Guidance

COVID-19: testing fromduring 1periods Aprilof 2023low prevalence

Explains testingthe frompurpose 1of Aprilongoing 2023testing onwards and sets out the purpose of ongoing testing, who willis becurrently eligible tofor access to testing and when tests should be used.

The role of testing

ThroughoutAs theset coronavirusout (COVID-19)in pandemic, the governmentLiving haswith prioritisedCOVID-19 protectingstrategy, the mostgovernment’s vulnerableobjectives andin thosethis inphase high-riskof settings.the Government-fundedcoronavirus testing(COVID-19) willresponse continueare to focusincreasingly onenable thesethe groups,management withof newCOVID-19 guidance coming into effect in Englandline fromwith 1other Aprilrespiratory 2023.

Theillnesses, ongoingwhilst successprotecting ofand thetreating vaccinationthose programme,who increasedare accessmost vulnerable to treatmentsmore andserious highoutcomes.

Testing immunityof amongstresidents, thepatients population,or hasstaff allowedwho theare governmentsymptomatic or to scalemanage backan testingoutbreak in England.high-risk Fromsettings Aprilwill onwards,continue testingthroughout will2022 beto provided2023. toAt individualstimes and(for settingsexample atduring highestperiods riskof fromhigh COVID-19,prevalence, whilstwhen continuingtransmission toof supportCOVID-19 diagnosisfrom forthe carecommunity andis accessmore tolikely) treatments.

Allasymptomatic testing willmay usealso lateralbe flowdeployed devicein (LFD)some tests,settings.

Individuals whichand havesettings provencontinue to be effectiveprotected atby detecting COVID-19 andvaccination provide(including aboosters), rapidpopulation result.immunity Infrom NHSinfection settings,and, polymerasefor chainindividuals reactionat (PCR)higher testsrisk mayof alsosevere beillness usedin tohigh-risk supportsettings, clinicalongoing diagnosis.

Testingavailability of residents,symptomatic servicetesting. usersThis and patients will continue to helpprovide managevital protection against outbreaks in high-riskthese settings. Symptomaticsettings testingand willthose alsowho continueare forat individualshighest whorisk areof eligibleserious illness will continue to accessbe COVID-19able treatments,to andaccess stafftesting workingand withtreatments patientsfor whoCOVID-19.

Current aretesting atproposals

Routine high-riskasymptomatic fromtesting severewill outcomes,be inpaused NHSfrom and31 hospiceAugust. settings.

Specific operational guidance will continue to be provided to the different high-risksettings settings,providing giving details of how the LFDtypes of tests and how these should be used.

WhereThe symptomaticgovernment continues to utilise both polymerase chain reaction (PCR) and rapid testing via lateral flow device (LFD) tests. The majority of testing is recommended,now thisconducted shouldby beLFD basedtests. onPCR testing is only advised in certain circumstances, typically in the currentNHS listwhere ofthere COVID-19is symptoms.

Alldirect otheraccess residents,to servicea users,laboratory patientsthat andcan staffprovide whorapid areresults.

Where symptomatic testing is recommended, this should followbe guidancebased foron the generalcurrent population.list of COVID-19 symptoms.

Testing currently recommended in NHS settings

Situation Type of test
Symptomatic adultshigh andrisk childrenpatients admittedidentified for careCOVID-19 ormonoclonal developingantibody symptomsand withinantiviral hospitalstreatment PCR whereor having COVID-19LFD
Symptomatic willpatients changefor clinical management,diagnostic pathway PCR

Primary care testing may also use LFD
Early release from self-isolation for example,patients toin informacute treatmentsettings PCRLFD andtesting from day 5 onwards to get 2 negative tests
Early release from self-isolation for patients in acute settings LFD attesting localfrom discretionday 5 onwards to get 2 negative tests
Symptomatic adultsor andimmunocompromised childrenmaternity eligiblepatients who are admitted for antiviralelective treatmentor emergency care PCR on site
Symptomatic or inimmunocompromised communityelective settingscare patients prior to informacute treatmentday case/overnight pre-admission LFD home testing
DischargeTransfers ofinto or within hospital for immunocompromised patients PCR on site
Discharge patients to care settings,homes/hospices PCR unless they have been positive for example,COVID-19 carewithin homes90 ordays hospices then it is an LFD test
Symptomatic NHS staff and staff in NHS-commissioned Independent Healthcare Providers (including workingreturn onto wardswork focussed on treating profoundly immunocompromised individualstesting) LFD home testing
Outbreak testing in healthcare settings LFDBoth in locally directed protocol, except where PCR neededand LFD forin diagnosisspecified protocol

