Coronavirus (COVID-19) testing for hospices

Introduction

From 31 August 2022, in line with public health advice and as set out in the Living with COVID-19 plan,strategy, routine asymptomatic testing in hospices waswill be paused. The UK Health Security Agency (UKHSA) is continuing to make symptomatic and rapid response coronavirus (COVID-19) testing available to all hospice staff in England. Hospice patients will continue to have access to symptomatic testing and testing on admission in England. Separate arrangements are in place for hospices in Scotland, Wales and NorthernWales. Ireland. This guidance will be kept under review.

All registered hospices have been contacted with details of how to apply for test kits for their staff and patients. Hospices will be responsible for ordering test kits for both ‘inpatient’ and ‘community-based’ settings.

Webinars

For more information you can watch our recorded webinars.

1. Summary: testing for hospices

1.1 WhatTypes hasof changedCOVID-19 test

ThisPolymerase guidancechain hasreaction been(PCR) updatedtests are over 99% effective and pick up positive results at early and late stages of infection. Completed tests are sent to a lab for processing.

Rapid lateral flow (LFD) tests are effective at detecting virus in linethose with thehigh decisionlevels of coronavirus in their system. Results are given within 30 minutes and kits do not need to pausebe routinesent asymptomaticto testinglabs for staff,processing.

1.2 patientsAbout the service

From 31 August 2022, asymptomatic staff testing and testing for visitors who provide close personal care to hospice patients.patients will be paused.

Staff are no longer required to test unless they are symptomatic, or as part of a setting’s rapid response testing protocol.

Visitors to a setting are no longer required to testtest. for COVID-19. This includes visitors who may have previously accessed testing becauseas theya wereresult of providing personal care to a patient. Please see section 1.41.5 for more information.

From 31 August 2022, this service now covers testing for:

• staff and patients who show COVID-19 symptoms
• rapid response testing, in the instance of an outbreak

1.21.3 Staff symptomatic testing

Anyone who has symptoms of a respiratory infection and a high temperature, or symptoms of a respiratory infection and does not feel well enough to work, is advised to stay at home and avoid contact with other people. Staff in these circumstances should conduct an LFD test on the day they start to feel unwell (day 0).

Hospice staff who are concerned they may be experiencing symptoms of COVID-19 are able to access LFD tests from their employer (free tests are provided for symptomatic testing and staff should ensure they have some at home for this purpose). If this test result is negative, they should take another test 48 hours later, continuing to stay away from work during this 48-hour period. If the second test is also negative, they can return to work if they arefeel nowell longerenough unwellto and they do not have a high temperature.so.

If either of the test results are positive, then they should follow the guidance for staff who test positive.positive.

Further information on what constitutes a symptom of a respiratory infection as well as what to do if a staff member is concerned they may be experiencing symptoms of COVID-19 can be found in the COVID-19 supplement to the infection prevention and control resource for adult social care.

Further information on reading LFD results can be found in section 4 of this document.

Hospice settings will be able to order LFD test kits for symptomatic testing based on the number of symptomatic staff and patients they have had over the past 426 days.weeks. Hospice settings will be able to make one symptomatic testing order every 42 days.

If the number of symptomatic staff increases within the 42-day42 day period in a setting, a manual order of LFD test kits can be requested through the 119 service.

1.31.4 Patient testing

1.3.11.4.1 On admission

Patients with a scheduled date of admission to a hospice as an inpatient from the community or a care setting will be eligible for a PCR test 72 hours before admission (if appropriate) and an LFD test on the day of admission.

If inpatients cannot be tested with a PCR test (for example, unplanned or urgent admissions, or if they have tested positive in the last 90 days) then an LFD test on admission is sufficient.

Patients admitted to a hospice setting from an NHS hospital will be given a PCR test by the NHS hospital on discharge.

1.3.21.4.2 Symptomatic

Patients showing symptoms of a respiratory infection and a high temperature, or who have symptoms of a respiratory infection and do not feel well enough to take part in usual activities should be tested with one LFD test on the day the symptoms show (day 0).

For guidance on how to manage patients who may be displaying symptoms of COVID-19, and how to manage those that test positive, follow the advice given in the COVID-19 supplement to the infection prevention and control resource for adult social care.

