appropriate.

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