Plans to permit social care staff to work rather than self-isolate risk “blanket applications”

Double-vaccinated frontline NHS and social care staff in England who have been told to self-isolate will be permitted to attend work in exceptional circumstances from today (Monday 19 July).

The measure is being introduced to alleviate pressure on NHS and social care services and will be contingent on staff members only working after having a negative PCR test, and also taking daily negative lateral flow tests for a minimum of seven days, and up to 10 days or completion of the identified self-isolation period.

The updated guidance comes as the country faces a surge of new cases, with daily new cases topping 50,000.

The new guidance will apply to staff who have been contacted as a close contact of a case of COVID-19 by NHS Test and Trace, or advised to self-isolate by the NHS COVID-19 app.

However, the Government says the change applies only to frontline NHS and social care staff where their absence “may lead to a significant risk of harm”, adding that the decision to allow NHS and social care staff to attend work after being told to self-isolate should be made on a case-by-case basis, and only after a risk assessment by the organisation’s management.

The decision to override the Test and Trace or app’s order to self-isolate must be authorised by the organisation’s local Director of Infection Prevention and Control, the lead professional for health protection, or the Director of Public Health relevant to the organisation.

Health Secretary Sajid Javid said the new rules will “fortify the country’s collective defences” against the virus.

“As we learn to live with this virus, it’s important that we ensure frontline staff can keep providing the best possible care and support to people up and down the country,” Javid said.

Careful consideration should be given by local NHS and social care organisations to the risk of onward transmission compared to the risk to delivery of critical services, the Government warned.

Despite being permitted to attend work, staff will remain under a legal duty to self-isolate as a close contact when not at work.

The announcement comes on the same day as COVID-19 restrictions are lifted in England, on so-called ‘Freedom Day’. It also comes just one day after the Prime Minister and Chancellor said they would be accessing a pilot scheme to avoid the need to self-isolate, and subsequently U-turning on this decision, after coming into close contact with the Health Secretary who recently announced he had tested positive for COVID-19.

Jenny Harries, UK Health Security Agency Chief Executive, said the measure will support the NHS and social care services under the strain of increased demand and sustained pressure.

“We have provided specific guidance to NHS and social care settings for circumstances where there is a significant risk to health or safety resulting from staff absence or a critical service cannot run.

“This measure only applies to double vaccinated staff, who will only be able to attend work after testing negative on PCR and daily lateral flow tests, and following a risk assessment and the supervision of the health service.”

In response to the announcement, the Association of Directors of Adult Social Services (ADASS) said in a statement that it welcomes the new measure as an initial attempt to alleviate some of the pressure the frontline workforce has experienced, but that it has concerns that the change is being introduced at a time when community transmission rates are very high across the country.

“We are hearing reports of care staff feeling enormous pressure to cover their colleagues’ shifts when they are isolating, working twice as hard to continue to provide care to those of us who need it. We are also hearing that care staff are leaving the sector at alarming rates due to better pay in retail, hospitality and tourism.”

“The Government needs to ensure that limitations and regulations for this new measure are stated clearly and with no room for doubt, defining exactly what exceptional circumstances and basic conditions must be met to allow some care workers to be permitted to attend work.”

“Our concerns are magnified by the fact that there has been an immediate change in policy with no prior warning, guidance and information about the change and how this can be introduced safely. The policy is intended to be applied on a case by case basis, and with a full risk assessment, but the absence of information and guidance raises the risk of blanket applications.”