Download our free Guidance on Shielding and Protecting People Who Are Clinically Extremely Vulnerable from COVID-19 here:
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A) What has changed from 1 June 2020?
- People who are shielding remain vulnerable and should continue to take precautions but can now leave their home if they wish, but only if they are able to maintain strict social distancing – at least 2m
- If they choose to spend time outdoors, this can be with members of their own household
- If they live alone, they can spend time outdoors with one person from another household – ideally, this should be the same person each time
- They should keep visits outside to a minimum (for instance once per day)
- Any essential carers or visitors who support someone with everyday needs can continue to visit unless they have any of the symptoms of COVID-19
B) Other people in the household
If they live with others the rest of the household does not need to shield themselves, but they should do what they can to support the shielding person and carefully follow guidance on staying alert and safe (social distancing), such as:
- minimise the time spent with the shielded person in shared spaces such as kitchens, bathrooms and sitting areas, and keep shared spaces well ventilated
- keep 2 metres (3 steps) away from the shielded person
- use a separate toilet and bathroom if possible, or clean surfaces every time after use
- avoid sharing the kitchen and dining areas with the shielded person, ensuring crockery and cutlery is cleaned separately and use a separate tea towel for drying
- Everyone in the household should continue to regularly wash their hands with soap and water for 20 seconds, avoid touching their face and clean frequently touched surfaces
- The shielding person and the rest of the family or household should try to follow this advice as far as they are able. There is no need for other members of the household to follow the shielding measures themselves
C) Symptoms
If anyone develops any of the symptoms of COVID-19, (a new continuous cough, a high temperature, or a loss of, or change in, your normal sense of taste or smell), they must self-isolate at home and arrange to have a test to see if they have COVID-19.
D) Further guidance
The full guidance can be found here.
E) GOV.UK NHS Test and Trace: Workplace Guidance
The government issued guidance on 27 May 2020 on the NHS test and trace service for employers, businesses and workers. The guidance should be used in conjunction with Working safely during coronavirus (COVID-19). The aim is for employers to reduce the risk of co-workers having to self-isolate if a member of staff tests positive for COVID-19.
F) The role of employers
Employers must make their workplaces as safe as possible and encourage workers to heed any notifications to self-isolate and supporting them when in isolation, however disruptive that might be. Employers must continue to protect the health and safety both of their workers and of other people who may be affected by their business, for example agency workers, contractors, volunteers, customers, suppliers and other visitors, and guidance has been developed on the 5 steps for working safely, along with sector-specific guidance.
Employers must continue to follow health and safety workplace guidance for their sector such as:
- making every reasonable effort to enable working from home as a first option
- where working from home isn’t possible, identifying sensible measures to control the risks in the workplace
- keeping the workplace clean, maintaining safe working separation, and preventing transmission through unnecessary touching of potentially contaminated surfaces
The measures employers put in place to maintain social distancing will depend on their individual business circumstances, including their working environment, the size of the site and the number of workers. The guidance will support employers to make an informed decision. The NHS test and trace service does not change the existing guidance about working from home wherever possible.
G) Workplace risk
COVID-19 is a new risk that must be incorporated into workplace risk assessments. Employers must therefore carry out a new COVID-19 risk assessment if they have not already done so. QCS has a Risk Assessment for Staff (including Vulnerable Groups during COVID-19).
The NHS test and trace service supplements the risk mitigation measures taken by employers by identifying people who have had close recent contact with someone who has tested positive for coronavirus and advising them to self-isolate.
H) Supporting employers with a workplace outbreak
If multiple cases of coronavirus appear in a workplace, an outbreak control team from either the local authority or Public Health England will, if necessary, be assigned to help the employer manage the outbreak. Employers should seek advice from their local authority in the first instance.
I) Supporting employees who need to self isolate
Employers should support workers who need to self-isolate and must not ask them to attend the workplace.
Workers will be told to isolate because they:
- have coronavirus symptoms and are awaiting a test result
- have tested positive for coronavirus
- are a member of the same household as someone who has symptoms or has tested positive for coronavirus
- have been in close recent contact with someone who has tested positive and received a notification to self-isolate from NHS test and trace.
