New schools guidance for children who require Aerosol Generating Procedures

Posted on the 13th November 2020

All children were supposed to return to school in the autumn term. However, some children who require suctioning or other procedures known as Aerosol Generating Procedures (AGP) were denied the opportunity to go back with their peers. This was because the Government guidance around how to manage AGP in educational settings could not always be safely followed by some schools as they lacked the necessary facilities and equipment.

After campaigning by parents, professionals, WellChild and many other organisations, the Department For Education (DFE) have today updated and expanded their guidance for children who require AGP in schools. Read the new guidance in full here >> 

The Department For Education has stated: “It is vital that all children [and] young people […] with complex or additional health needs, are supported to continue their education and care in their education or children’s social care setting, where it is safe to do so.” They say they have adapted the guidance to meet the specific needs of the settings, children and young people involved. They also stress the need for a collaborative approach between “education and children’s social care settings, families and local agencies” to find solutions.

Some key points from the updated guidance:

  • Clarification on the procedures classed as AGP. The following procedures are NOT considered AGP:
    • oral or nasal suction
    • the administration of nebulised saline, medication or drugs
    • chest compressions or defibrillation
    • chest physiotherapy
    • the administration of oxygen therapy
    • suctioning as part of a closed system circuit
    • nasogastric tube insertion and feeding
  • The list of procedures still classed as AGP include:
    • non-invasive ventilation (NIV)
    • bi-level positive airway pressure ventilation (BiPAP)
    • continuous positive airway pressure ventilation (CPAP)
    • respiratory tract suctioning beyond the oro-pharynx
  • Regarding suctioning, a footnote in the guidance states: “Currently, only open suctioning beyond the oro-pharynx is considered an AGP – oral or pharyngeal suctioning is not an AGP. The evidence on respiratory tract suctioning is being reviewed by the AGP panel”
  • Whilst the guidance states that “ideally” children should still be taken to a separate room for AGP, schools that do not have a suitable separate room can now allow AGP to take place in the classroom, providing anyone not involved with the procedure is 2 meters away and there is a window open for ventilation.
  • Further information for schools on how to source the PPE their staff need to carry out AGP is available here >>
  • The DFE have said “We expect children, young people and learners with complex health needs will be able to return to their education or social care setting without settings needing to make significant changes to their ways of work beyond required adherence to the system of controls”. This further suggests that it is the DFE position that children should no longer be denied access to school because they require AGP.
  • Further information on the full list of AGP in all settings can be found here >>

We welcome the improved guidance and hope that it will ensure that many children who require AGP who have missed more school than most can now attend alongside their peers. However, we will also continue to listen to families and be ready to highlight additional areas for future improvements.

Find more guidance on how the Government measures to stop the spread of Covid-19 might affect your family here>>

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