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Stirling Council Setting the Table Guidance (Aug 2025)

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Stirling Council Setting the Table Guidance (Aug 2025)

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Toolbox Talks Safe Moving and Handling of Inanimate Objects

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Toolbox Talks Safe Moving and Handling of Inanimate Objects

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Toolbox Talks Incident Reporting including Near Miss reporting 

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Toolbox Talks Incident Reporting including Near Miss reporting 

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Toolbox Talks Asbestos Containing Materials Awareness

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Toolbox Talks Asbestos Containing Materials Awareness

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Toolbox Talks Intro to Health & Safety at Work

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Toolbox Talks Intro to Health & Safety at Work

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Guide

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Management of hygiene waste produced as a result of personal care

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Management of hygiene waste produced as a result of personal care

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Creative STAR Learning | I'm a teacher, get me OUTSIDE here!

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I first blogged about this matter in March 2009 and then again in 2014. This is now the fourth update. I thought it was time to update it in light of the expansion of outdoor nurseries that is currently happening in Scotland as well as the national emphasis on outdoor learning as Scottish schools return. The post is mainly aimed at those who work with younger children but the advice can be adapted accordingly for any age. There's two elements to this post. Firstly there is 'temporary toileting' which covers advice when out and about. The second is when a site is well used and there are no public toilets or installed flush water toilets nearby.

As usual, common sense prevails along with available guidelines when it comes to toileting outdoors:

If you can use a public convenience then do so - and your local education COVID-19 guidelines permit this

Put in place an environmentally sustainable and Leave No Trace approach.

Be mindful of the need to respect children's privacy and dignity.

Ensure your procedures follow best hygiene and infection control practice as much as possible.

Is there a "best approach"?

When discussing the matter with staff working in outdoor nurseries and forest kindergartens, I found quite a number of approaches are taken to toileting outdoors. This is because different situations require different ways of thinking. There is no one-size-fits-all approach.

Generally, children are encouraged to go to the toilet before setting off or arriving on-site. Getting in and out of dungarees, all-in-one-suits and other outdoor gear is a faff, so children tend not to need the toilet as much outside. Some kindergartens create a little privy area behind a home-made fence or portable windbreak. Some choose key moments through the day, where every child goes to the toilet. I have mixed feelings about the latter approach in that this has the potential to disrupt play and for a child who can independently manage their toileting seems unnecessary.

Wild Toileting

When a site does not have toilet facilities or if you are too far away from public conveniences, it is important to follow the Scottish Access Code guidelines if you go to the toilet outside:

If anyone needs a pee, then this must be done at least 30m from open water, rivers or streams.

Although pee is less harmful than poo, its smell is unpleasant, so avoid peeing in caves, at the foot of crags or behind any buildings. Also encourage children (especially boys) to aim onto the ground. Remember to avoid peeing on logs or directly onto a "pee tree".

If anyone needs a poo, then go as far away as possible from buildings, from open water, rivers and streams, and from any farm animals. Remove the human poo and used toilet paper, in a double wrapped, sealed, biodegradable plastic bag and dispose of it off site, following your local authority guidelines for biological agents. This is the best approach in that it leaves no trace. If you are unable to remove the poo and paper, then you will first need to dig a shallow hole. Bury the poo in the hole and replace the turf. Carry a plastic trowel with you for this purpose. Be aware that this really is an emergency approach. Pathogens can hang around in the soil for a very long time.

Always treat sanitary towels and tampons in line with disposing of other blood-soiled products. Never bury these items. Double wrap in sealed plastic bags and take back to school for correct disposal.

Wash your hands, following good hand hygiene practices. Have a look at this blog post for the variety of ways and things to consider.

The Mountaineering Council of Scotland has a handy leaflet which explains other procedures more specifically, in order to minimise the impact of one's visit. This is important reading for all who lead off-site visits. It also gives sensible advice about sustainable approaches such as using cornstarch or biobags and the need to use biodegradable soap. Do be aware that some of its hand hygiene advice differs to that of Health Protection Scotland (HPS) and that schools and nurseries are should follow HPS advice in the first instance.

When using the same site continuously

In sites with higher usage then a wild toileting approach is not okay as the soil will not cope with large amounts of ammonia contained in the urine (interestingly, a well-managed compost heap does like urine, so bear this in mind). This is important if your setting or school is using the same site on a continuous basis. Discuss your proposals with a local environmental health officer. Public safety is of paramount importance and avoiding inadvertent contact with pathogenic material or the leaching of this into the wider area.

Portable potty and toileting approaches

In some instances, it may be appropriate to use a travel potty or portable toilet and then to dispose of the contents in line with your establishment's procedures for handling biological waste back at your centre. What does matter is that the approach leaves no trace, is hygienic and any product used is environmentally sustainable. With the increased popularity of festivals portable toilets of all types can be found with an online search. Be aware that children and adults sit at different heights so do not assume they can share a toilet.

Try googling "travel potty". This approach is fine if you have the occasional child needing an occasional poo. However, at an outdoor nursery, you may well get a lot of children needing to do this. Very quickly the "bag-it-up" approach becomes expensive and unsustainable in every way.

In due course, it may be that self-sanitising biodegradable options will become available in the UK . The Swedish Peepoople organisation has created a product which is being used in a variety of countries and including schools where no sanitation facilities exist. This could cut out the concerns around handling human waste associated with compost toilets (scroll down for more info here).

Little girls and wild peeing

There has been a tradition of lifting little girls up to let them pee so that they don't get their outdoor clothing wet. This is not recommended, either for the dignity of the child or for the unnecessary manual handling undertaken by the staff member. Instead, a potette potty can be put over a cleared patch of soil so that girls can sit on this and pee directly into the ground, without the need for a bag. Just remember to put back the woodland litter at the end of the session.

Disposal of bags

It is inadvisable to put nappies and bags of poo into public litter bins as a responsible childcare provider or educator. It is your responsibility to take them back to the nursery and dispose of them as per nappies and other human waste. If you do not have these facilities then you need to seek a place that has and come to an agreement over the costs of disposal.

There is an urban myth that it is okay to put nappies and bags of poo into doo poo bins. Again, this practice is questionable because the disposal of the contents of dog bins varies from council to council. Furthermore, dog poo bins are small. If you are putting a large bag in there, then there's less space for dog mess.

Chemical toilets

Some fixed outdoor nursery sites choose to use chemical toilets. It does mean the toilets need emptied on a weekly rather than daily basis. Many chemical approaches are becoming more environmentally friendly so it's worth finding out what products are available.

Regardless, someone will need to carry the toilets out and dispose of the contents. This will involve manual handling of the waste. Or this will have to be a paid-for service. It's worth asking a local campsite if they can offer to take the waste as they usually have the correct facilities for managing camper van toilets. At Oban Stramash to empty five or six toilets in this way involves one member of staff working for 1 to 1.5 hours. So this time needs to be factored in the weekly or fortnightly routines.

Hiring outdoor toilets

This can be an option for primary schools where children can cope with the height of the toilets. Do an online search to find out about local companies that can do this, precisely what is involved in the service, length of contract and any hidden costs. Be prepared to ask about environmentally friendly chemicals, whether the toilet is suitable for the age and amount of use you expect. Check about suitable places to site a toilet and footfall around the entrance. You need to avoid an inadvertent mud bath at the toilet so ground surface matters. Covid-19 measures are also likely to be in place.

Child protection and toileting outside with dignity

Child protection procedures always apply outdoors. If you have to change nappies, children clothes or assist with toileting, follow your school or local authority procedures. It means that a degree of privacy is needed.

In Sweden there is a proverb, "Walk seven bushes". Now this is very sensible advice. Try it for yourself the next time you are in a wood. It's just about the right distance to give you a suitable amount of privacy.

However, this is not so easy when working at open sites such as fields, the beach or walking in a built up urban area.

When walking down an urban street where there is no discrete place, using a human shield is an effective approach to maintaining a child's dignity. This is where the group gathers round in a circle or semi-circle facing outwards and the child who needs the toilet is sheltered from vision by the group and supported by a member of staff.

With beach visits, try experimenting with shelters such as the traditional wind break, pop up shelters and bothy shelters. However these can be time consuming to erect especially on windy or cold days. Watch out for pop up tents - you need one without a floor. A simple tripod is quick to erect if you are willing to bring long poles, e.g. 120cm or longer for children. Alternatively human shields can used if there is no rock, nook or cranny to nip behind or simply too many other visitors around.

How do you keep the toilet roll dry?

This is a good point. Wet loo roll is not good. A low cost hygiene approach is to take a toilet roll and remove the inside cardboard tube. Pull out some of the sheets from the inside hole you have left. Put the roll in a freezer bag and ensure the sheets coming from the inner hole come out of the top of the freezer bag. Loosely tie an elastic band around the top of the freezer bag and sheets of toilet paper. When you continue to pull the toilet paper it should easily come out of the bag.

What about adults accompanying children?

Remember to have procedures in place for enabling adults to go to the toilet. For example, some settings prefer adults to go in pairs, so that one can lookout for the other and ensure children do not accidentally come across an adult going to the toilet in the woods.

It has to be emphasised that some adults may need support and time to adjust to the concept of wild toileting or managing with more basic provision. Listen to their concerns and look for positive solutions. For example, having a designated space further away, a system for quietly being able to go, a way of managing sanitary needs, and even a portable seat can all make a difference to comfort levels and dignity. Portable seats are easy to find, such as these examples from Muddy Faces, Popaloo and Bog in a Bag.

How can we change children's nappies?

As much as possible, nurseries should be encouraging children to learn how to go to the toilet off-site too. Putting children back into nappies for the purposes of going off-site is probably not a helpful step forward. Instead have procedures in place for supporting children who are being toilet trained and take changes of clothes just in case an accident happens. For example, wearing waterproof trousers rather than dungarees or all-in-ones can speed up the process of toileting when time is of essence!

For nappy changing, pop-up shelters or pods can be handy, as can be a roll up changing mat for nomadic nurseries or if you visit a woodland on a weekly basis, particularly with babies. Standing up nappy changing is also an option to consider.

Whatever your method, ensure you discuss this both with the parent and the child so that everyone is informed and aware. Likewise, you need to ensure the privacy and dignity of the child and that the experience is okay for them. Your hygiene practices should also dovetail with Health Protection Scotland guidance.

At present there seems to be uncertainty nationally in Scotland about floor-based and raised nappy changing stations. This may depend on the age of the children in your care and their precise needs. The surface needs to be easy to clean and insulated so that children or babies are not lying on a cold or damp surface. What does matter is that staff have manual handling training and know how to change a nappy in a way that also looks after their own health as well as that of the child. Below is a raised nappy changing area in the disabled toilet at the Circle of Life Rediscovery CIC in East Sussex:

At Stramash Elgin, the pallet approach is also taken to nappy changing. The photo below is from their old site at Badger Wood in 2017. If you look carefully, you can see there's a pallet to raise the changing area off the ground. As with a standard changing area, there's a cleaning rota in place and infection control advice posted to remind staff of the correct procedure and things to remember. Everything is kept in a waterproof container to ensure it is clean and dry.

Compost toilets

Over the past few years, there has been a growing interest in using compost toilets which can be a sustainable solution. A useful starting point for finding out more about these is the Eco Loo Study, published in 2010, which states that:

" Water flush toilets are the standard offering that the public finds most comfortable, that contractors and regulatory authorities understand, and know how to manage. This standard then needs to be balanced with the needs of the natural environment: water-based toilets pollute large volumes of clean water which then need to be cleansed before being returned to nature. The nutrients that remain in faeces are wasted and typically released into the atmosphere as greenhouse gases that may also be malodorous.

The design of sustainable toilets and drainage should ensure that waste and wastewater is recovered, treated or disposed of without endangering human health or harming the environment, and in particular without risk to water, air, soils, plants or animals. Toilets should not cause a nuisance through noise or odours and toilet buildings should integrate sympathetically with their surroundings. " p6

Always discuss toileting approaches with the site owner or manager so that you both have a shared agreement and understanding of the procedures which are used. Again, you will need to involve your local environmental health officer. In addition, you may find you need planning permission, and have to consult SEPA (Scottish Environmental Protection Agency) who may need to approve the discharges.

You have to be aware that compost toilets are significantly more work to manage and maintain than installed water flush toilets. This should be factored into the site maintenance schedules. When working well, they can be a brilliant solution to managing waste onsite and the smell is minimal, if the compost toilet system is functioning properly. There are lots of different designs and approaches. You will need to do a lot of homework to ensure you fully understand what you need. What works well on one site, may not suit another. It depends on anticipated usage and site specific environmental factors. You need to consider how the waste will be processed and who will do this task as this element is often missed from the "oh, it's so easy" blurb found on many websites. The Eco Loo study makes a very significant comment:
We take the position that commercially-available 'composting toilets' do not work well at typical U.K. temperatures, and very little composting occurs. The storage vessels act primarily as holding tanks and therefore provision must be made for further processing of the accumulating solids. If there is no outlet on a composting unit, allowing liquid to drain, the vessel risks turning into a cesspool [G], which is illegal in Scotland. (p18)
One crux matter is to know how well used your compost toilets are likely to be. Occasional use by a group of ten children is very different to an all-day nursery with 30+ children. Some companies are beginning to provide better information on their website and are worth talking to in advance.