Hospice settings will be able to order symptomatic test kits for patients when ordering symptomatic tests for staff. This process is explained in section 1.21.3. Hospice settings will be provided with 2 test kits per symptomatic patient.

1.41.5 Visitor testing

All visitors (including those who may be providing personal care to a hospice patient) are no longer required to test. However, it is advised that individuals who are symptomatic and/or feeling unwell should not visit, even if they haveprovide a negative COVID-19 result from a test obtained privately, are fully vaccinated and have received their booster vaccination. Transmissible viruses such as flu, respiratory syncytial virus (RSV) and norovirus can be just as dangerous to hospice patients as COVID-19. If visitors have any symptoms that suggest they may have other transmissible viruses and infections, such as a cough, high temperature, diarrhoea or vomiting, they should avoid visiting, if possible, until at least 5 days after they feel better.

Visits at the very end of life, that is, the last few days or hours of life,life should continue to be supported where possible in all circumstances. Infection prevention and control (IPC) measures, for example providing personal protective equipment (PPE) and allowing visitors to go directly to the patient’s room without accessing any communal areas, will help reduce transmission.

1.51.6 Rapid response testing for hospices in England

If one or more positive cases of COVID-19 (staff or patient) are identified in a hospice, the hospice will be able to access rapid response LFD tests for all staff. Hospice staff working in the setting over the rapid response period should conduct daily rapid LFD testing every day they are working for 5 days from the day the positive case is identified. Staff not working during this period do not need to test.

Any staff member who tests positive should stay at home and try and avoid contact with other people. Staff should not return to work until they have had 2two consecutive negative test results taken 24 hours apart.results.

In addition to this, if any positive case is found in a hospice (either staff or patient), the hospice manager should contact their local health protection team (HPT) immediately, and follow the advice given.

Hospice settings will be able to order ‘outbreak kits’ as an option on the test kit ordering portal.

1.61.7 Regular asymptomatic testing for hospices in Wales and Scotland

Wales:

• all staff once a week using a PCR test
• patients upon admission (if appropriate)

Scotland: testing is delivered locally through the local NHS.

1.8 Guidance for staff who test positive

For staff who have tested positive, hospices are advised to follow the guidance for people with symptoms of a respiratory infection including COVID-19. In addition to this, staff should not attend work until they have had two consecutive negative LFD test results, they feel well, and do not have a high temperature.

The first LFD test should be taken 5 days after day 0 (the day symptoms started and or/when they tested positive), the second test should be taken 24 hours after the first. If both LFD test results are negative, they may return to work immediately after the second negative LFD test result (if symptoms have resolved).

If a staff member’s LFD test result remains positive after 10 days, they should continue to take daily LFD tests. They can return to work after a single negative LFD test result.

The likelihood of a positive LFD test after 14 days is considerably lower. If the staff member’s LFD test is still positive on day 14, they can stop daily testing and return to work on day 15. A risk assessment should be carried out and consideration given to redeployment.

For staff who test positive between days 10 and 14 and who do not have a high temperature or feel unwell, managers can undertake a risk assessment with the view to them returning to work.

1.9 Testing within 90 days of a positive result

Advice on testing patients on admission who have tested positive with a PCR test in the last 90 days can be found in the patient testing section of this document.

2. Ordering test kits

2.1 Unique organisation number (UON)

• UKHSA assigns all participating organisations a single unique organisation number (UON)
• managers will receive their UON via the registered email address – please make sure that the person who receives these emails understands the importance of this message and knows who to contact
• a UON is an 8-digit number that is exclusive to an individual organisation – this can be used to login to all online elements of the testing process

Managers will need to use their UON for:

• ordering test kits
• contacting the national coronavirus contact centre for support (dial 119)

Staff will need to use their UON for:

• registering completed test kits to make sure they will receive their results

If you have any issues with this process, please call 119.

Hospice managers can order test kits online.

You will be able to order:

• LFD tests, for any symptomatic patients or staff
• outbreak LFD tests, if Directors of Public Health have recommended that you participate in rapid response testing
• PCR testing for admissions, for the purpose of testing a new patient admitted from the community. You can order a maximum of 10 PCR tests at a time

You will need:

• your UON
• the total number of ‘staff’ and ‘patients’ for testing (‘staff’ only for community hospices)

Enter the number of staff who require testing, and the number of inpatient beds for the number of non-staff.