Employers should continue to communicate with workers in self-isolation and provide support. This includes allowing people to work from home if they remain well and if it is practicable to do so. This might include finding alternative work that can be completed at home during the period of self-isolation.
Employees in self-isolation are entitled to Statutory Sick Pay (currently £95.85 per week by employers for up to 28 weeks per period of sickness) for every day they are in isolation, as long as they meet the eligibility conditions. The NHS test and trace service will provide a notification that can be used as evidence that someone has been told to self-isolate.
If people can’t work from home, employers must ensure any self-isolating employee is receiving sick pay and give them the option to use their paid leave days if they prefer. An employee can ask to take their paid holiday for the time they’re off work, entitling them to full pay for the duration of their leave, as opposed to Statutory Sick Pay, if they choose.
J) Contact tracing: contact with co-workers
The NHS test and trace service will follow up with people who need to self-isolate because they have had close recent contact with someone, who might be a colleague, who has tested positive for coronavirus. It will do this through:
- dedicated contact tracing staff
- local public health experts
- online services
- the new NHS COVID-19 app, which will be rolled out nationally after the trial period in the Isle of Wight
When someone first develops symptoms and orders a test, they will be encouraged to alert the people that they have had close contact with in the 48 hours before symptom onset. If any of those close contacts are co-workers, the person who has developed symptoms may wish to (but is not obliged to) ask their employer to alert those co-workers. At this stage, those close contacts should not self-isolate, but they:
- must avoid individuals who are at high-risk of contracting COVID-19, for example, because they have pre-existing medical conditions, such as respiratory issues
- must take extra care in practising social distancing and good hygiene and in watching out for symptoms
- will be better prepared if the person who has symptoms has a positive test result and if they (the contact) receive a notification from the NHS test and trace service explaining they need to self-isolate
If the person who has symptoms has a positive test result for COVID-19, the NHS test and trace service will ask them to share information about their close recent contacts.
If they work in – or have recently visited or attended – one of the following settings, the contact tracing process will be escalated to local public health experts, who will liaise as necessary with the manager of the relevant setting:
- a health or care setting, for instance a hospital or care home
- a prison or other secure establishment
- a school for children with special needs
- any setting where there is a risk of a local outbreak
In other cases, any non-household contacts who need to self-isolate will be contacted by the NHS test and trace service. They will receive a formal notification (either a phone call, letter, email or text message) setting out how long they need to self-isolate for.
Workers can use this notification to inform their employer that they have been told to self-isolate. Employers will need this evidence if they are going to claim a rebate for Statutory Sick Pay.
The period of self-isolation will be for 14 days from the point of most recent contact with the person who has tested positive for coronavirus.
K) Guidance for employees
Workers who are self-isolating because they have symptoms of coronavirus or live with someone who has symptoms of coronavirus, can get an isolation note through NHS111 online.
Workers who are told to self-isolate should share the evidence provided by NHS test and trace to show that they have been told to self-isolate and explain to their employer that this means that they cannot come to work.
Workers who are already unable to work and have a ‘fit note’ which says they are not fit for work covering the period for which they have been told to self-isolate, must follow the public health advice they have been given.
Workers must self-isolate whenever they receive a notification from the NHS test and trace service asking them to do so. If this happens on multiple occasions, they should consider how you can better follow social distancing requirements.
Workers who think the contacts that have triggered these notifications are workplace contacts, should ask their employer to consider what further mitigating actions could be taken to reduce the risk of COVID-19, such as using screens to separate people or ‘cohorting’ to reduce the number of people each person has contact with.
Agency workers or workers on zero hours contract who have been told to self-isolate must work from home, unless it is impossible for them to do so. If they are unable to work from home, they may be eligible for Statutory Sick Pay or Universal Credit while self-isolating in line with government guidance.
L) Further guidance
The full guidance can be found here.
Part II: GOV.UK COVID-19: Management of Staff and Exposed Patients or Residents in Health and Social Care Settings
The government has issued an update on 31 May 2020 in light of test and trace guidance, addition of guidance on risk assessment of staff in the event of PPE breaches, and re-organisation with the addition of “Additional considerations”.
