Mass asymptomatic testing in specialist settings

This guidance is for leaders and others involved in the mass testing programme in:

• special academies
• maintained special schools
• alternative provision (AP) academies, including hospital schools
• registered independent AP, including hospital schools
• pupil referral units (PRUs)
• specialist further education (FE) colleges
• non-maintained special schools (NMSS)
• independent special schools
• local authorities
• clinical commissioning groups
• community health staff working with children and young people with special educational needs and disabilities (SEND)

Parents and carers of children and young people in the settings in this list may also find this guidance helpful.

This guidance supplements the guidance in the Testing handbook for schools and colleges, recognising that there are distinct issues for settings in the special school, specialist college and AP sectors. It is part of guidance and resources for schools and colleges to support preparations for coronavirus (COVID-19) testing in education settings.

We have published separate guidance on Mass asymptomatic testing in schools and colleges that covers other aspects of the testing programme, for example, the daily testing of close contacts following a child or young person returning a positive test.

Importance of testing secondary age pupils and students

The government is delivering a programme of rapid asymptomatic testing from the start of January for children and young people in year 7 and above (or equivalent) in secondary schools, FE colleges, special schools and specialist colleges, AP academies, PRUs and registered independent AP.

The objectives of this programme are to:

• keep education settings open
• ensure as many pupils and students as possible are receiving high quality, face-to-face education
• help safeguard the health of the staff of education settings and their pupils and students
• break chains of transmission of the virus

All these settings will receive an initial delivery of lateral flow device test kits to support asymptomatic testing from the start of the spring term.

Rapidly identifying and containing any asymptomatic cases, which comprise up to a third of all cases, will help avoid individuals carrying the infection unknowingly spreading it. This is all the more so in the settings covered by this guidance, where education often involves close proximity between children or young people and staff and social distancing can be harder to observe.

Testing is voluntary and no child or young person will be tested unless informed consent has been given by the appropriate person. There’s further guidance in the informed consent to testing section.

No one will be prevented from receiving face-to-face education if for any reason they are not tested.

Testing is similarly voluntary for members of staff.

Background

The coronavirus (COVID-19) pandemic has been extremely challenging for many families of children and young people with SEND. Supporting them is a priority for this government and their wellbeing remains central to our response.

We recognise that settings in the special school, specialist college and AP sectors are diverse and there will be a wide range of challenges in delivering effective testing to their pupils and students. This guidance, which has been drawn up with the help of representatives of these sectors, is intended to give leaders in these settings a framework within which they can devise and deliver an approach that is effective in their particular context.

Expectations on attendance at settings in January 2021

Special schools, specialist colleges and AP should remain open to allow all pupils and students to attend from the start of term. Some pupils and students, for example if they are clinically extremely vulnerable and live in tier 4, are currently being advised by the Department of Health and Social Care not to attend their educational setting. Education settings are being offered access to additional coronavirus (COVID-19) testing so that their secondary age pupils can be tested, reaching as many as possible as soon as is practicable.

All secondary age children and young people in special schools, specialist colleges and AP who want to attend their education setting should be allowed to attend from the first day of term (on or after Monday 4 January 2021), whether or not they have had a test. We remain committed to supporting and prioritising this group of children and young people. We do recognise the additional operational and logistical challenges that these settings face in rolling out testing.

Schools have the option of agreeing with parents that individual pupils can stay at home. This could help to support special schools and AP to mobilise the mass testing programme in the first week of term. The aim should be that all pupils in special schools and AP are back in school by the second week of term (on or after 11 January 2021). In maintained special schools, pupil referral units and non-maintained special schools parents would need to request a leave of absence for their child. This would be recorded as Code C: ‘leave of absence authorised by the school’. This must not be a blanket decision across the setting and should be agreed on a case-by-case basis with parents or the young person.

Specialist colleges and non-school AP settings may want to adopt a similar approach to support them to mobilise mass testing.

In all settings, children and young people known to a social worker should be prioritised for face-to-face education.

Pupils and students not receiving face-to-face education for whatever reason, ideally including where a leave of absence has been granted, should be provided with suitable remote education in line with relevant guidance, as set out in Guidance for full school opening and Further education operational guidance.

Children and young people that fall into the clinically extremely vulnerable group should continue to follow the Guidance on shielding and protecting extremely vulnerable person from COVID-19

State-funded schools can take an additional inset day to help them set up for testing and begin testing their workforce should they so wish. This inset day is in addition to the usual allowance.

