COVID-19 Updated Government/NHS guidance on testing

The key points are:

• Routine asymptomatic testing of patient facing healthcare staff continues: they should test twice a week, and report results on the Gov.UK portal.
• Staff who have symptoms of a respiratory infection and have a high temperature or do not feel well enough to go to work, are advised to stay at home and avoid contact with other people, and follow the guidance here (https://www.gov.uk/guidance/people-with-symptoms- of-a-respiratory-infection-including-covid-19)). In summary staff with symptoms should:

• work at home if possible (if this is not possible, should discuss their options with their employer)
• avoid meeting people at risk of becoming seriously unwell from COVID-19 especially those whose immune system means they are at higher risk of serious illness despite vaccination.

• Patient-facing healthcare staff who have symptoms of a respiratory infection, and who have a high temperature or do not feel well enough to attend work, should take a lateral flow test as soon as they feel unwell. They should follow the guidance below if the test is positive.
• If the lateral flow test result is negative, they can attend work if they are clinically well enough to do so and they do not have a high temperature unless they work with patients whose immune system means that they are at higher risk of serious illness despite vaccination (https://www.gov.uk/government/publications/covid-19-guidance-for-people-whose-immune- system-means-they-are-at-higher-risk). In that case, they should discuss this with their line manager who should undertake a risk assessment.
• If the staff member is still displaying respiratory symptoms when they return to work, they should also speak to their line manager who should undertake a risk assessment.
• All patient-facing healthcare staff should resume routine asymptomatic lateral flow testing when they return to work, taking the first of these tests 48 hours after the lateral flow test that was positive.
• Staff must continue to comply rigorously with all relevant infection control precautions (https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection- prevention-and-control) and PPE must be worn properly throughout the day.
• Staff who have a positive COVID-19 test result, regardless of whether they have symptoms, are advised not to attend work for 5 days.
• Patient-facing healthcare staff can return to work after a positive COVID-19 test when they have had two consecutive negative LFD test results (taken at least 24 hours apart). The first lateral flow test should only be taken 5 days after the day symptoms started. They may return to work immediately after the second negative lateral flow test result provided they meet the following criteria: 
  • they feel well enough to work, and they do not have a high temperature.
  • if they work with patients whose immune system means that they are at higher risk of serious illness despite vaccination (https://www.gov.uk/government/publications/covid-19- guidance-for-people-whose-immune-system-means-they-are-at-higher-risk), a risk assessment should be undertaken, and consideration should be given to redeployment until 10 days after their symptoms started (or the day their first positive test was taken if they did not have symptoms)
  • they must continue to comply rigorously with all relevant infection control precautions and PPE must be worn properly throughout the day.

• If the staff member’s lateral flow test result is positive on the 10th day, they should discuss this with their line manager who may undertake a risk assessment.
• Healthcare staff who are contacts of a confirmed case of COVID-19 should continue twice weekly asymptomatic lateral flow testing. Where they are a household or overnight contact of someone who has had a positive test they should discuss ways to minimise risk of onwards transmission with their line manager which may include:
• • redeployment to lower risk areas for patient-facing healthcare staff, especially if the member of staff works with patients whose immune system means that they are at higher risk of serious illness despite vaccination (https://www.gov.uk/government/publications/covid-19-guidance-for-people-whose- immune-system-means-they-are-at-higher-risk)
  • working from home for non patient-facing healthcare staff limiting close contact with other people especially in crowded, enclosed or poorly ventilated spaces

• While they are attending work, staff must continue to comply rigorously with all relevant infection control precautions (https://www.gov.uk/government/publications/wuhan- novel-coronavirus-infection-prevention-and-control).
• If staff develop any symptoms within a 10 day period of being a close contact they should follow the advice above for staff members with symptoms.

On 30 March 2022 NHS England and NHS Improvement also issued their updated guidance which can be found here.

What does this mean for employers?

Managing staff absence levels due to COVID-19 and the impact this has on service delivery remains a significant challenge for healthcare providers, against the backdrop of the pressing need to tackle the care backlog. The new Guidance endeavours to address the particular challenges of COVID-19 in the health and social care environment.

We knew from the Government’s Living with COVID-19 strategy that, at this stage of the pandemic, the onus would move onto employers and individuals to manage the risk of COVID-19 transmission rather than requiring compliance with emergency legislation brought into deal with the pandemic. 1 April was the backstop date for this shift, and NHS organisations now need to ensure their managers and staff are complying with the current guidance.

For the time being at least, testing continues to play a central role in both the health and social care sectors, along with the rigorous application of infection control measures in the workplace. The Government’s updated guidance (https://www.gov.uk/guidance/reducing-the- spread-of-respiratory-infections-including-covid-19-in-the-workplace) for all employers (Reducing the spread of respiratory infections, including COVID-19, in the workplace) confirms that employers are no longer required to explicitly consider COVID-19 in their statutory health and safety risk assessments. However, our view is that it remains important to ensure statutory health and safety risk assessments are reviewed and refreshed given the general duty to provide employees with a reasonably safe place of work. Employers will also need to carry out individual risk assessments in the circumstances detailed above, as well as for those employees who are immune-suppressed. The pre-pandemic requirement for pregnant employees to have a specific risk assessment also remains in place.

The Government’s updated general guidance also makes it clear that employers should continue to encourage employees to vaccinate themselves against COVID-19. This applies in the NHS notwithstanding the revocation of the requirement for mandatory vaccination as a condition of deployment in the NHS.