Coronavirus staff guidance University Hospitals Birmingham NHS Foundation Trust

Changes were made to patient and staff testing requirements on 10 May 2023.

Following the latest government (NHSE and UKHSA) guidance, the below will be implemented across the Trust immediately.

COVID-19 testing

Patient testing

Routine COVID-19 patient testing will no longer be required, with the exception of the following scenarios only:

• Symptomatic patients (new admissions), where a COVID-19 diagnosis will affect their clinical management (i.e. to inform treatment → PCR testing via POCT labs)
• Symptomatic patients (who are existing inpatients), where a COVID-19 diagnosis will affect their clinic management (i.e. to inform treatment → At QE PCR testing via QEHB main microbiology laboratory, at HGS PCR testing via POCT labs)
• Patients being admitted into designated high risk areas that predominantly care for severely immunocompromised patients (Heartlands ward 3, QEHB Wards 303, 304, 305, 306, 622, 623, 624, 625, 726, 727) → PCR testing via POCT labs
• Weekly patient screening on designated high-risk areas that predominantly care for severely immunocompromised patients, screening should occur weekly (QEHB wards 304, 622, 623, 624, 625, 726, 727) → PCR testing via QEHB main microbiology laboratory
• Organ transplant recipients and donors → urgent Cepheid PCR testing via QEHB main microbiology laboratory
• Patients being discharged to other care settings including care homes and hospices → ward-based LFD testing within 48 hours of discharge
• Testing under the direction of Infection Prevention and Control specialists, such as outbreak testing

Staff testing

Routine COVID-19 staff testing will be withdrawn, with the exception of the following scenarios only:

• Symptomatic staff who are providing direct inpatient care to patients who are severely immunocompromised (Heartlands Ward 3,QEHB wards 303, 304, 305, 306, 622, 623, 624, 625, 726, 727)→LFD testing via government website:
  • GOV.UK: order coronavirus (COVID-19) rapid lateral flow tests
• If the result of this LFD test is positive, they are advised not to attend work for at least 5 days and until they have a negative result on LFD test
• If they are still displaying respiratory symptoms when they return to work, or if their LFD remains positive beyond 10 days, they should speak to their line manager who should undertake a risk assessment
• Testing under the direction of Infection Prevention and Control specialists, such as outbreak testing

Symptomatic staff

Staff who are symptomatic and not in the above categories should follow the national guidance, which is:

• If you have symptoms of a respiratory infection, such as COVID-19, and you have a high temperature or do not feel well enough to go to work or carry out normal activities, try to stay at home and avoid contact with other people, until you no longer have a high temperature (if you had one) or until you no longer feel unwell
• If the staff members have a positive COVID-19 test result, regardless of whether they have symptoms, they should follow the national guidance, which is: try to stay at home and avoid contact with other people for 5 days after the day you took your test:
  • GOV.UK: people with symptoms of a respiratory infection including COVID-19
• Line managers should undertake a risk assessment before patient-facing healthcare staff return to work in line with normal return to work processes

Mask wearing

Staff

Staff should wear a surgical face mask when:

• Caring for patients who have respiratory symptoms
• Working on designated high risk areas that predominantly care for severely immunocompromised patients (Heartlands Ward 3, QEHB wards 301, 303, 304, 305, 306, 622, 623, 624, 625, 726, 727, satellite dialysis units and glaxo dialysis units)
• Caring for severely immunocompromised patients. Details of patients who are classed as severely immunocompromised are here:
  
  • GOV.UK: highest-risk patients eligible for new COVID-19 treatments: a guide for patients
• Existing guidance for PPE use during aerosol generating procedures remains unchanged

Visitors

Visitors should wear a surgical face mask when:

• Accompanying patients who have respiratory symptoms
• Visiting designated high risk areas that predominantly care for severely immunocompromised patients (Heartlands Ward 3, QEHB wards 303, 304, 305, 306, 622, 623, 624, 625, 726, 727, satellite dialysis units)

Patients

Patients should wear a surgical face mask, if able to tolerate it, when:

• They have respiratory symptoms
• They are being cared for on designated high risk areas that predominantly care for severely immunocompromised patients (Heartlands ward 3, QEHB Wards 303, 304, 305, 306, 622, 623, 624, 625, 726, 727, Dialysis satellite units)

We treat some of the most vulnerable and sick patients, and our overriding principle is the safety of patients and colleagues, therefore we keep the recommendations for staff mask wearing under constant review, and it is subject to change in response to circumstances. For example, universal masking may be re-instated in periods when respiratory pathogens (e.g. influenza) are at high prevalence, during hospital outbreaks, or if a new COVID-19 variant emerges.

Conversely, the requirement to wear masks may be completely withdrawn when more favourable conditions exist.

Isolation for inpatients with COVID-19

There has been changes to the isolation duration for inpatients with COVID-19.

The requirement for LFD testing to facilitate step-down of non-immunocompromised COVID-19 patients has been withdrawn and the new guidance is as follows:

Symptomatic patients and those testing positive for COVID-19 should be isolated, or cohorted together where possible away from others for a minimum of five days, with release from isolation guided by clinical judgement when well and free of fever for 48 hours (maximum 10 days isolation if not immunocompromised).