A) Staff with symptoms of COVID-19
If a health or social care worker develops symptoms of COVID-19:
- they should follow the stay at home guidance
- while at home (off-duty), they should not attend work and notify their line manager immediately
- while at work, they should put on a surgical face mask immediately, inform their line manager and return home
- comply with all requests for testing
If a member of staff develops symptoms, they should be tested for SARS-CoV-2 (COVID-19). Testing is most sensitive within 3 days of symptoms developing. If their symptoms do not get better after 7 days, or their condition gets worse, they should speak to the local occupational health department (if they have one) or use the NHS 111 online coronavirus service. Staff who have previously tested positive should still self-isolate and be tested again if they become symptomatic.
B) Staff return to work criteria
If staff are symptomatic when tested:
- Staff who test negative for SARS-CoV-2 (COVID-19) can return to work when they are medically fit to do so, following discussion with their line manager and appropriate local risk assessment
- Symptomatic staff who test positive for SARS-CoV-2 (COVID-19) or who have an inconclusive test result, and symptomatic staff who have not had a test, can return to work:
- no earlier than 7 days from symptom onset, provided clinical improvement has occurred and they have been afebrile (not feverish) without medication for 48 hours and they are medically fit to return
- if a cough or a loss of or a change in normal sense of smell (anosmia) or taste is the only persistent symptom after 7 days (and they have been afebrile for 48 hours without medication), they can return to work if they are medically fit to return (these symptoms are known to persist for several weeks in some cases)
- All members of a household shared with the individual should self-isolate for 14 days from the day the individual’s symptoms started. However, if any household member develops symptoms of COVID 19, they should isolate for at least 7 days from the onset of their symptoms, in line with the stay at home guidance.
If staff are asymptomatic when tested:
- Staff without symptoms may also be tested where there is a clinical need to do so
- Staff who test negative for SARS-CoV-2 (COVID-19) and who were asymptomatic at the time of the test can remain at work or return to work immediately as long as they remain asymptomatic if they were tested as part of routine testing
- Staff who test positive for SARS-CoV-2 (COVID-19) and who were asymptomatic at the time of the test must self-isolate for 7 days from the date of the test. If they remain well, they can return to work on day 8
- If, during the 7 days isolation, they develop symptoms, they must self-isolate for 7 days from the day of symptom onset
- All members of a household shared with the individual should self-isolate for 14 days from the day the individual’s test was taken. However, if any household member develops symptoms of COVID-19, they should isolate for at least 7 days from the onset of their symptoms, in line with the stay at home guidance
C) If staff have been notified that they are a contact of a confirmed case in the community
If they are a contact of a confirmed case of COVID-19 in the community (outside the health or social care setting or their place of work) they should inform their line manager and self-isolate for 14 days, in line with the Test and Trace guidance.
D) Risk assessment for staff exposures
If a health or care worker, has come into close contact with a confirmed COVID-19 patient, resident or service-user or a symptomatic patient, resident or service-user suspected of having COVID-19, while not wearing PPE, or had a breach in their PPE while providing personal care to a patient, resident or service-user with confirmed or suspected COVID-19, then the staff member should inform their line manager.
A risk assessment should be undertaken in conjunction with local infection prevention and control (IPC) policy.
The following factors should be taken into consideration:
- the severity of symptoms the other person (e.g. resident or patient) has
- the length of exposure
- the proximity of the other person
- the activities that took place when the worker was in proximity (such as aerosol-generating procedures (AGPs), monitoring, personal care)
- whether the health or social care worker had their eyes, nose or mouth exposed
If the risk assessment concludes there has been a significant breach or close contact without PPE, the worker should remain off work for 14 days
E) Resident exposures in care settings
Residents who are known to have been exposed to a confirmed COVID-19 patient (an exposure similar to a household setting), should be isolated or cohorted only with residents who do not have COVID-19 symptoms but also have been exposed to COVID-19 residents, until 14 days after last exposure.
If symptoms or signs consistent with COVID-19 occur in the 14 days after last exposure then relevant diagnostic tests, including for SARS-CoV-2 (COVID-19), should be performed. If they have been cohorted with other individuals, the other residents’ follow-up period recommences from the date of last exposure.
F) Additional considerations
Currently it is not known how long any immunity to COVID-19 might last. If staff become unwell again, they should self-isolate and may need to be tested again.
G) Further guidance
The full guidance can be found here.