When in the Czech Republic, one NGO that specialised in composting, had a sensible system that followed this approach. Firstly, the collection bin was not too big. The accumulating solids would be transferred every 3-4 months to a sealed composting unit nearby for further breakdown. From here, the waste matter was left to further break down in an outdoor compost heap. This contained only human waste matter (with the sawdust/wood shavings). Other traditional compost heaps were used for vegetable waste. Once it had broken down over a further few months, the compost was used. In line with best practice, the human waste compost was not put under trees, shrubs or on plots that were growing food for human consumption. In this sort of system, it is important to ensure children and visitors cannot access the human waste compost during any stage of the breakdown. PPE must be worn by the person who is working with the compost and a risk assessment carried out.

One thing to remember is that nursery-aged children are a lot smaller than adults. Using a standard compost toilet seat will not work. They need child-sized seats. Another consideration is the understanding of how much sawdust or equivalent needs to be added. There's a tendency to over add, especially if your toilet is already smelly - which may not be a good sign.

Other alternatives

There are other ways of managing human waste. As with other approaches, engaging with environmental health officers, SEPA and anyone else who needs to know is a must. World-wide pit latrines are common but I have yet to know of one that is accepted and used within an outdoor nursery. Highway Farm have a remote pit method which was established in consultation with their local environmental health officer. It involves daily removal of poo and pee from the toilets into a fenced off area. Fresh pits are dug every few months and the filled up gradually with the turf replaced daily. The nursery is onto it's second rotation now, after several years, so the holes are much easier to dig and the previous matter has been fully composted but is left in situ. If you have a site that is prone to flooding or getting very wet then this may not work and a raised system used.

Finally...

In my experience, toileting routines are a big concern prior to setting up regular off-site visits or outdoor nurseries but once things are up and running, this matter lessens and usually becomes no more of an issue than back at nursery or school. If you have a child who has particular toileting needs, then ensuring their parent or carer is involved in setting up systems can be helpful too so that there is consistency between home, school and the outdoor space.

Whilst this is a lot of toilet talk, your advice and thoughts are appreciated on this matter! Do you live outwith the UK? What advice can you give from your country?
Note: This blog post is written in good faith and should not be used as a definitive guide to toileting outside. It's a complex matter. Always seek expert advice.

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I first blogged about this matter in March 2009 and then again in 2014. This is now the fourth update. I thought it was time to update it in light of the expansion of outdoor nurseries that is currently happening in Scotland as well as the national emphasis on outdoor learning as Scottish schools return.

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Managing Risk in Play Provision: A position statement

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Managing Risk in Play Provision: A position statement

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Not your computer? Use Guest mode to sign in privately. Learn more about using Guest mode

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​The aim of this resource is to support leaders and those working within leadership teams to reflect on their understanding of pedagogical leadership as well as their role as a pedagogical leader and how this can be developed further or improved through professional reflection and dialogue.

This resource takes the form of a presentation with reflective questions and video clips including clips from a conversation filmed with June O'Sullivan CEO of the London Early Years Foundation (LEYF) and adviser to the UK Government and policy makers about services for early years across the country.

How to use this resource

There are number of interactive slides to stimulate reflection and discussion. The resource can be used with other leaders beyond your own setting to support professional dialogue. It can also be used to consider the practice of individual teams within one setting.

The presentation covers a number of issues therefore, you may find it useful to use it over a number of sessions, with each session having a focus, for example:

What is effective pedagogical leadership?

Linking research in pedagogy with practice.

The role of the reflective practitioner to support effective pedagogical leadership.

The video clips can be used as part of the resource or on their own, or in addition to the presentation and corresponding notes. These offer additional information and commentary for each of the slides.

Videos

Download(s)
PowerPoint File: Pedagogical Leadership in Early Learning and Childcare (3 MB) Word file: Pedagogical Leadership in Early Learning and Childcare - Accompanying notes (34 KB)
Let's talk about pedagogy, Scottish Executive (2005) ​
Christine Stephen - Pedagogy: the silent partner in early years learning

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Pedagogical Leadership in Early Learning and Childcare

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Education Scotland is a Scottish Government executive agency responsible for supporting quality and improvement in Scottish education.

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The 'Engaging parents and families: A toolkit for practitioners' is a comprehensive online resource which will continue to be reviewed and refreshed with new content. Each section of the toolkit is a standalone document to enable practitioners to select the specific topic they require.

Parental engagement focuses on ways in which parents, carers and families support and encourage their children's learning in school and in everyday life. Schools and partners can play a vital role in supporting families to do this effectively and with confidence.
(2018 National Improvement Framework, 2017, p14)

Explore this resource

Within the toolkit there are activities that can be used as a starting point and/or as a tool to measure and evaluate current practice in parental involvement and engagement, family learning and learning at home in early learning and childcare settings, schools or at a local authority level. The activities can also be used in partnership with Parent Council or parent groups.

The 'Engaging parents and families' toolkit is organised into various sections and has common themes running throughout each one. These are:

Building strong, positive relationships with parents, families and communities

Getting it Right for Every Child (GIRFEC)

Equality, diversity and inclusion

Children's rights and participation

Developing the Young Workforce (DYW)

How to use this resource

This toolkit can be used to help support practitioners to meet the challenges of raising attainment for all and ensuring every child and family has the same chance to thrive. It draws upon and replaces previous versions of the toolkit.

Practitioners will be supported to take forward self-evaluation and improvement in their early learning and childcare setting or school through the links to research and professional learning materials that can be used by individuals or groups.

Download(s)
PDF file: Section 1: Background and definitions (updated March 2022) (538 KB) PDF file: Section 2: Benefits of involving and engaging parents in their children's learning (updated February 2022) (1.0 MB) PDF file: Section 3: Involving all parents (updated July 2021) (877 KB) PDF file: Section 4: Learning at home (updated July 2021) (2.7 MB) PDF file: Section 5: Home-school partnerships (updated July 2021) (1.2 MB) PDF file: Section 6: Parental representation (updated July 2021) (5 MB) PDF file: Section 7: Family Learning (updated July 2021) (693 KB) PDF file: Section 8: Community connections (updated July 2021) (877 KB) PDF file: Section 9: Home-school link workers (updated July 2011) (927 KB) PDF file: Section 10: School improvement planning (updated July 2021) (414 KB) PDF file: Section 11: Reporting to parents and children (updated July 2021) (408 KB)

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Engaging parents and families - A toolkit for practitioners

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Education Scotland is a Scottish Government executive agency responsible for supporting quality and improvement in Scottish education.

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The 'Engaging parents and families: A toolkit for practitioners' is a comprehensive online resource which will continue to be reviewed and refreshed with new content. Each section of the toolkit is a standalone document to enable practitioners to select the specific topic they require.

Parental engagement focuses on ways in which parents, carers and families support and encourage their children's learning in school and in everyday life. Schools and partners can play a vital role in supporting families to do this effectively and with confidence.
(2018 National Improvement Framework, 2017, p14)

Explore this resource

Within the toolkit there are activities that can be used as a starting point and/or as a tool to measure and evaluate current practice in parental involvement and engagement, family learning and learning at home in early learning and childcare settings, schools or at a local authority level. The activities can also be used in partnership with Parent Council or parent groups.

The 'Engaging parents and families' toolkit is organised into various sections and has common themes running throughout each one. These are:

Building strong, positive relationships with parents, families and communities

Getting it Right for Every Child (GIRFEC)

Equality, diversity and inclusion

Children's rights and participation

Developing the Young Workforce (DYW)

How to use this resource

This toolkit can be used to help support practitioners to meet the challenges of raising attainment for all and ensuring every child and family has the same chance to thrive. It draws upon and replaces previous versions of the toolkit.

Practitioners will be supported to take forward self-evaluation and improvement in their early learning and childcare setting or school through the links to research and professional learning materials that can be used by individuals or groups.

Download(s)
PDF file: Section 1: Background and definitions (updated March 2022) (538 KB) PDF file: Section 2: Benefits of involving and engaging parents in their children's learning (updated February 2022) (1.0 MB) PDF file: Section 3: Involving all parents (updated July 2021) (877 KB) PDF file: Section 4: Learning at home (updated July 2021) (2.7 MB) PDF file: Section 5: Home-school partnerships (updated July 2021) (1.2 MB) PDF file: Section 6: Parental representation (updated July 2021) (5 MB) PDF file: Section 7: Family Learning (updated July 2021) (693 KB) PDF file: Section 8: Community connections (updated July 2021) (877 KB) PDF file: Section 9: Home-school link workers (updated July 2011) (927 KB) PDF file: Section 10: School improvement planning (updated July 2021) (414 KB) PDF file: Section 11: Reporting to parents and children (updated July 2021) (408 KB)

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Engaging parents and families - A toolkit for practitioners

# data[].attributes.attachment_link.description
Education Scotland is a Scottish Government executive agency responsible for supporting quality and improvement in Scottish education.

# data[].attributes.attachment_link.readable_text
The 'Engaging parents and families: A toolkit for practitioners' is a comprehensive online resource which will continue to be reviewed and refreshed with new content. Each section of the toolkit is a standalone document to enable practitioners to select the specific topic they require.

Parental engagement focuses on ways in which parents, carers and families support and encourage their children's learning in school and in everyday life. Schools and partners can play a vital role in supporting families to do this effectively and with confidence.
(2018 National Improvement Framework, 2017, p14)

Explore this resource

Within the toolkit there are activities that can be used as a starting point and/or as a tool to measure and evaluate current practice in parental involvement and engagement, family learning and learning at home in early learning and childcare settings, schools or at a local authority level. The activities can also be used in partnership with Parent Council or parent groups.

The 'Engaging parents and families' toolkit is organised into various sections and has common themes running throughout each one. These are:

Building strong, positive relationships with parents, families and communities

Getting it Right for Every Child (GIRFEC)

Equality, diversity and inclusion

Children's rights and participation

Developing the Young Workforce (DYW)

How to use this resource

This toolkit can be used to help support practitioners to meet the challenges of raising attainment for all and ensuring every child and family has the same chance to thrive. It draws upon and replaces previous versions of the toolkit.

Practitioners will be supported to take forward self-evaluation and improvement in their early learning and childcare setting or school through the links to research and professional learning materials that can be used by individuals or groups.

Download(s)
PDF file: Section 1: Background and definitions (updated March 2022) (538 KB) PDF file: Section 2: Benefits of involving and engaging parents in their children's learning (updated February 2022) (1.0 MB) PDF file: Section 3: Involving all parents (updated July 2021) (877 KB) PDF file: Section 4: Learning at home (updated July 2021) (2.7 MB) PDF file: Section 5: Home-school partnerships (updated July 2021) (1.2 MB) PDF file: Section 6: Parental representation (updated July 2021) (5 MB) PDF file: Section 7: Family Learning (updated July 2021) (693 KB) PDF file: Section 8: Community connections (updated July 2021) (877 KB) PDF file: Section 9: Home-school link workers (updated July 2011) (927 KB) PDF file: Section 10: School improvement planning (updated July 2021) (414 KB) PDF file: Section 11: Reporting to parents and children (updated July 2021) (408 KB)

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Engaging parents and families - A toolkit for practitioners

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Education Scotland is a Scottish Government executive agency responsible for supporting quality and improvement in Scottish education.

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Additional resources to support practitioner/learner understanding and engagement.

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Toolkit 2 Learning and Development Pathways

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Realising the Ambition : Developing Literacy through Interactions, Experiences and Spaces

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Realising the Ambition : Developing Literacy through Interactions, Experiences and Spaces

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Food Safety : Help for Early Years Providers

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Food Safety : Help for Early Years Providers

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Help for early years providers : Food safety

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Healthy Start and Best Start Foods
A practical guide

The aim of this guide is to provide support to families to help them to get the most out of the Healthy Start scheme in England, Wales and Northern Ireland, or the Best Start Foods scheme in Scotland. The guide provides a range of healthy family recipes using ingredients that can be bought through the Healthy Start or Best Start Foods schemes, and shows how these can feed the whole family.

There is no hard copy available of this resource, but a local printer could produce copies from the pdf if needed.

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Eating well early years - First Steps Nutrition Trust

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The aim of this guide is to provide support to families to help them to get the most out of the Healthy Start scheme in England, Wales and Northern Ireland, or the Best Start Foods scheme in Scotland.

