Coronavirus staff guidance University Hospitals Birmingham NHS Foundation Trust

Self-isolation period extended to 10 days

People who test positive for COVID-19 or display symptoms must now self-isolate for 10 days.

The change was announced today by the UK's chief medical officers.

They said that the period must increase from the current rule of seven days because of the risk individuals may still be able to spread coronavirus.

The chief medical officers for England, Wales, Scotland and Northern Ireland issued a joint statement which said that it is "now the correct balance of risk" to extend the isolation period for those who test positive or have symptoms to 10 days.

The statement said: “In symptomatic people COVID-19 is most infectious just before, and for the first few days after symptoms begin. It is very important people with symptoms self-isolate and get a test, which will allow contact tracing.

“Evidence, although still limited, has strengthened and shows that people with COVID-19 who are mildly ill and are recovering have a low but real possibility of infectiousness between seven and nine days after illness onset.

“We have considered how best to target interventions to reduce risk to the general population and consider that at this point in the epidemic, with widespread and rapid testing available and considering the relaxation of other measures, it is now the correct balance of risk to extend the self-isolation period from seven to 10 days for those in the community who have symptoms or a positive test result.”

• How long to self-isolate
• Statement from the UK Chief Medical Officers on extension of self-isolation period

Mouth care and prevention of secondary pneumonia

Supporting our patients to maintain good mouth care whilst in hospital is vital. For patients with COVID-19 or suspected COVID-19 (plus other high acuity patients), brushing teeth and maintaining a clean comfortable mouth helps prevent additional infection and reduce the likelihood of developing bacterial pneumonia.

The mouths of COVID-19 patients who are ventilated because of viral pneumonia can also become very dry and will benefit from regular mouth care, including dry mouth treatment to reduce the risk of getting bacterial pneumonia.

Staff should always wear PPE to avoid contact and droplet transmission. This means wearing disposable gloves, a plastic apron, eye protection and a surgical mask. Please note that delivering mouth care is not an aerosol generating procedure.

Public Health England has released official guidance for providing mouth care during COVID-19 as follows:

Mouth care for non-ventilated patients:

• For patients who are likely to cough during mouth care, be gentle, stand to the side or behind them, take breaks to allow the patient to rest and swallow.
• If possible, sit the patient upright.
• Make sure the patient’s lips are kept moist (with products available) particularly before cleaning.
• If the patient has a dry mouth, apply a dry mouth product to their tongue, inside of their cheeks and roof of their mouth.
• Do not use an electric toothbrush as this may cause droplets and splash.
• If the patient is unable to spit and suctioning is available, then use a gentle level of suctioning to remove excess saliva and toothpaste.

Mouth care for ventilated patients:

• Work under the direction of the nurse in charge who will make sure the ET cuff is inflated to help prevent aspiration, it is vital that you do not displace or disconnect the tube.
• Moisten the patients mouth with chlorhexidine mouthwash using a green swab or soft toothbrush.
• Keep the patients lips moist with regular application of a dry mouth product.

For more information and support around Mouth Care Matters at UHB, contact the Mouth Care Team:

Email: MouthCareTeam@uhb.nhs.uk

Updated travel guidance for staff

Arrangements for quarantine

Staff who travel outside the UK must factor into their travel plans any quarantine (self-isolation)  arrangements that may be required by the country or countries they are visiting or required on re-entry to the UK.

This may include new quarantine requirements which are imposed at short notice after the travel has been booked or during the period of travel itself.

As part of their annual leave request, staff travelling abroad must agree with their line manager what measures they will take to ensure that they can comply with any quarantine arrangements that may be required on their return to the UK (quarantine period can be up to 14 days from date of return to UK).

Potential measures to ensure compliance include:

• Taking an additional period of annual leave (from their usual leave allowance) to cover the quarantine period.
• Taking a period of unpaid leave to cover the quarantine period.
• Working from home where this is possible within their role.
• Any combination of the above.

As there is not a “one-size-fits-all” answer to this issue, line managers should be sympathetic to each individual’s circumstances.

COVID-19 testing

If a member of staff wishes to be tested for COVID-19 before or after their travel they need to arrange this through NHS 111. 

The Occupational Health teams will not be responsible for organising these unless the staff member is travelling abroad on NHS business or meet the criteria set out at:

• Staff testing

Any staff member who tests negative for COVID-19 on returning from abroad must still comply with and complete any quarantine requirements in force at the date of return.

Where a registered practitioner has been newly recruited to the Trust from outside of the UK, they will be exempt from any quarantine requirements. The individual will need a negative swab before they can commence employment with the Trust.  The testing in these circumstances will need to be arranged via the Trust’s Occupational Health department.

This advice is being kept under review and will be updated accordingly.

For further information, please visit:

• Travel advice: coronavirus (COVID-19)

Solihull Hospital staff parking

Due to the repurposing of Solihull Hospital as part of the COVID-19 phase two response, individual patient pathways have been designed with the majority of departments having their own patient entrance.

As a result, the rear of the hospital has experienced an increase in patient activity to access services via the small staff car park located on the internal road between Solihull Hospital and Solihull School sports fields.

This area is also required for patient drop-off and pick-up. As a consequence, staff access (except district nurses) to this car park will be suspended as of Tuesday 4 August.

From Tuesday 4 August, please use the main staff car park that is accessible from the Warwick Road via Union Road.