Working with children and young people and their parents

We recognise that the self-swabbing may cause significant concerns for some children and young people with SEND. Some of these concerns may be alleviated by discussing them with the child or young person and their family, agreeing strategies to help reduce anxiety and putting in place any reasonable adjustments (if the individual has a disability). There may for example be a set of simple, practical steps that the setting’s staff and parents can co-produce to smooth the testing process, such as the use of a visual timetable.

With careful and sensitive management, we are confident that the mass testing programme can be rolled out to most children and young people with SEND. However, where this is not the case, it is crucial that there is no disadvantage to their education.

Testing technology is developing all the time. We are continuing to work proactively on other approaches to testing for children and young people who are unable to self-administer a throat and/or nasal swab.

Scheduling of testing

School and college staff know the children and young people in their settings best and may want to think about how to prioritise testing, for example by testing their workforce first and by reference to other considerations such as:

• prioritising those who may struggle with maintaining social distancing, those known to a social worker and those who are children of critical workers
• providing more time for those who may need longer preparations to help reduce their anxiety about the prospect of testing

Settings should aim to complete testing as soon as is reasonably practicable. We recognise that it may take longer to arrange and deliver the administration of all the tests than it would for mainstream schools and general FE colleges.

The staff, children and young people who are eligible for testing

Settings will be provided with sufficient test kits and PPE for the testing of:

• all staff
• all pupils and students of secondary school age
• students aged 19 to 25 with education, health and care (EHC) plans

Any staff working on a setting’s site – including teachers, teaching assistants, clinical staff where employed by school, other support staff (including therapists) and those involved in cleaning testing sites – can be offered tests at the setting’s discretion. Settings can offer others testing too, for example, school nurses or drivers or escorts, liaising as appropriate with both the individuals and their employers. Some staff, particularly those employed through the NHS, may have separate arrangements for regular testing.

Where a child routinely attends more than one setting on a part-time basis, for example because they are dual registered at a mainstream school and an AP setting or special school, those settings should work together to determine where the pupil should receive the testing and share the outcomes of the testing with the other settings. However, as a general guide, we would usually expect the setting where the pupil spends most of their time to take responsibility for the administration of the testing.

Variants of the usual testing process

Settings may want to consider updating risk assessments to understand which of their pupils or students are unlikely to be able to self-swab and therefore are likely to require additional support and/or reasonable adjustments to be put in place.

In some cases, the individual may wish to have a trusted adult from the setting to supervise the self-swab of the test. The setting may also wish to consider whether it would agree in exceptional circumstances to a parent coming into the setting to support their child to self-swab or to swab their child. This might be a reasonable adjustment for the testing of a child or young person with a disability, for example.

If a parent is to swab their child, then the setting should consider providing them with guidance on swabbing, like they would do for those self-swabbing.
If a parent is to swab their child, they should be supervised by a person trained and assessed as competent to undertake swabbing. Settings will need to put in place suitable measures to manage the infection risk to staff and other children and young people of such a person being present.

We recognise that self-swabbing tests may be inappropriate for a wide range of children and young people with SEND, for example, because:

• they lack the fine motor skills to do so
• the process of their inserting the swab into the mouth and nostrils would cause great anxiety (because, for example, they have an aversion to such touch or they are not comfortable with a gagging reflex)
• their level of learning difficulty affects their ability to fully understand, and therefore co-operate with, the testing process
• the child or young person has medical needs such that this process would present a disproportionate risk given the benefit

Special schools and specialist colleges already have a range of staff to meet the health needs of children and young people. These staff have undertaken a variety of training to support health needs and it might be appropriate for them to administer swabs for those who cannot self-administer.

Where possible a combined nose and throat swab should be taken. However, a person-centred approach should be used to assess which sample to take from each child or young person. A child or young person may find it difficult to take a throat swab due to their having difficulty in understanding instructions, needing to keep their mouth open during the period of swabbing or their having a strong gag reflex. In such cases, where a combined nose and throat swab is not possible, a nose swab from both nostrils can be taken. Similarly, if for some reason a nasal swab is not feasible, a throat swab alone will suffice.

Informed consent to testing

Testing is voluntary, but those who are eligible for tests are strongly encouraged to participate to reduce the risk of transmission within schools and colleges.