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Ogham - Using the ancient tree alphabet in outdoor learning

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Ogham - Using the ancient tree alphabet in outdoor learning

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Managing specific infectious diseases: A to Z

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Managing specific infectious diseases: A to Z

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Athlete's foot is an infection caused by a fungus which affects the skin on feet.

The person affected may have scaling, peeling or cracking of the skin, especially between the toes and on soles of the feet, and it can sometimes be very itchy. They may also develop blisters. In some cases, it can cause toenails to become discoloured, thick and crumbly.

It is generally spread by direct or indirect contact with skin lesions of infected people. For example, when visiting places barefoot, such as contaminated floors in gyms (showers, locker room, around swimming pools). Spread can also occur when sharing socks, shoes or towels with a person who has the infection.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.

Exclusion is not required.

You do not need to contact your health protection team ( HPT).

Advise the individual, parent or carer to:

visit their local pharmacy or GP for advice and treatment

take care to dry between the toes after bathing - this may include using a fungicidal dusting powder, which can be bought over the counter at a pharmacy, on the feet, between the toes and in the socks and shoes

enable the individual to wear shoes that allow feet to breathe and change socks frequently

ensure the individual covers the affected foot with a rubber sock when going swimming

Do not allow people who have the infection to share socks, shoes, towels or bathmats with others.
Athlete's foot - NHS.UK
Chickenpox (varicella) and shingles

Chickenpox is a mild and common childhood illness that most children catch. Chickenpox is most common in children under the age of 10. Nine out of 10 adults are immune because they had chickenpox during childhood. People usually catch chickenpox in winter and spring, particularly between March and May.

Chickenpox has a sudden onset with fever, runny nose, cough and a generalised rash. The spotty rash starts with fluid filled blisters which then scab over and eventually drop off. Some people have only a few spots, but other people can have spots that cover their entire body. In most people, the blisters crust up and fall off naturally within one to 2 weeks.

Chickenpox in children is considered a mild illness. There is no specific treatment but there are pharmacy remedies that may alleviate symptoms. These include paracetamol to relieve fever, and calamine lotion and cooling gels to ease itching.

Chickenpox tends to be more severe in adults and they tend to have a higher risk of developing complications.

Some children and adults are at higher risk of serious problems if they catch chickenpox, including:

These people should seek medical advice as soon as they are exposed to chickenpox or if they develop chickenpox symptoms. They may need a blood test to check if they are protected from (immune) chickenpox.

Shingles is caused by the chickenpox virus. When people get chickenpox, the virus remains in the body. It can be reactivated later and cause shingles if someone's immune system is lowered.

Shingles presents as a blistering rash in the area supplied by the affected nerve, usually only one side of the body. It can be very painful. Most people recover fully. There is often altered sensation before the rash appears, accompanied by 'flu like' symptoms.

Chickenpox is highly infectious and spreads by respiratory secretions or by direct contact with fluid from blisters.

Direct contact with fluid from the blisters of a person that has shingles can cause chickenpox in someone who has never had it before.

People with chickenpox are generally infectious from 2 days before the rash appears and until all blisters have crusted over (usually 5 to 6 days after the start of the rash).

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.

Exclusion is recommended.

Chickenpox and shingles: what you need to do

Send any individual with chickenpox home. Keep the individual away from the setting until all blisters have crusted over. In cases of shingles, the decision to exclude an individual will depend on whether the rash or blisters can be covered.

Keep the individual away from the setting if they have a weeping shingles rash that cannot be covered.

Ensure that anyone who is at higher risk (pregnant women, newborn babies, and people with a weakened immune system) seek medical advice as soon as they are exposed to chickenpox or if they develop chickenpox symptoms.

Advise individuals, parents or carers to:

seek immediate medical advice if the individual is seriously ill or if they develop any abnormal symptoms such as:

the blisters becoming infected

a pain in their chest or difficulty breathing

avoid contact with other people for at least 5 days from the onset of the rash and until all blisters have crusted over (if chickenpox) or can be covered (shingles)

Do not allow the individual to return to the setting until all the blisters have dried and crusted over.

Further information about chickenpox and shingles
Chickenpox - NHS.UK Shingles - NHS.UK
Chlamydia

Genital chlamydia infection is a sexually transmitted infection ( STI) caused by a bacterium, chlamydia trachomatis. The bacteria is usually spread from one infected person to another through unprotected sex (sex without a condom) or via contact with their infected genital fluids (semen or vaginal fluid). The prevalence of infection is highest in young sexually active adults, aged 15 to 24 years old.

Symptoms usually develop 1 to 3 weeks after becoming infected and include:

unusual discharge from the vagina

discharge from the penis or pain in the testicles

burning and itching in the genital area

bleeding between periods or during, or just after, sexual intercourse

pain when passing urine (cystitis)

lower abdominal pain

It is important to note that half of all infected men and 70% of women do not have any symptoms and consequently many people remain undiagnosed and can pass the infection on to others.

The test for chlamydia is simple and painless - a urine sample or a swab that can be done at home. Specimens are sent to the laboratory for analysis, and results are given via email, letter or text message.

Chlamydia is easily treated with antibiotics. It is important that recent sexual partners (within the last six months) are also tested and, if necessary, treated in order to prevent re-infection.

Chlamydia can have serious complications if it is not treated promptly:

There is no vaccine available to reduce the risk of contracting chlamydia.

People can't get chlamydia from kissing, hugging, sharing baths or towels, from swimming pools, toilet seats or sharing cups, plates or cutlery.

Exclusion is not required.

Chlamydia: what you need to do

You do not need to contact your HPT.

Any sexual contacts of people diagnosed with chlamydia should be advised to attend the local GUM clinic for screening and not have sex until the result is known.

Advise sexually active men and women that they can lower their risk of STIs by reducing their numbers of partners, and by using condoms correctly and consistently during sexual intercourse.

Advise screening for chlamydia in people aged under 25 years old.

Maintain confidentiality and do not divulge personal identifiable information to non-health professionals without permission from the individual.

Further information about chlamydia
Chlamydia - NHS.UK Chlamydia - Sexwise
Cold sores

Cold sores are caused by a virus called herpes simplex and usually appear on and around the lips. They sometimes also appear on other areas of the face and nose. It is estimated that more than half of us carry the virus but most of us do not develop cold sores.

It is usually a mild self-limiting virus. Most people who get cold sores will have been infected early in life.

The first signs are tingling, burning or itching in the area where the sore is going to appear. This phase may last for as little as 24 hours. There is reddening and swelling of the infected area resulting in fluid filled blisters which are usually clumped together in patches. Cold sores can be painful, and the blisters may form ulcers. They then dry up and crust over.

Cold sores may be triggered by factors such as having a cold, fever, other infection, stress, sunlight, or a weakened immune system.

The virus is spread by direct contact. People are at risk of getting a cold sore if they come in contact with the fluid of a cold sore or the saliva of someone who has the virus.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.

Exclusion is not required.

Cold sores: what you need to do

You do not need to contact your HPT.

Advise individuals to try not to touch the cold sore or pick at the blisters to prevent spread.

Advise individuals to avoid contact with the sores and blisters by avoiding:

Advise the individual who had a cold sore to avoid touching their eyes, including taking extra care when applying or removing make-up.

Further information about cold sores
Cold sores - NHS.UK
Conjunctivitis

Conjunctivitis is an inflammation of the outer lining of the eye and eyelid causing a sore or itchy red eye(s) with a sticky or watery discharge. It can be caused by bacteria or viruses or allergies.

The eye(s) become(s) reddened and swollen and there may be a sticky or watery discharge. Eyes usually feel sore or itchy and 'gritty'. Topical ointments or eye drops can be obtained from a pharmacy to treat the infection.

Conjunctivitis is spread by contact with discharge from the eye such as when an affected person rubs their eyes with their hands, or a towel then handles another person's face or towel. Prompt treatment and good hand hygiene helps to prevent spread.

Exclusion is not required.

Conjunctivitis: what you need to do

You do not need to contact your HPT.

Advise individuals, parents or carers to seek advice from their local pharmacist.

Encourage the individual not to rub their eyes and to wash their hands frequently.

Advise the affected individual to avoid sharing towels, flannels and pillows.

Further information about conjunctivitis
Conjunctivitis - NHS.UK
Cryptosporidiosis

Cryptosporidiosis is an infection caused by Cryptosporidium, a microscopic parasite.

Cryptosporidiosis is spread from those with the infection to others when the parasite enters the gut by the mouth for example when contaminated hands or objects are put in the mouth or after eating or drinking contaminated food or drinks. It can also be spread by direct contact with farm animals particularly cattle and sheep. Spread by contaminated or untreated water and milk has also been reported.

Cryptosporidum's high tolerance to chlorine enables it to survive for long periods of time in chlorinated drinking and swimming pool water. This means people swallowing contaminated water could get infected.

Symptoms include abdominal pain, diarrhoea and occasionally vomiting. The incubation period is between 7 to 10 days but can sometimes be as long as 28 days. Shedding of the parasite by infected people begins when the symptoms begin and can last for weeks after the symptoms stop.

Exclusion is recommended.

Cryptosporidiosis: what you need to do

Exclude the infected individual until 48 hours after symptoms have stopped and they are well enough to return.

Contact your UKHSA HPT if there are 2 or more cases with cryptosporidium. Your UKHSA HPT or the local authority environmental health officer ( EHO) will advise you if any actions need to be taken

Encourage individuals to implement good hand hygiene practices.

Clean kitchen and toilet areas regularly (for more details, see cleaning)

Use personal protective equipment (PPE) when handling blood or bodily fluids such as vomit or diarrhoea.

Do not allow individuals with cryptosporidium to go to a swimming pool until 14 days after the last diarrhoeal episode.

Diarrhoea and vomiting (gastroenteritis)

Diarrhoea and vomiting may be due to a variety of causes including bacteria, viruses, parasites, toxins or non-infectious diseases. Gastrointestinal infections are spread when the germs enter the gut by the mouth or when contaminated hands or objects are put in the mouth or after eating or drinking contaminated food or drinks.

The most commonly reported bacterial infections are salmonella and campylobacter, usually associated with food poisoning. The most commonly reported viral infection is norovirus, usually associated with person-to-person transmission.

However, as a general principle, all cases of gastroenteritis should be regarded as potentially infectious unless there is good evidence to suggest otherwise.

A liquid stool is more likely to contaminate hands and the environment than a formed stool and is therefore a greater risk. Vomit, like liquid stool, may also be highly infectious such as when there is norovirus circulating in the setting. Infection can also be spread when the affected person vomits. This is because aerosols can spread the organism directly to others and contaminate the environment. A person will be infectious while symptoms remain.

People affected by infectious gastrointestinal diseases may have diarrhoea and/or vomiting.

Diarrhoea is defined as 3 or more liquid or semi-liquid stools (type 6 or 7) within a 24-hour period in adults and older children or any change in bowel pattern in young children.

The incubation period (the delay between infection and the appearance of symptoms) will vary depending on the cause of the infection.

Exclusion is recommended.

Diarrhoea and vomiting: what you need to do

Exclude the infected individual until 48 hours after symptoms have stopped and they are well enough to return. If medication is prescribed, ensure that the full course is completed and there is no further diarrhoea and/or vomiting for 48 hours after the course is completed.

Encourage individuals to implement good hand hygiene practices.

Clean kitchen and toilet areas regularly (for more details, see cleaning).

Use when handling blood or bodily fluids such as vomit or diarrhoea.

Further information about diarrhoea and vomiting
Diarrhoea and vomiting - NHS.UK
E. coli STEC (Shiga Toxin-producing E. coli)

Escherichia coli (E. coli) are bacteria found in the environment, food, and guts of people and animals. There are several different types of E. coli and most are harmless.

Some types, known as Shiga Toxin-producing E. coli (STEC), produce a toxin, which can cause illness. These types of E. coli live in the guts of animals, particularly cattle and sheep.

Symptoms vary depending on the severity of the infection but include diarrhoea (which might be bloody), abdominal pain, and sometimes vomiting and fever. The incubation period is 1 to 10 days and cases are infectious as long as bacteria are present in the faeces. Symptoms usually resolve within 5 to 7 days but on rare occasions infection can cause serious complications such as kidney failure.

Spread is mainly by eating contaminated food (such as undercooked meat, unpasteurised milk and cheese, unwashed vegetables which may have been contaminated by manure from infected animals) or contact with infected animals or their faeces.

Person-to-person spread is by direct contact with someone who has the infection particularly within families and childcare settings. Outbreaks and sporadic cases have also been linked with handling animals. Therefore, adults should supervise children and young people while washing their hands during visits to petting zoos and farm centres. For more information, see additional considerations for outdoor learning.

Exclusion is recommended.

