Covid-19 - Testing
If you’re an essential worker, you can apply for priority testing through GOV.UK by following the guidance on testing for essential workers. You can also get tested through this route if you have symptoms of coronavirus and live with an essential worker.
Lateral Flow Antigen testing for asymptomatic staff, previously available to Trusts, is also now being made available to practices (December 2020). A letter has gone put to practices from NHSE with details.
Patient-facing staff will be asked to test twice a week using self-administered nasal swabbing and report their results through an online platform, and any positive lateral flow antigen tests will need to be followed up by a confirmatory PCR test. It is voluntary for practices and individuals to take part in this, and is not a contractual requirement, however, if you do start testing, it is a statutory requirement to report all of your results. The results from the lateral flow antigen test for primary care staff should be documented at home by the individual via the Gov.uk website.
NHSE have published a Lateral Flow Device SOP, FAQs and also a handy guide for healthcare staff on how to use the testing device.
Lateral flow device (LFD) distribution - From 5 July 2021, the NHS will move to an individual ‘pull’ model of LFD supply. This means that, from this date, staff will replenish their tests by ordering a box online from https://www.gov.uk/order-coronavirus-rapid-lateral-flow-tests to be sent to them at home. This will mean:
For primary care - practices will no longer order tests for their staff via the Primary Care Support England (PCSE) portal. Staff will be able to order their own tests online and input the postcode of their workplace to ensure the tests are registered as belonging to an NHS member of staff. A box of seven tests will be posted to staff at their home address. Staff will continue to report the results of their tests on the gov.uk website as per current practice. Organisations and regions will receive management information from NHS Test and Trace to help them understand what proportion of their staff have ordered and reported tests including contractor group and region.
For anyone else who has any of the symptoms of coronavirus, they can ask for a test through the NHS website.
People who do not have access to the internet can now order PCR home testing kits over the phone by calling 119, without needing an email address or any other digital requirement.
This means that people without access to the internet or digital services can order PCR tests to use in their homes, if they have symptoms. The home testing service is available to everyone in the United Kingdom with COVID-19 symptoms, and can still be accessed through the home testing online portal.
For technical issues related to booking tests and results enquiries contact the Coronavirus Testing Helpdesk - 0300 303 2713. There are a number of routes available including regional test centres, home test kits, mobile testing centres and NHS facilities.
Test and Trace Service
The government have introduced this service to help return life more to normal, in a way that is safe and protects our NHS and social care. The service will allow them to trace the spread of the virus and isolate new infections and play a vital role in giving public health early warning if the virus is increasing again, locally or nationally.
The NHS test and trace service:
- ensures that anyone who develops symptoms of coronavirus (COVID-19) can quickly be tested to find out if they have the virus, and also includes targeted asymptomatic testing of NHS and social care staff and care home residents.
- helps trace close recent contacts of anyone who tests positive for coronavirus and, if necessary, notifies them that they must self-isolate at home to help stop the spread of the virus.
Essentially, anyone who has symptoms will need to self isolate for at least 10 days, have a test and if positive will need to continue to the end of the isolation period and share all their recent close contacts (see website for full details on what is defined by close contact) with the NHS Test and Trace service. Any household contacts of the symptomatic patient will also need to self isolate for 10 days from when the patient's symptoms started and if their test is positive continue the isolation to the end of the 10 day period.
If you are contacted by the NHS test and trace service, because you have been identified by a patient (who has had a positive test result) as a close contact, you will be told to begin self-isolation for 10 days from your last contact with the person who has tested positive. If you develop symptoms you will need to request a test at www.nhs.uk/coronavirus or call 119 if you have no internet access.
The government advise that if you work in a health or care setting, you should follow the separate guidance for COVID-19: management of staff and exposed patients or residents in health and social care settings, which includes details on testing and when to return to work.
It is worth noting that this guidance does say that:-
If staff have been notified that they are a contact of a confirmed case in a health and care setting
If health and social care staff are providing direct care to a patient or a resident with COVID-19 and are wearing the correct PPE in accordance with the current IPC guidance, they will not be considered as a contact for the purposes of contact tracing and isolation. They will also not be required to self-isolate for 10 days (organisations have agreed the standards for PPE specification, fit testing and regimes of use for clinical and care activities).
July 2020 NHS Digital confirms that test results are now being automatically sent to GP systems as well as being communicated to the individual
The Primary Care Bulletin 5.6.20 gave the following update on COVID-19 National Testing: Flowing results to GP records
PCR swab testing is now routinely available to members of the public by visiting nhs.uk/coronavirus or calling 119.
When a patient receives their test result from the national COVID-19 PCR swab testing, this will also be sent to GP systems and appear in the patient’s record as a laboratory test result. Results from tests previously undertaken through the same route will also shortly be sent to GP systems – with the exception of a small number of cases where there was insufficient information to identify the patient’s NHS number.
The test results will have the Requesting GP as G9999981 and Requesting GP Surname of COVIDpillar2; this will ensure they are clearly distinguishable from other test results. Bulk upload of test results into GP records will take place without any manual patient by patient process. GP practices will shortly receive further guidance by their own system supplier about how this will work in their own system of choice, as well as details on how results will be filed in the system.
There will be no action required from the practice on receipt of these results. In particular:
- There will be no need to communicate results to patients, as these will have already been sent to them by text and email;
- No clinical action will be necessary, as patients will have also received links to national guidance in their text and email, such as requirements on isolation or what to do if symptoms worsen;
- The results will not need to be notified to Public Health England under the notifiable diseases requirements, as this will have already been done.
Results from the test will be communicated as one of the following three options: negative, positive or unclear. They will appear in patients’ records as “SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) RNA (ribonucleic acid) detection result negative / positive / unknown”. When a result is “unknown” it means this was unclear and the patient will be advised to be tested again through the original route they use to request a test.
CQC Guidance on Regulating independent providers offering coronavirus (COVID-19) testing
In recent weeks, CQC have been made aware of a small number of independent providers who are offering coronavirus swab testing kits for sale to the general public. They aim to provide clarification on when such activity will fall within scope of CQC registration, and also set out their expectations of providers offering this service. On 18 April 2020, Professor John Newton, national coordinator of the UK coronavirus testing programme, released a statement advising against the use of unapproved antibody tests in the UK.
The CQC guidance advises on which coronavirus swab testing that falls within the scope of CQC registration and what they expect of those providers. The full details can be read on their website at :- https://www.cqc.org.uk/guidance-providers/independent-healthcare/regulating-independent-providers-offering-coronavirus