New COVID-19 testing guidance published

April 1, 2022

New guidance outlining free COVID-19 tests for specific groups, including care home residents and staff was published this week.

However, free testing for the general public ends from today (1st April) as part of the Living with COVID plan which last month set out the Government’s strategy to live with and manage the virus.

Under the plans set out today free symptomatic testing will be provided for:

  • Patients in hospital, where a PCR test is required for their care and to provide access to treatments and to support ongoing clinical surveillance for new variants.
  • People who are eligible for community COVID-19 treatments because they are at higher risk of getting seriously ill from COVID-19. People in this group will be contacted directly and sent lateral flow tests to keep at home for use if they have symptoms as well as being told how to reorder tests.
  • People living or working in some high-risk settings. For example, staff in adult social care services such as homecare organisations and care homes, and residents in care homes and extra care and supported living services, NHS workers and those working and living in hospices, and prisons and places of detention (including immigration removal centres), where infection needs to be identified quickly to minimise outbreaks. People will also be tested before being discharged from hospital into care homes and hospices.

Asymptomatic lateral flow testing will continue from April in some high-risk settings where infection can spread rapidly while prevalence is high.

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

Changing social care guidance

A number of changes and new guidance is also being confirmed today for adult social care including:

  • 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 also continue.
  • Updated hospital discharge guidance will be published setting out how all involved 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.
  • Streamlined guidance on infection and prevention control measures will be published to set out long-standing 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.
  • Updated guidance for adult social care providers and staff to set out the current testing regime across adult social care.
  • 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. Around five million people will be eligible for a spring booster around six months after their previous dose, and the NHS has contacted over 600,000 people inviting them to book an appointment. Anyone who has not yet had a COVID-19 jab continues to be encouraged to take up the ‘evergreen’ offer.

Although COVID-19 infections and hospitalisations have risen in recent weeks, the Government said over 55% of those in hospital that have tested positive are not there with COVID-19 as their primary diagnosis.

The Government’s reasoning behind the change in guidance is that free universal testing has come at a significant cost to the taxpayer, with the testing, tracing and isolation budget costing over £15.7bn in 2021 to 2022 – something that the Government says was necessary due to the severe risk posed by COVID-19 when the population did not have a high level of protection.

From today, anyone with a positive COVID-19 test result will be advised to try to stay at home and avoid contact with other people for five days, which is when they are most infectious.

Advice will be provided for individuals who need to leave their home when they have symptoms or have tested positive, including avoiding close contact with people with a weakened immune system, wearing a face covering and avoiding crowded places.

Unpaid carers

Commenting on the Government’s next steps for living with COVID-19, including eligibility for access to free COVID testing, as set out in a written ministerial statement by the Secretary of State for Health and Social Care, Helen Walker, Chief Executive of Carers UK said, ‘Carers UK is deeply disappointed that tests will not be made free of charge to unpaid carers whether they are symptomatic or not.

‘Having borne the brunt of the pandemic and gone to extraordinary lengths to protect their relatives, unpaid carers are now being asked to pay in order to protect those they care for who are at risk of COVID.  This is a short-sighted move, that will make little sense to unpaid carers.’

Carers UK raised this issue many times with the Government, with the UKHSA and with Parliamentarians and is now asking the Government to reconsider for unpaid carers.

Care homes

Saint Cecilia’s Care Group says it is happy to allow visitors into its nursing home and three care homes but wants to protect its residents and staff too.

Managing Director Mike Padgham said, ‘We believe, with infection rates for COVID-19 soaring, that the Government might have been a little premature in relaxing so many of the rules. From 1st April, we are happy to have visitors, but we will still require them to take a test. To prevent that from being a financial burden, we will provide a test when they arrive or supply them with tests to use before they come, at our expense.

‘Our residents and their relatives were apart for too long during the pandemic and so we are pleased that they are now able to enjoy more contact with each other.’

The care provider is also mindful of the impact an outbreak can have.

Mike Padgham added, ‘If we have a COVID-19 breakout at one of our homes, it has serious repercussions for us and there is no longer any support from the Government.

‘We have to keep our residents safe and, to the best of our ability, protect our staff too, so that we can remain a viable operation and keep on providing care for around 110 people.’

The testing will include the care group’s Nursing Home on Filey Road in Scarborough, the Saint Cecilia’s and Normanby House care homes in Scarborough and the Alba Rose care home in Pickering.

Homecare

The Homecare Association welcomes the news that asymptomatic testing has been reduced to twice weekly for homecare staff. We are however deeply concerned about non-renewal of the Infection Control and Testing Fund, and the implications this will have on staff and the people they care for.

Responding to the news, Homecare Association's CEO Dr Jane Townson said, ‘For the past six weeks, we have been urging the government to review the policy for testing, which is important to help protect people receiving homecare.

‘We welcome the government’s decision to reduce the requirement for lateral flow tests (LFTs) in social care to twice weekly, bringing it in line with most of the NHS. We are also pleased that the costs for the supply of tests are covered at a time when financial pressures on homecare providers are at an all-time high. We believe this strikes the right balance between protecting people at higher risk and avoiding unintended consequences for the health and care system.’

However, the Homecare Assocation is deeply concerned that funding to cover costs of paying staff when isolating and the time and administrative costs of testing has been stopped.

Jane Townson explains, ‘Lack of available infection control funding risks careworkers being unable to afford to isolate when COVID-19 positive, particularly as cost of living is escalating. Many are already on low wages and paid by the minute because councils purchase care by the minute. People receiving care are typically in higher risk categories for COVID-19 and we must do all we can to minimise spread.

‘We are hearing from providers who currently have up to 30% of their workforce off sick, and therefore unable to provide care for older and disabled people in the community. Workers only become eligible for Statutory Sick Pay after three days, and infection control funding is essential to help providers pay staff as close to a full wage as possible while isolating. Most local authority fee rates for homecare are inadequate to cover normal costs of homecare delivery never mind additional costs due to COVID-19.

Living with COVID-19

‘The Government and its public health advisors at the UK Health Security Agency claim we should learn to live with COVID-19 in the way we have with influenza and adopt a similar approach to infection prevention and control. Recent variants of COVID-19 are far more transmissible than ‘flu and, unlike the latter, have been shown to damage the immune system and multiple organs, including the brain, with potentially serious long-term consequences for population health. Re-infection rates with COVID-19, even in vaccinated people, are substantial. COVID-19 is not like ‘flu. In addition to regular vaccination to maintain immunity, testing and PPE, we need to reduce exposure, making indoor air as much like the outdoors as possible, by improving building ventilation and investigating novel approaches to routine disinfection such as use of far-UVC light.

Call to Government

The Homecare Association is calling on the Government to make Infection Control Funding available urgently to help homecare providers support their staff, who in turn care for the most at risk in society and to develop an evidence-based and effective approach to “learning to live with COVID-19.”

Visit the UK Government website for more information on the changing COVID-19 testing guidance.

In other news, The National Audit Office (NAO) has published insights today relating to the management of PPE contracts in health and social care sector during the COVID-19 pandemic.


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