E. coli STEC: what you need to do

Exclude individual until 48 hours after diarrhoea and or vomiting symptoms have stopped, and they are well enough to return.

Encourage individuals to implement good hand hygiene practices.

Clean kitchen and toilet areas regularly (for more details, see cleaning.

Use when handling blood or bodily fluids such as vomit or diarrhoea.

Further information about E. coli STEC
Shiga toxin-producing Escherichia coli (STEC): symptoms, how to avoid, how to treat
Food poisoning

Food poisoning is a general term used for gastrointestinal ( GI) infections caused by consuming contaminated food or drink or by person-to-person spread.

Gastrointestinal infections can be caused by a variety of bacteria, viruses or parasites; the most commonly reported bacterial infections are salmonella and campylobacter, usually associated with food poisoning. However, as a general principle, all cases of gastroenteritis should be regarded as potentially infectious unless there is good evidence to suggest otherwise.

A liquid stool is more likely to contaminate hands and the environment than a formed stool and is therefore a greater risk. Vomit, like liquid stool, may also be highly infectious such as when there is norovirus circulating in the setting. Infection can also be spread when the affected person vomits. This is because aerosols can spread the organism directly to others and contaminate the environment. A person will be infectious while symptoms remain.

Food poisoning outbreaks can occur when people eat the same contaminated food. Or if food is prepared by someone who has the infection and did not wash their hands properly before preparing the food.

People affected by infectious gastrointestinal diseases may experience diarrhoea and vomiting. Diarrhoea is defined as 3 or more liquid or semi-liquid stools ( type 6 or 7) within a 24-hour period in adults and older children or any change in bowel pattern in young children.

The incubation period (the delay between infection and the appearance of symptoms) will vary depending on the cause of the infection.

Symptoms of food poisoning usually begin within 1 to 2 days of eating contaminated food, although they may start at any point between a few hours and several weeks later depending on the cause. The main symptoms include feeling sick (nausea), vomiting, diarrhoea, abdominal pain and fever.

Exclusion is recommended.

Food poisoning: what you need to do

Exclude the infected individual until 48 hours after diarrhoea and vomiting symptoms have stopped, and they are well enough to return.

Inform your UKHSA HPT if there are 2 or more cases with similar symptoms linked in time or place or a greater than expected rate of infection compared with the usual rate.

Encourage individuals to implement good hand hygiene practices.

Clean kitchen and toilet areas regularly (for more details, see cleaning).

Use when handling blood or bodily fluids such as vomit or diarrhoea.

Further information about food poisoning
Food poisoning - NHS.UK
Genital herpes

Many people become infected and do not have any symptoms at all. However, others will experience:

After each episode, the virus enters a dormant (inactive) phase in nearby nerves. From time to time the virus reactivates causing symptoms - in some cases a person will experience several episodes a year. However, over time, episodes tend to become less frequent, and the symptoms are milder with each recurrence.

Some people get warning signs that a recurrence is about to occur, such as itching, tingling or pain in the genital area.

There is no cure for genital herpes. If caught early, some infectious episodes can be treated with antiviral drugs (such as acyclovir), which can reduce the length and severity of the infection.

There are no specific long-term problems for people with genital herpes. However, a woman can pass on a serious infection to her baby during childbirth if she has genital herpes.

There is no vaccine available to reduce the risk of contracting genital herpes.

People can't get genital herpes from hugging, sharing baths or towels, from clothing, from swimming pools, toilet seats or from sharing cups, plates or cutlery.

Exclusion is not required.

Genital herpes: what you need to do

You do not need to contact your HPT.

Any sexual contacts of people who have genital herpes should be advised to attend the local GUM or sexual health clinic for screening.

Advise sexually active men and women that they can lower their risk of STIs by reducing their numbers of partners, reducing frequency of partner change, and by using condoms correctly and consistently during sexual intercourse.

Please note, for genital herpes use of condom alone does not offer sufficient protection - see route of transmission above.

Maintain strict confidentiality and do not divulge personal identifiable information to non-health professionals without permission from the individual.

Further information about genital herpes
Genital herpes - NHS.UK Genital herpes - Sexwise
Giardiasis

Giardiasis is a parasitic disease caused by Giardia, a microscopic parasite, that causes diarrhoea. Many infections are picked up while travelling abroad.

Giardiasis is spread from those with the infection to others when the parasite enters the gut through the mouth for example when contaminated hands or objects are put in the mouth or after eating or drinking contaminated food or drinks.

Infection with giardia may not cause any symptoms. When symptoms do occur, they may include abdominal pain, bloating, fatigue and pale, loose stools or diarrhoea. Cases may need treatment. The incubation period is between 5 and 25 days, and symptoms generally last anywhere from 2 to 6 weeks but may last longer in people with weakened immune systems.

Exclusion is recommended.^ Exclusion is recommended.

Giardiasis: what you need to do

Exclude the infected individual until 48 hours after the symptoms have stopped, and they are well enough to return.

Encourage individuals to implement good hand hygiene practices.

Clean kitchen and toilet areas regularly (for more details, see cleaning).

Use when handling blood or bodily fluids such as vomit or diarrhoea.

Do not allow individuals with Giardia to go to a swimming pool until 14 days after the last diarrhoeal episode.

Further information about Giardiasis
Giardiasis - NHS.UK
Glandular fever

Glandular fever is a viral infection that mostly affects young adults, it is caused by the Epstein-Barr virus.

Symptoms present as fatigue, aching muscles, sore throat, fever, swollen glands in the neck and occasionally jaundice (yellowing of the skin and eyes). In children, the disease is generally mild. The incubation period is about 4 to 6 weeks.

Symptoms of glandular fever can be unpleasant, but most pass within 2 to 3 weeks. Fatigue, however, can occasionally last longer.

The virus is found in the saliva of infected people and can be spread by direct contact with saliva such as kissing, being exposed to coughs and sneezes and sharing of eating and drinking utensils. It can also be spread by indirect contact via contaminated objects if hands are not washed adequately.

Exclusion is not required.

Glandular fever: what you need to do

You do not need to contact your HPT.

Encourage individuals to implement good hand hygiene and respiratory hygiene practices.

Further information about glandular fever
Glandular fever - NHS.UK
Gonorrhoea

Gonorrhoea is a STI caused by the bacteria Neisseria gonorrhoeae. The infection, which does not always have obvious symptoms, is passed on during unprotected sex (sex without a condom).

The symptoms of gonorrhoea usually develop between one and 14 days after the initial infection and men are more likely to have symptoms than women. The most common symptoms are:

an unusual discharge from the vagina or penis

a burning sensation when passing urine

The infection can also affect other areas such as the anal passage, throat and eyes.

Gonorrhea can usually be treated with an antibiotic, often given as a single dose. However, there are many strains of gonorrhoea, and some are now resistant to the commonly used antibiotics. This makes it important for anyone with suspected gonorrhea to be properly investigated.

Gonorrhoea can be passed from a woman to her baby during childbirth, usually causing an infection of the eyes. In the long-term, gonorrhoea can lead to chronic inflammation of the reproductive organs and can lead to infertility.

There is no vaccine available to reduce the risk of contracting gonorrhoea.

People can't get gonorrhoea from kissing, hugging, sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery.

Exclusion is not required.

Gonorrhoea: what you need to do

You do not need to contact your HPT.

Any sexual contacts of people who have gonorrhoea should be advised to attend the local GUM or sexual health clinic for screening.

Advise sexually active men and women that they can lower their risk of STIs by reducing their numbers of partners, reducing frequency of partner change, and by using condoms correctly and consistently during sexual intercourse.

Maintain strict confidentiality and do not divulge personal identifiable information to non-health professionals without permission from the individual.

Further information about gonorrhoea
Gonorrhoea - NHS.UK Gonorrhoea - Sexwise
Group A Streptococcus (GAS)

Group A streptococcus ( GAS), also referred to as Strep A is a common type of bacteria. It can cause a number of infections, some mild and some more serious.

Milder infections caused by group A streptococcus include scarlet fever, impetigo and 'strep throat'. These can be easily treated with antibiotics.

Group A Streptococcus (GAS): what you need to do

If an individual with GAS has a mild infection, they can usually recover at home in a few days.

Most strep A infections can be easily treated with antibiotics.

An individual with a strep A infection, should stay away from the setting for 24 hours after starting to take antibiotics. This will help stop the infection spreading to other people.

Further information about Group A Strep
Strep A - NHS Invasive Group A Strep
Hand, foot and mouth disease is a common viral illness in childhood. It is generally a mild illness caused by an enterovirus. In rare instances it can be more severe.

The individual may develop a fever, reduced appetite and generally feel unwell. One or 2 days later a rash may develop with blisters, on hands, feet, insides of their cheeks, gums and on the sides of the tongue. Not all cases have symptoms. The incubation period is 3 to 5 days. Persons affected are most infectious during the first week of the illness.

The illness is usually mild and clears up by itself in 7 to 10 days. If the individual develops the rare additional symptoms of high fever, headache, stiff neck, back pain, or other complications then they should seek prompt medical advice.

Spread is caused by direct contact with the secretions of the infected person (including faeces) or by aerosol spread such as coughing and sneezing. Younger children are more at risk because they tend to play closely with their peers.

Although there is usually no risk to the pregnancy or baby, it is best to avoid close contact with anyone who has hand, foot and mouth disease. This is because having a high temperature during the first 3 months of pregnancy can very rarely lead to miscarriage, and getting hand, foot and mouth disease shortly before giving birth can mean your baby is born with a mild version of it. Pregnant women who have been in contact with an affected individual may wish to speak to their GP or midwife.

Do not confuse with foot and mouth disease which is found in animals. Individuals do not need to be excluded from the setting if they are well.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.

Exclusion is not required.

You do not need to contact your HPT.

Encourage individuals to implement good hand hygiene practices, particularly in those affected and the staff who carry out nappy changing or assist with toileting. This should continue even after the person is well because the virus can still be present in the faeces and saliva for a few weeks.

Encourage individuals to implement good respiratory hygiene practices.

Strongly encourage staff to adhere to toileting and sanitation guidance.
Hand, foot and mouth disease - NHS.UK
Head lice

Head lice and nits are common in young children and their families. They do not have anything to do with dirty hair and are picked up by head-to-head contact.

Head lice are tiny insects that only live on humans. The eggs are grey or brown and about the size of a pinhead which stick to the hair, close to the scalp. The eggs hatch in 7 to 10 days. Empty eggshells (nits) are white and shiny and are found further along the hair shaft as they grow out.

Head lice are spread by direct head-to-head contact and therefore tend to be more common in children because of the way they play. They cannot jump, fly or swim. Itching and scratching occurs 2 to 3 weeks after coming into close contact with someone who has headlice.

Exclusion is not required.

Head lice and nits: what you need to do

You do not need to contact your HPT.

Consider carefully before sending letters and notifications to parents or carers. These generally do not reduce the risk of transmission and may provoke anxiety.

Encourage parents or carers to give regular head checks and provide good hair care to help identify and treat head lice early.

Further information about head lice and nits
Head lice and nits - NHS.UK
Hepatitis A

Hepatitis A is a viral infection which affects the liver. The hepatitis A virus is caught by eating or drinking contaminated food or water. The infection can also be spread by close contact with an infected person, especially where there is poor personal or public hygiene. The virus is very contagious and is found in the stools and blood of people who are infected.

People should be vaccinated against hepatitis A before travelling to countries where hepatitis A is common.

Symptoms include abdominal pain, loss of appetite, nausea, fever and fatigue, followed by jaundice (yellowing of the skin and eyes), dark urine and pale faeces. The severity of the disease varies from a mild illness lasting 1 to 2 weeks to a more serious illness lasting several months. Young children may have mild infections without jaundice or other symptoms, and many may have no symptoms at all.

Exclusion is recommended.

Hepatitis A: what you need to do

Exclude the infected individual for 7 days after the onset of jaundice or from the onset of symptoms if no jaundice is present.

Encourage individuals to implement good hand hygiene practices.

Clean kitchen and toilet areas regularly (for more details, see cleaning).

Household and other close contacts of cases will be offered a hepatitis A vaccine if they are not immune.

Educate young people on safe sex to protect them from hepatitis infection (and other sexually transmitted infections) through sexual contact. A lesson plan is available to support.

Further information about hepatitis A
Hepatitis A - NHS.UK
Hepatitis B

Hepatitis B is a liver disease caused by the hepatitis B virus ( HBV). There are several different viruses which affect the liver, primarily hepatitis A, B, C, D and E.

The main difference between the viruses is how they are spread; the way they cause liver damage and the effects they have on health. In the UK, hepatitis B infection is not a common viral infection in young children and young people.

Hepatitis B can cause an acute or a chronic illness. An acute illness is one that gets better quickly, usually within weeks or at most a few months.