The person giving the consent (parent or legal guardian or the young person) needs to have a sound understanding of the risks and benefits of testing. The setting is responsible for communicating the purpose of the testing.

Even if the child or young person and/or the parent or legal guardian has given consent, if the individual at any point is not willing to participate in testing then that choice should be respected.

Young people aged 16 or over do not need parental or legal guardian consent provided that they are able to make the decision for themselves. However, the setting will need to decide whether the young person can reasonably provide informed consent themselves and may exceptionally need to consider undertaking a mental capacity assessment (MCA). Settings may want to draw on any MCAs completed for the young person previously, including referring to parents if a parent has acted as the appropriate person for previous decisions. Young people themselves should be given the opportunity to express their views and preferences to the extent that they are able. Settings should keep a record of how the decision on consent was made. There is further guidance on the Mental Capacity Act 2005 and deprivation of liberty safeguards (DoLS) during the coronavirus (COVID-19) outbreak.

For a looked after child or young person in local authority care, such as those from children’s homes, including secure settings, or residential special schools, individuals would need to agree to be tested, where age appropriate. Where parental consent is required, as the children or young person in these settings are looked after, this would need to be secured through the child’s or young person’s social worker unless existing arrangements are in place which cover this.

For a looked after child or young person from a fostering or kinship care household, in most circumstances local authority (via social worker) or birth family consent would be required to allow foster or kinship carers or schools to administer tests.

Safeguarding

Schools and colleges must comply with their legal duties regarding pre-appointment checks when utilising agency staff, contractors and volunteers to support testing schools and colleges, including having regard to the statutory safeguarding guidance Keeping children safe in education and Safeguarding in Colleges: best practice.

Managing the anxiety of pupils and students

School and college staff know the children and young people in their settings well and will be able to put in place an approach that helps reduce any anxiety as much as possible. They will also need to consider whether there are reasonable adjustments that they would need to make to the context in which the tests were conducted for disabled children and young people while maintaining the integrity of the testing process.

Where a setting has concerns about the anxiety levels of a child or young person, it will often be helpful to talk the issues through with them and their parents.

Practicalities of testing

We recognise that some settings may not have rooms that meet the requirements set out in the Testing handbook for schools and colleges, for example, because otherwise suitable rooms have a carpet or other porous floor covering. Settings are encouraged to be pragmatic. We have provided additional funding that can be used to help equip rooms for these purposes.

Financial and workforce support

A total of £78m has been made available for schools and colleges and will be paid retrospectively. The amount of funding available to a school or college will depend on its size, as this will impact the number of additional staff or additional staff hours required to conduct testing. We have provided a ready reckoner that provides illustrative workforce requirements and associated funding.

We have accounted for different staffing levels needed in special schools and specialist colleges to deliver mass testing and further information on funding will be available soon. Non-maintained special schools and independent special schools will also receive funding to support them with testing costs. In considering their workforce requirements settings should use the illustrative staffing levels provided for state funded special schools in the workforce planning tools which are available separately through Google Drive.

Residential special schools and specialist colleges

The guidance on Safe working in education, childcare and children’s social care settings, including the use of personal protective equipment (PPE) includes the actions to be taken in the event of a child or young person being tested positive for coronavirus (COVID-19).

Further information on what to do if a child of young person tests positive for coronavirus (COVID-19) on a lateral flow device can be found within the Testing handbook for schools and colleges. They will need to take a confirmatory polymerase chain reaction (PCR) test and follow the isolation guidelines.

Transport

Where a child or young person has tested positive for coronavirus (COVID-19), they need to be sent home. The setting should contact the parent or carer who should make arrangements for the child or young person to journey home as soon as possible. They may walk or cycle if it is possible for them to do so and they are able to wear a face covering and keep a safe distance from others. They must not travel on public transport. In exceptional circumstances, where it is not possible for the parent or carer to make arrangements for the child’s or young person’s journey home, home to school transport may be provided.

Further information on what to do if a pupil or student tests positive for COVID-19 on a lateral flow device can be found within the Testing handbook for schools and colleges.

Support available from local health services

Settings are encouraged to liaise with local health bodies and services, who they already work alongside to support children and young people in education, regarding what support and advice they can offer.

Resources

Schools and colleges can access more resources at Mass asymptomatic testing.

Contact

Schools and colleges can email [email protected] or call 0800 046 8687 (Mon-Fri 8am-6pm; Sat-Sun 10am-6pm) if they have further questions.