Due to a combination of high levels of immunity secondary to vaccines and infections, as well as the milder nature of the current dominant variant, the risk of serious illness due to Covid-19 is now far lower.
In response to this, and as part of adapting to living with Covid-19, the government and UKHSA have ended the national Covid-19 testing programme as of 31 March 2022. Asymptomatic staff testing in the NHS has been paused as of 31 August 2022.
The end of the national Covid-19 testing programme means most people will no longer be able to access free Covid-19 tests. Staff should therefore manage patients with suspected Covid-19 in the same way that all patients with viral symptoms are managed.
Patients who are eligible for Covid-19 therapies have access to lateral flow devices (LFDs) to use if they develop symptoms, direct from UKHSA or via 119.
Patients presenting with viral symptoms might have Covid-19, the flu, or another respiratory virus. Staff should manage these patients in the same way they have always managed people with viral illnesses. Patients should be assessed using appropriate IPC measures (if clinically needed). Based on these assessments, you should then advise on supportive management at home, treat as per symptoms, or escalate to secondary care.
Public health advice on attending school or work is that people should stay at home if febrile or feeling too unwell to go. If at work or school with viral symptoms, people are advised to ‘catch it, kill it, bin it’, wear face coverings, keep spaces well ventilated and wash hands frequently.
Where people have used an LFD and it is positive, the guidance recommends that they should isolate for five days (or three days if under 18 years old).
There are groups of people in the community who will continue to have access to testing:
- High-risk patients who have been identified for Covid-19 nMAB/antiviral treatments will receive LFDs from UKHSA. Where these patients are known to primary care but not the national system and present with symptoms, you can advise they access tests via 119 or the national portal.
- NHS patients in community or primary care requiring a test to support clinical decisions during their care should be offered an LFD ordered via the government portal.
- Staff testing in primary care:
- Symptomatic staff are advised to test using LFDs as soon as they develop symptoms.
- If LFD positive, they should isolate and repeat LFD tests on days five and six. They can return to work if they are afebrile, feel well enough, and have two negative tests, or if they are well and it is after day ten.
- If a staff member tests LFD negative, is afebrile and feeling well enough they can return to work. A risk assessment is advised if they are likely to be caring for immunocompromised patients.
- Household contacts can now return to work if their LFD result is negative, and they are asymptomatic.
- Asymptomatic testing with LFDs bi-weekly for all patient-facing staff has been paused due to current low prevalence.
- UKHSA may re-instate asymptomatic staff testing if prevalence starts to increase.
- Tests can be accessed from the government portal where results should also be logged. This will be reviewed by UKHSA based on prevalence levels.