A chronic illness lasts much longer, sometimes waxing and waning. Chronic hepatitis B is when it lasts longer than 6 months.

Symptoms can vary and may include general fatigue, nausea and vomiting, loss of appetite, fever and dark urine. Older children and adults may develop jaundice (a yellowing of the eyes and skin).

Many people never have any symptoms, but they can pass on the infection. The incubation period (the delay between infection and the appearance of symptoms) can be between 4 weeks and 6 months.

It is spread is by contact with infected blood and bodily fluids entering the bloodstream through broken skin or mucous membranes (eyes, mouth and nose), for example through a bite which breaks the skin or if the skin is pierced by a contaminated object.

The virus can also be passed on via tattooing or from medical and dental treatment if equipment is not adequately sterilised.

All blood and bodily fluids should be considered potentially infectious, and spills should be cleaned wearing protective clothing and using a spillage kit.

Exclusion is not required.

Hepatitis B: what you need to do

Do not exclude individuals with chronic hepatitis B infection or restrict their activities.

People with acute hepatitis B will typically be too ill to attend their setting. Follow their doctor's advice regarding when they can return.

Clean kitchen and toilet areas regularly (for more details, see cleaning).

Wear when handling or cleaning blood, urine, loose stools and vomit.

Take a standard approach to cleaning all spillages of blood and bodily fluids, managing all as potentially infectious (for more details, see Safe management of blood and bodily fluids).

Always complete the accident book with details of injuries or adverse events.

Educate young people on safe sex to protect them from hepatitis infection (and other sexually transmitted infections) through sexual contact. A lesson plan is available to support this.

Further information on hepatitis B
Hepatitis B - NHS.UK
Hepatitis C

Hepatitis C is not a common infection in children.

Hepatitis C virus ( HCV) is a blood borne virus affecting the liver. Symptoms of hepatitis C infection can often be vague and include loss of appetite, fatigue, nausea and abdominal pain. Jaundice (yellowing of the skin and eyes) occurs less commonly than in hepatitis B infection. Up to 80% of those infected may be carriers of the virus and can pass it on to others.

HCV is present in blood and other bodily fluids of infected persons. It is spread in the same way as hepatitis B virus. Hepatitis C, like hepatitis B, cannot be spread through casual contact.

Exclusion is not required.

Hepatitis C: what you need to do

Do not exclude individuals with chronic hepatitis C infection or restrict their activities.

Always complete the accident book with details of injuries or adverse events.

Encourage individuals to implement good hand hygiene practices.

Take a standard approach to cleaning all spillages of blood and bodily fluids, managing all as potentially infectious (for more details, see Safe management of blood and bodily fluids).

Ensure personal hygiene items such as toothbrushes, nail cutters, razor and nail scissors are not shared.

Ensure the setting has appropriate sanitary item disposal containers and contracts in place.

Educate young people on safe sex to protect them from hepatitis infection (and other sexually transmitted infections) through sexual contact. A lesson plan is available to support this.

Further information on hepatitis C
Hepatitis C - NHS.UK
Many people living with HIV have no obvious signs and symptoms. It can take many years for symptoms to appear after being infected with HIV.

HIV is managed by taking daily medication that is effective and safe. This means that the immune system stays healthy and can continue to fight infections normally. HIV medication is available to everyone living or studying in the UK, and free of any cost. If an individual is taking their medication correctly, they can lead a healthy life with a normal life expectancy.

If left untreated, HIV infection can damage the immune system, and make it difficult to fight common infections.

Reducing the risk of HIV

There is no vaccine available to reduce the risk of contracting HIV. However, there are ways in which the risk can be reduced.

Condoms

Correct use of condoms remains an effective and safe way to protect against HIV infection, as well as other STIs and pregnancy.

Post exposure prophylaxis (PEP)

PEP is freely available from all GUM clinics or out of hours from A&E departments. It is only given when the risk of HIV is sufficient to warrant taking this medication. This will be assessed before the medication is given.

Pre-exposure prophylaxis (PrEP)

This medication is now freely available on NHS and can be accessed via GUM clinics. There is more PrEP information from Terrence Higgins Trust.

HIV: what you need to do

Maintain strict confidentiality and do not divulge personal identifiable information to non-health professionals without permission from the individual.

You do not need to contact your HPT.

Advise sexually active men and women that they can lower their risk of STIs by reducing their numbers of partners, reducing frequency of partner change, and by using condoms correctly and consistently during sexual intercourse.

Exclusion is not required

Further information about HIV
British Association for Sexual Health and HIV British HIV Association Terrence Higgins Trust
Human papillomavirus (HPV) and genital warts

Genital warts is a STI caused by HPV. It is one of the most common viral STIs and can spread through unprotected sex or via skin to skin contact of genital area.

There are about 100 different types of HPV, 40 of which can be sexually transmitted. High risk types cause cervical and other cancers, whereas low-risk types lead to benign genital warts.

Many people infected with HPV never have any symptoms at all. For those that do have symptoms, it can take a few months after the initial infection for the warts to develop. When they do, they resemble the common warts that some people develop on their skin - painless, small, rough lumps in the genital or anal area.

There are a number of ways to treat genital warts, such as creams, freezing, laser or surgery. In most cases the body's immune system eventually gets rid of the virus without causing long-term problems.

There is currently no vaccination programme for genital herpes. However, as of 2008, there is an HPV immunisation programme for girls and boys aged 12 to 13 years to protect against some cancers and genital warts. Vaccinated individuals should still consider offers of cervical screening when they are invited, aged 25 years and over, as the vaccine does not protect against all subtypes of HPV.

People can't get genital warts from kissing, hugging, sharing baths or towels, from swimming pools, toilet seats or sharing cups, plates or cutlery.

Exclusion is not required

HPV and genital warts: what you need to do

Any sexual contacts of people who have genital warts should be advised to attend the local GUM or sexual health clinic for screening.

Advise sexually active men and women that they can lower their risk of STIs by reducing their numbers of partners, reducing frequency of partner change, and by using condoms correctly and consistently during sexual intercourse.

Please note, for genital warts, use of condom alone does not offer sufficient protection - see route of transmission above.

Maintain strict confidentiality and do not divulge personal identifiable information to non-health professionals without permission from the individual.

Further information about HPV and genital warts
Genital warts - NHS.UK Genital warts - Sexwise Human papillomavirus (HPV) - NHS.UK Cervical screening - NHS.UK
Impetigo

Impetigo is a bacterial skin infection caused by Streptococcus pyogenes, or group A streptococcus (GAS). It mostly affects infants and young children. It is very infectious and appears most commonly as reddish sores on the face. It may be a primary infection or a complication of an existing skin condition such as eczema, scabies or insect bites.

The sores can develop anywhere on the body but tend to occur as reddish sores on the face, especially around the nose and mouth and on hands and feet. After about a week, the sores burst and leave golden brown crusts. It can sometimes be painful and itchy. The incubation period is between 4 to 10 days.

Impetigo can easily spread to other parts of the affected person's body or to other people such as through direct physical contact, or by sharing towels, flannels or eating and drinking utensils.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician or consult NHS 111.

Exclusion is recommended.

Impetigo: what you need to do

Exclude the individual from the setting until all lesions (sores or blisters) are crusted over or until 48 hours after commencing treatment (antibiotics and/or hydrogen peroxide cream).

You do not need to contact your HPT.

Encourage individuals to implement good hand hygiene practices.

Encourage children, young people and staff to avoid touching or scratching the sores, or letting others touch them.

Do not allow towels, flannels and eating and drinking utensils to be shared by others.

Ensure that equipment, including toys and play equipment are thoroughly cleaned daily. Non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly (for more details, see cleaning).

Further information about impetigo
Impetigo - NHS.UK
Influenza

Influenza, commonly known as flu, is caused by a virus, usually influenza A or B. Flu viruses are always changing so this winter's flu strains will be slightly different from previous winters.

Flu can affect anyone but if people have a long-term health condition the effects of flu can make it worse even if the health condition is well managed and they normally feel well.

Some people who may develop serious influenza complications are eligible for a flu vaccination. Check who can have the:

For more information about influenza and the vaccinations read the UKHSA Green Book.

Influenza is a respiratory illness and commonly has a sudden onset. Symptoms include headache, high temperature, cough, sore throat, aching muscles and joints and fatigue.

Cases can be infectious one day before to 3 to 5 days after symptoms appear. Importantly, children may sometimes present differently with flu - for example, without fever but with diarrhoea.

It is transmitted by breathing in droplets coughed out into the air by infected people or by the droplets landing on mucous membranes. Transmission may also occur by direct or indirect contact with respiratory secretions for example via soiled tissues or from contaminated surfaces. It spreads easily in crowded populations and in enclosed spaces.

The risk of infection can be minimised through vaccination. For further details, see the section on supporting immunisation programmes and the UK's national immunisation schedule. For details of school years eligible for flu vaccination, please see the annual programme letter.

Exclusion is recommended.

Influenza: what you need to do

Exclude individuals with symptoms of the flu, until they have recovered. However, do not exclude individuals with only mild symptoms of a respiratory illness, such as a runny nose, sore throat, or mild cough, but who are otherwise well.

You do not need to contact your HPT.

Encourage those in eligible groups to have the flu vaccine.

Encourage individuals to implement good hand hygiene and respiratory hygiene practices.

Further information about influenza

Invasive Group A Streptococcus (iGAS)

The most serious infections linked to group A streptococcus come from invasive group A strep, known as iGAS. These infections are caused by the bacteria getting into parts of the body where it is not normally found, such as the lungs or bloodstream. In rare cases an iGAS infection can be fatal.

Invasive group A streptococcal disease is 'notifiable', meaning registered medical practitioners have a duty to notify the UKHSA HPT. The HPT will contact the children's or young people's setting if they are notified of a person with iGAS and further assessment is required or to provide advice.

Invasive Group A Streptococcus (GAS): what you need to do

Serious strep A infections (invasive group A strep, iGAS) may need to be treated in hospital.

Inform your if you have a case of iGAS in your setting. The HPT will carry out a risk assessment and undertake appropriate investigations and/or actions as required.

Further information about iGAS
Strep A - NHS Group A Strep
Measles

Measles is a very infectious virus that can spread from person-to-person quickly, especially in education and childcare settings. Symptoms include a high temperature, a runny or blocked nose, sneezing, a cough, conjunctivitis (red, sore, watery eyes), and small white spots (Koplik spots) inside the cheeks. A rash usually appears 2 to 4 days after the cold-like symptoms started. The rash starts on the face and behind the ears before spreading to the rest of the body. This can look different depending on skin tone. Symptoms of measles usually start between 10 and 12 days after catching the infection. Sometimes it can take up to 21 days for any symptoms to appear.

Measles is spread by airborne transmission (for example by droplets which are expelled when someone with the infection sneezes or coughs) and direct contact (for example contact with nose or throat secretions). A person with measles can spread the infection in the 4 days before they get the rash. Once a person has the rash, they can still spread the infection for another 4 days.

The measles, mumps and rubella ( MMR) vaccine is the safest and most effective way to protect against measles. People need 2 doses of MMR vaccine to be protected against measles, mumps and rubella.

During the coronavirus (COVID-19) pandemic, there was a significant decrease in children getting vaccinated with the MMR and other childhood vaccines. Measles is very infectious so even a small decrease in children getting the MMR vaccine can lead to a large increase in measles cases.

This guidance is not intended to replace advice from a medical professional.

Exclusion is recommended.

Measles: what you need to do

If you are made aware of any likely or confirmed cases of measles among people who have attended your setting, who have been diagnosed by a doctor or another healthcare professional, then you should contact your local HPT.

Exclude any infected individuals from the setting, on public health grounds, while they are likely to be infectious (from 4 days before rash onset and for a further 4 full days). Cases should only return to the setting when they have fully recovered; this is because they may be more likely to get other illnesses when they have measles.

Advise people who have a weakened immune system, are unvaccinated and pregnant, or are under 12 months of age, who have been in the setting at the same time as the likely or confirmed measles case, to seek advice from their GP or midwife. They should tell their GP, or their midwife that they may have been exposed to measles.

Encourage all children and young people over the age of one year old to have the combined MMR vaccination as per the national immunisation schedule. Schools and childcare settings can play an important role in raising awareness of the importance of the MMR vaccine.

Further information about measles
Measles - NHS.UK
Meningitis

Meningitis is a general term that describes an inflammation of the membranes covering the brain and spinal cord. It can be caused by a range of germs including bacteria or viruses.

Bacterial meningitis is less common but more serious than viral meningitis and needs urgent medical attention. In some cases, bacterial meningitis can lead to septicaemia (blood poisoning).

Common signs and symptoms of meningitis and septicaemia include fever, severe headache, photophobia, neck stiffness, non-blanching rash (see glass test below), vomiting, drowsiness.

