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31st March 2022

Self-isolation for health and social care workers

Michelle Rob, Employment Paralegal at Napthens unpicks the guidance on self-isolation for care workers.

As part of the ‘Living with COVID-19’ guidance, the Government announced that the ‘Stay at home’ guidance would be withdrawn, meaning the legal requirement to self-isolate following a positive test would be removed for the general public. Instead, the legal requirement to self-isolate was replaced with public health guidance stating that people with any of the main symptoms of COVID-19 or a positive test result should stay at home and avoid contact with other people.

The government announced however, that there would be specific guidance published for staff in particularly vulnerable services, such as health and social care . The Covid-19: Management of Staff and Exposed Patients or Residents in Health and Social Care Settings guidance confirmed that due to the higher risk nature of health and social care settings, the advice for staff members working in these settings has not changed.

Therefore, the guidance remains for Health and Social Care workers who develop one of the main symptoms of COVID-19, i.e., a new continuous cough, a high temperature or a loss of or change in their normal sense of taste and smell, should stay at home and arrange to have a PCR test. They should not attend work while awaiting their PCR test result and should notify their employer immediately.

The guidance acknowledges that there are several other symptoms which are linked with COVID-19 but may have another cause and therefore recommends that if a member of staff is concerned about their symptoms, they should seek medical advice.

What happens if you have a positive COVID test?

 The guidance in terms of a member of staff receiving a positive Lateral Flow Test (‘LFT’) or PCR test remains that they should stay at home and avoid contact with other people. It also reiterates that there is no requirement to take a confirmatory PCR test after receiving a positive LFT test result.

In terms of attending work, Health and Social Care staff should not go to work until they have had 2 consecutive negative LFT results (taken at least 24 hours apart), they feel well, and they do not have a high temperature. The guidance confirms that the first test should only be taken from 5 days after the day of their symptoms started (or the day their test was taken if they did not have symptoms). This requirement recognises that while lifting self-isolation could have helped ease the severe staffing crisis in the sector, health and social care workers have a duty to keep residents safe.

The guidance confirms that once a member of staff has received two negative tests, they may return to work immediately after the second negative result, provided they meet the criteria below:

  • The staff member’s symptoms have resolved, or their only symptoms are cough or anosmia (which can last for several weeks)
  • If the staff member works with patients or residents who are especially vulnerable to COVID-19 (as determined by the organisation), a risk assessment should be undertaken, and consideration should be given to redeployment until 10 days after their symptoms started (or the day their test was taken if they did not have symptoms)
  • The staff member should continue to undertake daily LFT tests until 10 days after their symptoms started (or the day their test was taken if they did not have symptoms).
  • If any of these LFT test results are positive the staff member should isolate and should wait 24 hours before taking the next LFT test
  • On days the staff member is working, the LFT test should be taken prior to beginning their shift, as close as possible to the start time
  • The staff member must continue to comply with all relevant infection control precautions and personal protective equipment (PPE) must be worn properly throughout the day

The guidance also states that if an inconclusive PCR test is received, staff should not attend work and should arrange another PCR test.

The guidance is clear that if a staff member is providing care or is in close contact with and individual with COVID-19 and is wearing the correct PPE in accordance with the UK infection prevention and control guidance, they will not be considered as a contact for the purposes of isolation. This applies regardless of the vaccination status of the staff member. If a member of staff is a contact of a confirmed COVID-19 case, should inform their line manager or employer immediately if they are required to work in the 10 days following their last contact with the case. The majority of health and social care staff who are contacts will be able to continue in their usual role, however there are further considerations which must be taken into account before they return to work.

Will free LFTs remain for care staff?

In terms of testing, the Living with COVID-19 guidance confirms that free tests will be scrapped for most people from 1 April 2022 onwards, however, free symptomatic testing will continue to be provided for people working in some high-risk settings such as staff in adult social care services. Asymptomatic lateral testing will continue in some high-risk settings where infection can spread rapidly while occurrence is high. This includes patient-facing staff in the NHS and NHS commissioned Independent Healthcare Providers, staff in hospices and adult social care services. In addition, testing will be provided for residential SEND and care home staff during an outbreak.

Will visitors to care homes need to take a COVID test?

Most visitors to adult social care settings, and visitors to the NHS will no longer be required to take a test. Further guidance on what people should do when visiting social care settings will be published by 1 April.

Further changes to the adult social care sector include:

  • From 1 April, those working in adult social care services will also continue to receive free personal protective equipment (PPE). Priority vaccinations and boosters for residents and staff will continue
  • Updated hospital discharge guidance is expected to be published setting out how all in health and social care will work together to ensure smooth discharges from hospital and people receive the right care at the right time in the right place
  • Designated settings will be removed. These were initially set up to provide a period of isolation to COVID-19 positive patients before they move into care homes and before routine point of care testing for COVID-19 was available. Restrictions on staff movement will also be removed
  • Outbreak management periods in care homes, which can include visiting restrictions, have been reduced from 14 to 10 days
  • People aged 75 and over, residents in care homes for elderly adults and those who are immunosuppressed are now eligible to receive a spring booster jab to top up their immunity to COVID-19

In terms of Infection Prevention Control requirements, streamlined guidance on measures will be published to set out principles on good practice, and support consistency across the adult social care sector. This will include details on future measures for COVID-19 and other respiratory viruses to ensure providers have the latest information on best practice which will include information on admissions, visiting and PPE.

In terms of pay, NHS organisations and their subcontractors are expected to ensure that any member of staff, including bank and sub-contractor staff, who have to be physically present at an NHS facility to carry out their duties, receives full pay for any period in which they cannot attend work as a result of public health advice.

The stringent criteria for staff in the health and social care sector is reflective of the fact that it is such a high risk setting and it would therefore not be safe to remove the requirement to self-isolate as well as other restrictions yet and the priority must be ensuring the safety of staff and patients.

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

Napthens LLP

Employment Law Specialists

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