2.2 Preparation

You will receive an email from organisation.coronavirus.testing@notifications.service.gov.uk who will confirm the estimated delivery date.

Test kits will be delivered to the registered address. It is their responsibility to accept delivery of kits and arrange for dispatch or collection. Re-ordering should be done on a monthly basis.

2.3 Capturing important information before distributing rapid lateral flow test kits

It’s important that you capture the following details before distributing LFD test kits to staff or visitors:

• name, phone number and email address of each staff member receiving the box or boxes
• details of the lot or batch number of each LFD home test kit given to each staff member.member The– the lot number is found on the side of each boxbox; andit’s is 8 characters long: one letter followed by 7 numbers
• date of issue to user and number of test kits provided

3. PCR test kits

3.1 Conducting PCR tests

PCR tests should be reserved for new patients admitted from the community. Patients should conduct a combined throat and nose self-swab for the test.

Follow the instructional video on how to do a throat and nasal swab.

3.2 Registering PCR tests

You will need:

• your UON
• the barcode number of the test kit you’re registering
• the email address and mobile phone number to which the test results should be sent
• the patient’s personal details

3.3 Returning PCR test kits by post

Each PCR test should be returned to the laboratory via a Royal Mail priority box.

Only use a Royal Mail priority post box. It will be labelled with the priority box sign and one of the regional NHS logos.

Find your nearest priority post box and its collection times.

3.4 Receiving PCR test results

The patient tested will receive:

• an email
• a text message (if a mobile phone number was provided at registration)

The results will also include guidance on next steps for the patient tested.

4. LFD test kits

4.1 ReportingReading your result

EveryIf a staff member receives a negative result with an LFD test resultand remains without symptoms, they can continue working. Staff members must continue following all IPC measures such as wearing PPE, washing their hands, and physical distancing where possible.

If any staff member tests positive, they should follow the guidance above in this document for staff who test positive.

4.2 Registering your result

Every LFD test must be reportedregistered online once completed.

Complete the registration as soon as the test result is determined. You need the ID number on the test strip to register the result.

Register your result here: Report a COVID-19 rapid lateral flow test result.

When using the online form, there is the option to create a user account. When you create a user account, you link your email address to your personal details. After you reportregister your first LFDrapid testlateral resultflow test using your user account, your personal details will be saved, and you will not have to re-enter them when you register in future.

Creating an account should take about 2 minutes and will save about 5 minutes each time you reportregister a test result in the future.

Report your result as soon as the test result is determined. You need the ID number on the test strip to report the result.

Individuals or visitors canreporting reportrapid anlateral LFDflow test resultresults here:can Reportsign ain COVID-19to rapidan lateralNHS flowaccount testto result,report withtests thequicker optionand toalso signuse intothe andigital NHSread account.service.

To reportregister a test result:test:

1. Enter who you are reporting for.
2. Select whether you would like to sign in or create an account or continue without an account.
3. Follow the step-by-step instructions for creating an account (if required).
4. Enter why you took the test (select testing for ‘a social care service’).
5. Enter your role.
6. Select ‘I work in an adult social care service’.
7. Enter your UON.
8. Select the appropriate country for where you live.
9. Select the date of the test.
10. Enter the test kit ID number (which can be found via the QR code).
11. Add in the result of the test.

4.24.3 Digital reader

You are able to use the digital reader for reading LFDlateral flow test results via the self-report journey. For detailed information, please visit the Digital reader guide (PDF, 2.25 MB, 6 pages).

Support and resources

Coronavirus testing contact centre

Call 119. Lines are open:

• Monday to Friday (including bank holidays), 8am to 6pm
• Saturday and Sunday, 9am to 1pm

After selecting your country, language requirements and data preferences, press ‘1’ for calling from an organisation who receives test kits directly from the national testing programme.

Consent form templates that can be used for staff and patients have been shared with local authorities.

Easy reads on coronavirus and testing:

• COVID-19 PCR home test kit instructions