The incubation period varies but for bacterial meningitis the incubation is between 2 and 10 days.

There is no effective medication for the treatment of viral meningitis, but symptoms are usually much milder.

The routine childhood immunisation schedule provides protection against meningitis caused by mumps, polio, Haemophilus influenzae type b ( Hib), pneumococcus and Neisseria meningitidis group A, B, C, W and Y. There is no vaccination for some types of meningitis. Children and young people. Individuals should be encouraged to be up to date with their vaccinations.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.

Exclusion is recommended.

Meningitis: what you need to do

Exclude the infected individual until they have recovered.

If a glass tumbler is pressed firmly against a septicaemic rash, the rash will not fade. The rash will be visible through the glass. If this happens, seek urgent medical attention.

Note that the rash is a late symptom - if any of the other symptoms have already occurred seek medical advice immediately and advise individuals, parents and carers to do the same.

Encourage individuals, parents and carers, in respect to their children, are up to date with their vaccinations.

Further information about meningitis
Meningitis - NHS.UK
Meningococcal meningitis and septicaemia (sepsis)

Meningococcal meningitis and septicaemia require immediate medical attention.

The bacteria Neisseria meningitidis causes meningococcal meningitis and meningococcal septicaemia (known collectively as 'meningococcal infection').

There are 13 known groups of the bacteria, the most common worldwide are A, B, C, W and Y. In the UK, groups B and C are the most common. Meningococcal infection is a rare but serious disease and is fatal in around 1 in 10 people with the illness. About 15% of those that recover have long-term complications.

Symptoms include fever, severe headache, photophobia, drowsiness, non-blanching rash (see glass test). Not all the symptoms will be present, and cases can have symptoms of meningitis and septicaemia.

Spread is from person to person through respiratory droplets and direct contact with nose and throat secretions. About 10% of us carry the bacteria harmlessly in our nose and throat.

Close and prolonged contact is needed to pass the bacteria to others (such as contacts in a household setting or intimate kissing). Only a small proportion of people develop meningitis or septicaemia if they come into contact with it. For this reason, only people that have had significant close contact with the case in the previous 7 days will be offered antibiotics and immunisation later if applicable.

The case is considered non-infectious 24 hours after taking appropriate antibiotic treatment.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.

Exclusion is recommended.

Meningococcal meningitis and septicaemia: what you need to do

Exclude the infected individual until they have been treated with antibiotics and recovered. Do not exclude household and close contacts unless they have symptoms suggestive of meningococcal infection.

If a glass tumbler is pressed firmly against a septicaemic rash, the rash will not fade. The rash will be visible through the glass. If this happens, seek urgent medical attention.

Note that the rash is a late symptom - if any of the other symptoms have already occurred seek medical advice immediately and advise individuals, parents or carers to do the same.

Further information about meningococcal meningitis and septicaemia
Meningitis - NHS.UK Symptoms of sepsis - NHS.UK
MRSA (Methicillin-resistant Staphylococcus aureus)

(methicillin-resistant Staphylococcus aureus) are bacteria that have developed resistance to methicillin (a type of penicillin) or other antibiotics.

Staphylococcus aureus (Staph aureus) are bacteria that live on healthy skin. One in 3 healthy people carry Staph aureus on their skin or in their nostrils without it causing any harm. Sometimes Staph aureus causes infections, mainly of the skin. It can occasionally cause serious infection.

Spread is mainly by direct contact with contaminated hands and objects.

Exclusion is not required.

MRSA: what you need to do

You do not need to contact your HPT.

Encourage individuals to implement good hand hygiene practices.

All infected wounds should be covered.

Further information about MRSA
Staph infection - NHS.UK
Mpox

If someone at your setting has mpox they should stay away from the setting until confirmed safe to return by their clinician or in line with any current guidance:

People at higher risk from mpox

Mpox is usually a mild illness. Some people are at higher risk of serious complications if they get mpox, for example:

Post-exposure mpox vaccination

Vaccination within 4 days of contact with mpox may provide some protection against catching the disease.

The mpox vaccine may also be offered up to 14 days after contact for people at higher risk of serious complications if they get mpox. These include:

About mpox

Mpox is a rare disease that is caused by infection with a virus called MPXV.

There have been a small number of cases of mpox in the UK since 2022. These have all been a type of mpox that may be milder (called clade II mpox).

There have not been any cases of the type of mpox that may be more serious (called clade I mpox) in the UK.

So far this type of mpox has mainly been found in countries across west, central and east Africa.

The risk of catching mpox in the UK is low.

Mpox infection is usually a self-limiting illness, and most people recover within
several weeks. However, severe illness can occur in some individuals.

The illness begins with:

Within 1 to 5 days after the appearance of fever, a rash develops, often beginning on
the face then spreading to other parts of the body. The rash changes and goes
through different stages before finally forming a scab which later falls off.

Mpox does not spread easily between people, unless there is close contact.

Spread between people may occur through:

It is possible that clade I mpox may spread between people through close and prolonged face-to-face contact such as talking, breathing, coughing, or sneezing close to one another. However, there is currently limited evidence so this will be updated as new information is available.

Spread of mpox may also occur when a person comes into close contact with an infected animal (rodents are believed to be the main animal reservoir for transmission to humans), or materials contaminated with the virus. Mpox has not been detected in animals in the UK.

People with mpox are infectious:

The incubation period for mpox (the delay between getting infected and showing symptoms) is between 5 and 21 days.

Exclusion is recommended.

Find out more about mpox on GOV.UK and on the NHS website.

Mumps

Mumps is a viral infection. The first symptoms of mumps are usually a raised temperature, swelling and tenderness of salivary glands (parotid) accompanied by headaches, joint pain and general malaise. The swelling can be one sided or affect both sides.

Mumps is usually fairly mild in young children, but can cause swelling of the testicles and rarely, infertility in males over the age of puberty.

The mumps virus is highly infectious and can be spread by droplets from the nose and throat, and by saliva.

Exclusion is recommended.

Mumps: what you need to do

You do not need to contact your HPT.

Exclude the affected individual until 5 days after the onset of swelling and well enough to return.

Encourage individuals to implement good hand hygiene practices.

Advise the individual, parents or carers to seek advice from a general practitioner.

Encourage everyone (aged one year old and over) to have the combined MMR vaccination as per the national immunisation schedule.

Encourage all staff to be up to date with their MMR vaccinations.

Further information about mumps
Mumps - NHS.UK
Norovirus

Norovirus is the most common cause of gastroenteritis in England. Also known as the 'winter vomiting bug', it causes symptoms such as nausea, diarrhoea, and vomiting.

The virus can spread from person to person through hand to mouth contact and can be picked up from contaminated surfaces such as equipment, hands, toys, or dirty nappies. It can also spread through the air by sneezing and coughing, though this is less common.

Exclusion is recommended.

Norovirus: what you need to do

Exclude the infected individual until 48 hours after symptoms have stopped and they are well enough to return.

Encourage individuals to implement good hand hygiene and good respiratory hygiene practices.

Clean kitchen and toilet areas regularly (for more details, see cleaning).

Use when handling blood or bodily fluids such as vomit or diarrhoea.

Further information about norovirus
Norovirus (vomiting bug) - NHS.UK
Panton-Valentine Leukocidin Staphylococcus aureus (PVL-SA)

Staphylococcus aureus (Staph aureus) are bacteria that live on healthy skin. One in 3 healthy people carry Staph aureus on their skin or in their nostrils without it causing any harm. Sometimes Staph aureus causes infections, known as staph infections, mainly of the skin.

PVL-SA are types of Staph aureus which produce a toxin and can cause recurrent boils, skin abscesses or cellulitis if it enters deeper layers of skin through a graze or wound. Occasionally it may enter the blood stream, causing more serious problems.

Risk factors for acquiring PVL-SA include:

close contact with someone who is already affected, for example household contacts or close contact sports

contact with contaminated surfaces or equipment, for example gym equipment

sharing towels, flannels and razors

chronic skin condition, for example eczema

living in closed communities, for example boarding school

Exclusion is recommended.

PVL-SA: what you need to do

Exclude the infected individual if there is a lesion or wound that cannot be covered.

Do not allow the affected individual to visit gyms or swimming pools until the wounds have healed.

Advise affected individuals to avoid sharing towels, flannels and pillows with others.

Clean contaminated surfaces promptly using detergent and water.

Clean common areas in settings (for example toilets, locker rooms, dining room, and so on) (for more details, see cleaning)

Encourage individuals to implement good hand hygiene practices including before and after use of the gymnasium and other communal sports activities or outings, and whenever hands are contaminated or soiled.

Encourage individuals to implement good respiratory hygiene practices.

Further information about PVL-SA
Staph infection - NHS.UK
Respiratory infections are common, particularly during the winter months. Symptoms can be caused by several respiratory infections including the common cold, COVID-19, flu, and respiratory syncytial virus (RSV).

For most individuals, these illnesses will not be serious and they soon recover.

People with respiratory infections can experience a range of symptoms including a runny nose, high temperature, cough and sore throat.

It is not possible to tell which germ someone is infected with based on symptoms alone.

Some children aged 2 years and under, especially those with a heart condition or born prematurely, and very young infants, are at increased risk of hospitalisation from RSV.

Respiratory infections can spread easily between people. Sneezing, coughing, singing and talking may spread respiratory droplets from an infected person to someone close by.

Droplets from the mouth or nose may also contaminate hands, eating and drinking utensils, toys or other items and spread to those who may use or touch them, particularly if they then touch their nose or mouth.

Exclusion is recommended.

Respiratory infections: what you need to do

It is not recommended that children and young people are tested for COVID-19 unless directed to by a health professional.

Exclude any affected individual who has a high temperature and are unwell until they no longer have a high temperature and are well enough to attend the setting.

Do not exclude individuals with mild symptoms such as a runny nose, sore throat, or mild cough, who are otherwise well.

Advise individuals aged 18 years and under with a positive COVID-19 test result to try to stay at home for 3 days after the day they took their test.

Advise individuals aged over 18 years with have a positive COVID-19 test result to stay at home for 5 days after the day they took the test.

a higher than previously experienced and/or rapidly increasing number of staff or student absences due to acute respiratory infection

evidence of severe disease due to respiratory infection, for example if a child, young person or staff member is admitted to hospital

Individuals who usually attend an education or childcare setting and who live with someone who has a positive COVID-19 test result should continue to attend as normal.

Encourage individuals to implement good respiratory hygiene practices.

Advise all individuals to follow the Living safely with COVID-19 and other respiratory infections guidance.

Further information about respiratory infections
Respiratory tract infections (RTIs) - NHS.UK Respiratory syncytial virus (RSV): symptoms, transmission, prevention, treatment - GOV.UK
Ringworm

Ringworm, also known as tinea, is a fungal infection of the skin, hair or nails. It is caused by various types of fungi and infections are named after the parts of the body that are affected, namely face, groin, foot, hand, scalp, beard area and nail.

The main symptom of ringworm is a rash. The rash may be scaly, dry, swollen or itchy and may appear red or darker than surrounding skin.

Scalp ringworm in children is becoming more common in the UK, particularly in urban areas. Until recently this was usually spread from infected animals but can spread within families and in children and young people's settings.

Ringworm of the scalp starts as a small red spot which spreads leaving a scaly bald patch. The hair becomes brittle and breaks easily.

The appearance of human scalp ringworm varies from lightly flaky areas, often indistinguishable from dandruff to small patches of hair loss on the scalp. There may be affected areas on the face, neck and trunk.

Ringworm of the body is found on the trunk or legs and have a prominent red margin with a scaly central area.

Ringworm of the nails often appears with infection of the adjacent skin. There is thickening and discolouration of the nail.

Spread is by direct skin to skin contact with an infected person or animal, or by indirect contact with contaminated surfaces.

Scalp ringworm is treated with oral anti-fungal agents. An anti-fungal cream is used to treat ringworm of the skin and feet.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool.

Exclusion is recommended.

Ringworm: what you need to do

Advise the individual, parents or carers to seek advice from a general practitioner for recommended treatment. Once treatment has started, individuals can return to their setting.

You do not need to contact your HPT.

Ensure the individual with ringworm of the feet is wearing socks and trainers. The individual should have his or her feet covered for physical education.

Discourage the individual from scratching the affected skin or area as it can spread to other parts of the body.

Advise affected individuals to avoid sharing towels, flannels, pillows, socks and shoes with others.

Encourage individuals to implement good hand hygiene practices.

Further information about ringworm
Ringworm - NHS.UK
Rotavirus

Rotavirus is a highly infectious virus that is more common in the winter months, but it can be seen throughout the year. Rotavirus spreads easily between people through hand to mouth contact and contact with contaminated surfaces such as equipment, hands, toys or dirty nappies. It can also be spread through the air by coughing and sneezing.