InLocal addition to the recommended testing identified, local healthcare organisations, with appropriate advice (including from Medical Directors, Nursing Directors or Directors of Infection Prevention and Control), may exercise local discretion to continue testing for specific individuals or cohorts in line with broader infection prevention and control measures.measures, Thisfor includesexample emergencyto admission,asymptomatically electivetest pathwaystaff andor transferpatients who are at higher risk of careserious admissions,illness forfrom exampleCOVID-19 toand/or amay wardbe caringin forcontact with patients who are severelyat immunosuppressed.higher risk of serious illness from COVID-19.

Testing currently recommended in care services (adult social care and hospices)

SettingSituation TestingType of test
CareAdmission testing from the community for care homesOutbreak testingand hospices PCR unless they have been positive for COVID-19 within 90 days then it is an LFD test
 Symptomatic testingadult forsocial thosecare eligibleand forhospice COVID-19 therapeuticsstaff (including return to work testing) LFD home testing
HospicesOutbreakSymptomatic testingcare home, extra care and supported living and hospice residents LFD
 SymptomaticEarly testingrelease offrom patientself-isolation facingfor staffresidents in care homes and hospices LFD, where recommended by the hospice
 SymptomaticRapid response testing forin thosecare eligiblehomes, for COVID-19high-risk therapeuticsextra care and supported living settings, and hospices LFD
ExtraOutbreak caretesting and supportedin livingcare homes SymptomaticBoth testing for those eligible for COVID-19PCR therapeuticsand LFD in specified protocol

Adult social staff includes staff of care homes, homecare organisations, eligible extra care and supported living services, eligible adult day care centres, personal assistants, Shared Lives carers, Care Quality Commission (CQC) inspectors and social workers as defined in COVID-19 testing in adult social care.

Testing currently recommended in other non-healthcare settings

TheseOther settings include prisons, immigrationyoung retentionoffender orinstitutions, removalsecure training centres, IRCs, asylum reception centres, asylum hostel accommodationaccommodation, andresidential receptionspecial centres,educational homelessnessneeds settingsand (includingdisability night(SEND) shelters,settings, hostels,defence hotels,detention, otherdefence temporaryhealthcare, accommodationnight andshelters, outreach services),services, domestic abuse refugesrefuges, respite rooms, homeless shelters and respitetemporary rooms.accommodation.

SettingSituation TestingType of test
Non-Reception healthcaretesting settingsOutbreakin testingline with public health advice for symptomatic prisoners of prisons and IRCs LFD
 Symptomatic testing forin thoseprisons; eligiblenight forshelters; COVID-19 therapeuticsLFD

Thehomelessness riskservices, ofhotels harmand fromother COVID-19temporary foraccommodation; childrenother andoutreach youngservices peopleincluding isday verycentres; domestic low.

Childrenabuse andrefuges; youngrespite peoplerooms; (CYPIRCs), settingsasylum doreception notcentres requireand continuedasylum accesshostel accommodation; defence healthcare (including return to work testing) LFD Outbreak testing in residentialprisons; specialnight educationalshelters; needshomelessness services, hotels and disabilityother (SEND)temporary settingsaccommodation; orrespite therooms; CYPIRCs, secureasylum estatereception (CYPSE).

Settingscentres areand encouragedasylum tohostel followaccommodation; guidanceSEND onresidential GOV.UK:

Publishedtemporary 24asymptomatic Augustreception 2022
Lasttesting updatedin 30certain Marchcircumstances. 2023 + showIn allthese updates
  1. Updateprotection toteams reflectwill changesprovide fromadvice 1directly Aprilto 2023.settings.

Published 24 August 2022

First published.