We want to inform you of planned updates to the Transmission Based Precautions (TBPs) guidance within the National Infection Prevention and Control Manual (NIPCM), which will come into effect on 3 August 2026.

TBPs remains an essential component of infection prevention and control, helping to protect social care workers, residents/people supported, visitors and the wider healthcare environment from the transmission of infection.

The updated guidance introduces changes to both the terminology used to describe transmission routes and the approach to selecting masks (either Fluid Resistant Surgical Masks or Respiratory Protective Equipment) when caring for individuals with suspected or confirmed respiratory infection.

What is changing?

Historically, transmission routes have been described as:

contact
droplet
airborne.

From August 2026, transmission routes will instead be described as:

contact transmission
air transmission.

This revised approach is intended to provide greater clarity and support health and social care workers in applying risk-based precautions consistently, appropriately and in line with the evidence base.

In addition, Aerosol Generating Procedures (AGPs) will no longer be referred to within the guidance.

Introduction of respiratory categories

The updated guidance will also introduce respiratory categories (R1, R2, R3) which help form the basis of a risk assessment to support health and social care workers in selecting the most appropriate mask or respiratory protective equipment (RPE) when delivering care to individuals with suspected or confirmed respiratory pathogens.

This change takes account of many factors which impact transmission including the severity of outcome.

Face fit testing reminder

Health and social care workers and providers are reminded that staff must undergo a successful face fit test before wearing any tight-fitting respiratory protective equipment (RPE). Each time RPE is donned, a fit check must be performed.

Providers should ensure appropriate local arrangements are in place to support compliance with face fit testing requirements ahead of implementation.

What to expect

Accompanying the launch of updated guidance, a range of supporting materials will also be published including:

a new mask selection algorithm
a “what’s changed” guide
frequently asked questions (FAQs)
posters
webinars (dates to be confirmed).

Additional information and advice can also be obtained through your local Infection Prevention and Control Team, Public Health team and the Care Inspectorate.

Thank you for your continued support in maintaining safe and effective infection prevention and control practices.