An oral vaccine against rotavirus infection is given to babies as part of their routine childhood vaccinations.

Apart from vaccination, good hygiene is the most important way of preventing the spread of rotavirus.

Rotavirus infection can cause severe diarrhoea usually with vomiting, stomach cramps, dehydration and mild fever. The symptoms usually last 3 to 8 days.

Adults can become infected with rotavirus, but the infection is usually very mild. Rotavirus infection is more common in infants and younger children than in teenagers.

Most babies and children recover within a week, but in a small number of cases, rotavirus infection can become serious, with babies getting dehydrated (fluid loss) and possibly needing hospital treatment.

Exclusion is recommended.

Rotavirus: what you need to do

Exclude the infected individual until 48 hours after the diarrhoea and vomiting symptoms have stopped.

Encourage uptake of the rotavirus vaccination.

Encourage individuals to implement good hand hygiene practices.

Clean surfaces regularly (for more details, see cleaning).

Use when handling blood or bodily fluids such as vomit or diarrhoea.

Further information about rotavirus
Rotavirus vaccine overview - NHS.UK Rotavirus: guidance, data and analysis - GOV.UK Protecting your baby against rotavirus - GOV.UK
Rubella (German measles)

Recovery from rubella is usually rapid and complications rarely occur. Rubella does, however, have serious consequences for pregnant women who are not immune and for the unborn baby if acquired during the first 20 weeks of pregnancy.

The symptoms of rubella are mild. Usually, the rash is the first indication of rubella infection. The main symptoms are:

swollen lymph glands around the ears and back of head 5 to 10 days before the onset of a rash

sore throat and runny nose 1 to 5 days before the rash appears

mild fever, headache, tiredness

conjunctivitis (sore, itchy, watery, red and/or sticky eyes)

red rash mostly seen behind the ears and on the face and neck

painful and swollen joints

If someone has had both doses of the MMR vaccination, they are very unlikely to have rubella.

Rubella is highly infectious. It is spread by respiratory droplets through coughing or sneezing, or by direct contact with the saliva of an infected individual. People with rubella are infectious from one week before the symptoms start and for 5 days after the rash first appears.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.

Exclusion is recommended.

Rubella: what you need to do

Exclude the infected individual for 5 days from the appearance of the rash.

Cases of laboratory confirmed rubella are quite rare (although it may be more common for an individual with a rash to be told that it looks like rubella by their GP).

In the event of a confirmed case of rubella, the HPT will speak to the individual, parents and carers directly and contact you if there is a risk to the setting. You do not need to contact your HPT where a laboratory test for rubella has not yet been done.

Encourage all individuals aged one year and over to have the combined MMR (measles, mumps and rubella) vaccination as per the national immunisation schedule.

Any staff who are unvaccinated or partially vaccinated with the MMR vaccination should be encouraged to seek advice from their general practitioner or practice nurse

Advise staff who are pregnant and not sure of their immunity, that they should seek advice from their general practitioner or midwife. When contacting the GP or midwife they should inform them that there has been exposure to a case of rubella.

Further information about rubella
Rubella (german measles) - NHS.UK
Scabies

Scabies is a skin infection caused by tiny mites that burrow in the skin. The pregnant female mite burrows into the top layer of the skin and lays about 2 to 3 eggs per day before dying after 4 to 5 weeks.

The appearance of the rash varies but most people have tiny pimples and nodules on their skin. Secondary infection can occur particularly if the rash has been scratched.

The scabies mites are attracted to skin folds such as the webs of the fingers. Burrows may also be seen on the wrists, palms, elbows, genitalia and buttocks.

Spread is most commonly by direct contact with the affected skin. The rash usually spreads across the whole body, apart from the head. Scabies remains infectious until treated.

Occasionally if there is impaired immunity or altered skin sensation, large numbers of mites occur, and the skin thickens and becomes scaly.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.

Exclusion may be recommended in specific circumstances.

Scabies: what you need to do

Affected individuals can attend the setting with advice to avoid close physical contact with others until 24 hours after the first dose of chosen treatment.

Young children not able to adhere to this advice due to their age (for example those under 5 years old) or additional needs, should be excluded from the setting until 24 hours after the first dose of chosen treatment. The risks and benefits of this should be reviewed on a case by case basis and take into account the holistic needs of the individual and the impact on their wellbeing, as well as the risk of transmission of scabies to the wider school population.

Encourage the affected individual to complete all recommended doses of treatment. It is important that the full treatment course is completed. This may involve several treatments spread out over time.

In line with clinical recommendations all household contacts and any other very close contacts should also receive treatment in a manner that is coordinated with the case and should also complete their full course of recommended treatment.

If the case is treated before the contacts, the case should then be re-treated at the same time as ongoing contacts to prevent reinfection.

Contacts do not need to be excluded from the setting.

Further information about scabies
Scabies - NHS.UK
Scarlet fever

Scarlet fever (sometimes called scarlatina) is a bacterial illness caused by Streptococcus pyogenes, or group A streptococcus (GAS). It mostly affects young children.

A wide variety of bacteria and viruses can cause tonsillitis and other throat infections. Most are caused by viruses but streptococci bacteria account for 25 to 30% of cases. It sometimes produces toxins (poisons), which usually cause a rash.

Symptoms vary but in severe cases there may be high fever, difficulty swallowing and tender enlarged lymph nodes. The rash usually develops on the first day of fever, it is red, generalised, pinhead in size and gives the skin a sandpaper-like texture and the tongue has a strawberry-like appearance.

The scarlet fever rash may be confused with measles. The fever lasts 24 to 48 hours. Scarlet fever is usually a mild illness but in rare circumstances complications such as ear infections, rheumatic fever which affects the heart, and kidney problems may develop.

Scarlet fever is highly infectious and is spread by close contact with someone carrying the bacteria. The incubation period is 2 to 5 days.

Coughing, sneezing, singing and talking may spread respiratory droplets from an infected person to someone close by.

Droplets from the mouth or nose may also contaminate hands, eating and drinking utensils, toys or other items and spread to others that use or touch them, particularly if they then touch their nose or mouth.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician or consult NHS 111.

Exclusion is recommended.

Scarlet fever: what you need to do

Advise the individual, parent or carer to seek advice from their general practitioner.

Exclude the affected individual from the setting until 24 hours after commencing appropriate antibiotic treatment. Individuals who decline treatment with antibiotics should be excluded until resolution of symptoms.

Contacts of scarlet fever cases (including siblings or household members) who are well and do not have symptoms do not require antibiotics and can continue to attend the setting. They should seek treatment if they develop symptoms.

Infection control advice for limiting transmission:

Hygiene

Encourage individuals to implement good hand hygiene and good respiratory hygiene practices.

Cleaning and disinfection

Daily cleaning using standard cleaning products such as detergents and bleach (Hypochlorite at 1000 ppm of available chlorine) for equipment, hard surfaces, hard toys, and sleep mats is an important part of reducing transmission. Single use cloths or paper towels should be used for cleaning. Soft toys should be machine washed.

Carpets and soft furnishings should be vacuumed daily.

Frequently touched surfaces such as taps, toilet flush handles, and door handles, should be cleaned regularly throughout the day.

Cover broken skin

Make sure that all cuts, scrapes and wounds are cleaned and covered. This also applies to bites. This is because breaching the skin barrier provides a portal of entry for the organism.

The HPT will require information about the number of cases and classes/year groups affected with dates their symptoms started and may provide written guidance and letters to send out to affected groups or contact you for further information.

Further information about scarlet fever
Scarlet fever - NHS.UK
Slapped cheek syndrome (parvovirus B19)

Slapped check syndrome (also called fifth disease or parvovirus B19) is common in children and should get better on its own. It is rarer in adults and can be more serious in individuals with immune deficiencies, some inherited blood disorders, and for unborn babies in the first 20 weeks.

The illness may only consist of a mild feverish illness which escapes notice but in others a rash appears after a few days.

The rose-red rash makes the cheeks appear bright red, hence the name 'slapped cheek syndrome'. The rash may spread to the rest of the body but unlike many other rashes it rarely involves the palms and soles.

The affected individual begins to feel better as the rash appears. The rash usually peaks after a week and then fades. The rash is unusual in that for some months afterwards, a warm bath, sunlight, heat or fever will trigger a recurrence of the bright red cheeks and the rash itself.

The virus can affect an unborn baby, particularly in the first 20 weeks of pregnancy.

Spread is by the respiratory route and a person is infectious 3 to 5 days before the appearance of the rash. Individuals are no longer infectious once the rash appears. There is no specific treatment.

Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.

Exclusion is not required.

Slapped cheek syndrome: what you need to do

You do not need to contact your HPT.

Anyone exposed to an affected individual early in pregnancy (before 20 weeks) should be advised to seek prompt advice from whoever is providing antenatal care.

If there are complications, advise individuals, parents or carers to seek advice from a general practitioner.

Further information about slapped cheek syndrome
Slapped cheek syndrome - NHS.UK
Syphilis

Syphilis is a STI caused by an organism called Treponema pallidum.

Syphilis can be transmitted from one person to another during unprotected sex (sex without a condom), or by contact with the ulcers of someone who has syphilis. It can also spread from an infected pregnant woman across the placenta to a developing baby, causing congenital syphilis.

If the symptoms of syphilis are not treated, the illness takes a progressive course.

There are 3 stages; primary, secondary and tertiary syphilis:

All stages of syphilis can be treated with antibiotics. All current and recent sexual partners of a person with syphilis should be tested and treated to prevent reinfection and the further spread of disease. Treatment is offered whether or not there are any signs of infection.

There is no vaccine available to reduce the risk of contracting syphilis.

People can't get syphilis from sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery.

Exclusion may be required.

Syphilis: what you need to do

Any sexual contacts of people who have syphilis should be advised to attend the local GUM clinic for screening.

Advise sexually active men and women that they can lower their risk of STIs by reducing their numbers of partners, reducing frequency of partner change, and by using condoms correctly and consistently during sexual intercourse.

Maintain confidentiality and do not divulge personal identifiable information to non-health professionals without permission from the individual.

Further information about syphilis
Syphilis - NHS.UK Syphilis - Sexwise
Threadworm

Threadworm infection is an intestinal infection and is very common in childhood. They are tiny worms in stools and can spread easily.

Worms may be seen in stools or around an individual's bottom. They look like pieces of white thread.

Symptoms include extreme itching around the anus or vagina, particularly at night. They can also cause individuals to be irritable and wake up during the night.

Pharmacies can advise on treatment.

Re-infection is common and infectious eggs are also spread to others directly on fingers or indirectly on bedding, clothing and environmental dust.

Regular hand washing, laundry and regular cleaning can help reduce the risk of infection and re-infection. Transmission is uncommon in education or childcare settings.

Exclusion is not required.

Threadworm: what you need to do

You do not need to contact the HPT for threadworm.

Encourage individuals, parents or carers to contact the pharmacy for treatment.

Encourage individuals to implement good hand hygiene practices.

Keep fingernails short.

Wash towels, flannels, sheets and sleepwear on a hot temperature. For more information, see safe management of linen and soft furnishings.

Further information about threadworm
Threadworms - NHS.UK
Tuberculosis (TB)

is a bacterial infection that can affect any part of the body, including the lungs.

People with TB might have all or some of the following symptoms: weight loss, fever, night sweats, prolonged cough, loss of appetite, fatigue, breathlessness, pains in the chest and lumps or swellings.

Exclusion is recommended for infectious TB only.

TB: what you need to do

Contact your UKHSA HPT, TB nurses, school nurse or health advisor if you are informed of a suspected case of TB and before taking any action.

Facilitate the HPT to carry out a risk assessment with the setting and follow their advice, for example regarding screening for other individuals.

Support individuals with infectious TB to return to their setting or normal activities after 2 weeks of effective antibiotic treatment prescribed by specialist TB services, and if they are well enough.

Further information about TB
Tuberculosis (TB) - NHS.UK Tuberculosis (TB) and children
Typhoid and paratyphoid fever

Typhoid and paratyphoid fever are uncommon but serious illnesses caused by typhoidal Salmonella bacteria that are related to the Salmonella that cause food poisoning. They are spread by consuming food or water contaminated by the faeces or urine of someone with the illness or someone without symptoms who may be excreting the organism. These infections are most commonly acquired abroad.

Symptoms of typhoid fever are fatigue, fever, general aches and pains, and constipation, whereas those of paratyphoid fever are fever, diarrhoea and vomiting. The severity of the illness varies - infection can be life-threatening with typhoid, but infected people may also not show any symptoms.

The incubation periods are typically (typhoid) 1 to 3 weeks and (paratyphoid) 1 to 10 days. Symptoms can last from anything from a few days (paratyphoid fever) to several weeks to months for typhoid fever.

Exclusion is recommended.

Typhoid and paratyphoid fever: what you need to do

Exclude the affected individual until 48 hours after the diarrhoea and vomiting symptoms have stopped.

For some groups (for example pre-school infants and food handlers), longer periods of exclusion may be required. For these groups, your UKHSA HPT will advise you if any action is required.

Encourage individuals to implement good hand hygiene practices

Clean kitchen and toilet areas regularly (for more details, see cleaning)

Further information about typhoid and paratyphoid fever
Typhoid fever - NHS.UK Typhoid and paratyphoid - Travel Health Pro
Whooping cough (pertussis)

Whooping cough (pertussis) is an acute bacterial infection caused by Bordetella pertussis.

The national immunisation schedule recommends that women between weeks 16 and 32 of their pregnancy should be immunised to maximise the likelihood that the baby will be protected from birth. Typically, pregnant women will receive their whooping cough vaccine around the time of their mid-pregnancy scan (usually 20 weeks).

Babies receive 3 doses of vaccination by their 16th week and an additional pre-school booster.

The early stages of whooping cough, which may last a week or so, can be very like a heavy cold with a temperature and persistent cough.

The cough becomes worse and usually, the characteristic 'whoop' develops. Coughing spasms are frequently worse at night and may be associated with vomiting. The cough may last several months.

The disease is usually more serious in children of pre-school age and especially young babies. Antibiotics rarely affect the course of the illness but may reduce the period the individual is infectious.

It is spread by breathing in infectious respiratory particles coughed out into the air by infected people or by the droplets landing on mucous membranes.

Exclusion is recommended.

Whooping cough: what you need to do

Exclude the infectious individual until they have had at least 48 hours of the appropriate antibiotic or until 14 days from the onset of coughing if no antibiotics have been taken and they feel well enough to return.

However, if the case is a member of staff who provides close, personal care to vulnerable babies meeting priority group definitions (see section 2.2.3 of the UKHSA national guidance) in a nursery or other childcare setting, they should be excluded for 21 days from the onset of coughing if they have not had at least 48 hours of the appropriate antibiotic.

Encourage parents or carers to have their child or young person immunised against whooping cough. The whooping cough vaccine is included in the national immunisation schedule.

Advise individuals, parents or carers to seek advice from their general practitioner.

Encourage individuals to implement good hand hygiene and respiratory hygiene practices.

Allow the individual to return to the setting after the exclusion periods outlined above even if they are still coughing.

Further information about whooping cough
Pertussis: national guidelines for public health management Whooping cough - NHS.UK

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Managing specific infectious diseases: A to Z

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Athlete's foot is an infection caused by a fungus which affects the skin on feet. The person affected may have scaling, peeling or cracking of the skin, especially between the toes and on soles of the feet, and it can sometimes be very itchy. They may also develop blisters.

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British Science Week 2025 : early years activity taster pack

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British Science Week 2025 : early years activity taster pack

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British Science Week 2024 : early years resource pack

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British Science Week 2024 : early years resource pack

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British Science Week 2023 : early years resource pack

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British Science Week 2023 : early years resource pack

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British Science Week 2022 : early years resource pack

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British Science Week 2022 : early years resource pack

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British Science Week 2021 : early years resource pack

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British Science Week 2021 : early years resource pack

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British Science Week 2020 : early years resource pack

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British Science Week 2020 : early years resource pack

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British Science Week 2019 : early years resource pack

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British Science Week 2019 : early years resource pack

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British Science Week 2018 : early years resource pack

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British Science Week 2018 : early years resource pack

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National Guidance for Child Protection in Scotland 2021 updated 2023

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National Guidance for Child Protection in Scotland 2021 updated 2023

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Children and Young People (Scotland) Act 2014

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Children and Young People (Scotland) Act 2014

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Legislation is available in different versions:

Latest Available (revised): The latest available updated version of the legislation incorporating changes made by subsequent legislation and applied by our editorial team. Changes we have not yet applied to the text, can be found in the 'Changes to Legislation' area.

Original (As Enacted or Made): The original version of the legislation as it stood when it was enacted or made. No changes have been applied to the text.

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Children and Young People (Scotland) Act 2014

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Latest Available (revised): The latest available updated version of the legislation incorporating changes made by subsequent legislation and applied by our editorial team. Changes we have not yet applied to the text, can be found in the 'Changes to Legislation' area.

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Legislation is available in different versions:

Latest Available (revised): The latest available updated version of the legislation incorporating changes made by subsequent legislation and applied by our editorial team. Changes we have not yet applied to the text, can be found in the 'Changes to Legislation' area.

Original (As Enacted or Made): The original version of the legislation as it stood when it was enacted or made. No changes have been applied to the text.

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An Act to reform the law of Scotland relating to children, to the adoption of children and to young persons who as children have been looked after by a local authority; to make new provision as respects the relationship between parent and child and guardian and child in the law of Scotland; to make…

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Child protection system for Scotland | NSPCC Learning

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Explains how the child protection system works in Scotland, outlining key legislation and guidance for anyone who works with children and families.

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Managing specific infectious diseases: A to Z

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Athlete’s foot is an infection caused by a fungus which affects the skin on feet.

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Education Scotland is a Scottish Government executive agency responsible for supporting quality and improvement in Scottish education.

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Learning for Sustainability (LfS) is about exploring local and global issues. It's about children, young people and communities taking action for a better future.

LfS connects people and the planet. It brings together sustainable development, outdoor learning and global citizenship. This provides relevant and inspiring contexts for learning across the curriculum.

Join us in exploring and celebrating the work of learners from across Scotland. Find things to inspire you and others, as we work together to improve our world now and in the future.

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Education Scotland is a Scottish Government executive agency responsible for supporting quality and improvement in Scottish education.

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The Primary One Literacy Assessment and Action Resource (POLAAR) is designed to support improvement by helping P1 teachers identify and assess children who are most at risk of developing later difficulties with reading and writing.

It is based on a staged intervention model of 'observe-action-observe' which helps identify the most effective intervention to take at classroom and child levels. In the following video, Dr Nancy Ferguson, depute principal psychologist, explains why the POLAAR resource has been created.

Video transcript: Word file: POLAAR Video 1 - Introduction

Explore the resource

Observing the literacy environment and taking action

Children's literacy abilities can only be accurately assessed when they have had appropriate literacy learning experiences. Observing the literacy environment and taking action is, therefore, a key component which should be addressed first.

Once areas for action in the class environment have been identified using the Early Literacy Environment Assessment, more accurate judgements about the child's own literacy development can then be made.
Word file: Early literacy environment assessment (99 KB) Word file: Early literacy environment assessment - GME version (55 KB)
Using the early literacy environment assessment

In the following video, Dr Nancy Ferguson, depute principal psychologist, and practitioners including Jill Cameron, head teacher of East Calder Primary, discuss how to use the Early Literacy Environment Assessment.

Video transcript: Word file: POLAAR Video 2 - Observing the literacy environment

Observing the child and taking action

Observing the child and taking action comes next. The Child Observational Assessment is designed to be used with individual children rather than with groups or whole classes.

It is in two parts: an observational schedule questionnaire, which is done with the child first, then a list of suitable actions and experiences which relate to each of the 20 questions of the observational schedule.

The observational schedule offers 20 questions to be answered on the basis of teacher judgement which are highly predictive of children's future literacy abilities. Each can be scored on a four point scale of independence.

As children require less adult support and move towards greater independence, the scale provides a good index of their current literacy skills. Of course, children will normally only approach full independence across all 20 items towards the end of P1.

For each of the 20 questions, associated actions to improve each skill are suggested in the Child Observational Assessment with Actions section of the resource. Look at the question(s) you are interested in to see the suggested actions which relate to it/them.

It is advised that the P1 teacher initially uses this assessment with any pupils whom they consider to be struggling with early literacy development fairly early on in Primary 1.
Word file: Child observational assessment (79 KB) Word file: Child observational assessment - GME version (117 KB) Word file: Child observational assessment with actions (89 KB) Word file: Child observational assessment with actions - GME version (49 KB)
Performing an observational assessment

In the following video, Dr Nancy Ferguson, depute principal psychologist, and Carol-Ann Campbell, class teacher at Holytown Primary, discuss how to use the Child observational assessment. Jill Cairns, class teacher at East Calder Primary School, then demonstrates an example of an intervention that can be used to support pupils.

Video transcript: Word file: POLAAR Video 3 - Child observational assessment

Three-minute teacher assessment

Over time, your actions should have an effect. You may wish to complete the Child Observational Assessment checklist a second time to demonstrate progress. If your action is not working, you may wish to change the action or focus on a different literacy skill from the checklist.

Alternatively, you might decide to do a more detailed assessment using the three-minute teacher assessment, below. This provides three measures to take for each of the three areas most predictive of future literacy development according to the Literature Summary research. This will take around 10 minutes with one child.
PDF file: Three-minute teacher assessments (293 KB) PDF file: Three minute teacher assessments - Gaelic version (147 KB)
Using the three-minute teacher assessment

In the following video, Dr Nancy Ferguson, depute principal psychologist, and Lynne Brennan, head teacher at Holytown Primary, discuss how to use the Three-minute teacher assessment. Head teachers then give their endorsement of the POLAAR resource.

Video transcript: Word file: POLAAR Video 4 - Three-minute assessment

Further detailed assessment

In a further three months, you might want to undertake a more detailed assessment of a child's strengths and areas for development using a computer-assisted assessment. These generally take more time, so you may wish for a classroom assistant to sit with the child during the assessment. Various commercially-produced, computer-assisted assessments are available which administer, score and report the assessment.

Computer-assisted assessments are of two kinds: attainment and diagnostic. Attainment assessments tell you the level the child is at. Diagnostic tests try to give you some idea of why the child might be struggling with certain aspects of their literacy development e.g. reading.

For further information on computer-assisted assessments, see the summary of research findings in the related links section.

About the authors

This resource was created within Education Scotland's literacy team.

Downloads
Zip file: Polaar Resources (4 MB)
POLAAR for Gaelic Medium Education

Education Scotland has worked in partnership with Argyll and Bute Council on the adaptation of these POLAAR resources. The materials support children's learning and development through total immersion. In the zipped folder, practitioners will find guidance documents and assessment items, along with pedagogy, to promote total immersion and fluency.
Zip file: Polaar Resources for Gaelic Medium Education (23 MB)
The project received support funding from Bòrd na Gàidhlig. Fhuair am pròiseact taic maoineachaidh bho Bhòrd na Gàidhlig.

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Primary One Literacy Assessment and Action Resource (POLAAR)

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Education Scotland is a Scottish Government executive agency responsible for supporting quality and improvement in Scottish education.

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Out to Play - Caring for our Outdoor Spaces

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Out to Play - Caring for our Outdoor Spaces

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Out to Play - Caring for our Outdoor Spaces

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Out to Play - Caring for our Outdoor Spaces

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Management of Medication in Daycare of Children and Childminding Services - Old Version

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Management of Medication in Daycare of Children and Childminding Services - Old Version

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The Handling of Medicines in Social Care Settings

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The Handling of Medicines in Social Care Settings

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Royal Pharmaceutical Society

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Clothing

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Good info on hand washing

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Some really good things to think about regarding food outdoors and how to use it to promote wellbeing and inclusion.

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Taking Literacy Outdoors with your Child

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Taking Literacy Outdoors with your Child

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Taking Literacy Outdoors with your Child

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Taking Literacy Outdoors with your Child

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Updated Sept 2024

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Updated Sept 2024

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Updated Sept 2024

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National Early Language and Communication Project

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National Early Language and Communication Project

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National Early Language and Communication (NELC) Project

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We are excited to share with you an amazing array of early SLC practice sharing storyboards from across Scotland.

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National Early Language and Communication Project

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National Early Language and Communication Project

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National Early Language and Communication (NELC) Project

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We are excited to share with you an amazing array of early SLC practice sharing storyboards from across Scotland.

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CPL is necessary for the development of everyone who works in social work, social care and the children and young people workforce. CPL supports a workforce that is capable of designing, delivering, evaluating and improving high quality care and service.

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CPL is necessary for the development of everyone who works in social work, social care and the children and young people workforce. CPL supports a workforce that is capable of designing, delivering, evaluating and improving high quality care and service.

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Promoting & Developing Race Equality and Anti-Racist Education

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Promoting & Developing Race Equality and Anti-Racist Education

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Show Racism the Red Card's Match Actions Campaign is back again in 2023, with clubs across Scottish football showing their commitment to anti-racism over one weekend - Friday 20th, Saturday 21st and Sunday 22nd October

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Connecting with your childcare setting - a guide for families

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Connecting with your childcare setting - a guide for families

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Connecting with your childcare setting - a guide for families

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Connecting with your childcare setting - a guide for families