Frontline health and care staff don't have to self-isolate if they've been in contact with someone with COVID-19

On Monday 19 July, the government announced that double vaccinated frontline NHS and social care staff in England, who have been told to self-isolate because they've been in contact with someone with COVID-19, can continue to work.

It has updated its guidance on management of staff and exposed patients or residents in health and social care settings to reflect the change in approach.

Why has the government changed its advice on self-isolation?

We're in the midst of a third wave. Cases are surging and are predicted to reach 100,000 confirmed infections per day next week. To control the virus, anyone who is in close contact with someone who has tested positive should self-isolate. There's a legal requirement to self-isolate if you're contacted by NHS test and trace (or another qualified medical professional) and a 'moral' requirement to self-isolate if you're pinged by the NHS test and trace app. You may also have professional and/or a contractual obligation to self-isolate.

This has been hugely disruptive for many organisations - including those in the hospitality, food and health sectors. 

Hospitals have had to cancel appointments because staff, who don't have COVID-19 symptoms, are self-isolating. Nick Hulme, the chief executive of East Suffolk and North Essex trust told the Guardian newspaper that he's recently lost 32 staff who’ve been pinged by the NHS Covid app and told to isolate for 10 days. To put it into context, “Two senior consultants pinged off for 10 days means we have lost 200 outpatient appointments and 200 operations, leaving an entire team redundant.” 

This is putting a huge strain on hospitals, care homes and other medical services.

How do the new rules work?

The rules only apply to frontline NHS and social care staff. There are a number of qualifications:

1. There must be 'exceptional circumstances' in your organisation which pose a significant risk to health and safety.  According to the press release this might occur where there aren't enough staff available to provide care or run critical services.  

2. Staff must have received both vaccinations (the second vaccination must have been administered at least 14 days before they are eligible to return to work).

3. They must not have COVID-19 symptoms.

4. They must self-isolate until have received a negative PCR test.

5. They must take daily lateral flow tests (which must also be negative) during the entire period they would otherwise have to self isolate.

6. They must comply with all relevant infection control precautions and PPE should be properly worn throughout the day. 

7. They should not work with clinically extremely vulnerable patients or residents, as determined by the organisation.

Do all frontline NHS and social care staff that meet these qualifications potentially qualify?

We don't think so. According to the BBC, a government spokesperson has said 'this is not a blanket exception' and anyone who is eligible will be specifically named on a letter from a government department.   

What steps to employers have to take before allowing staff to return to work within the 10 day isolation period?

You must treat each employee who is asked to self-isolate on a case by case basis. 

You need to undertake a risk assessment which considers the risk of onward transmission compared to the risk to delivery of critical services. Once you've done that you need to get approval from your local Director of Infection Prevention and Control, the lead professional for health protection, or the Director of Public Health relevant to your organisation.

Do staff have to self-isolate outside of work?

Yes. This exemption only applies to the workplace. 

Staff who are permitted to attend work will remain under a legal duty to self-isolate as a close contact when not at work (if they've been contacted by NHS test and trace). However, they have a ‘reasonable excuse’ under the Self-Isolation regulations to leave self-isolation to attend work where their absence could result in harm. They will continue to receive self-isolation reminders.

When do these rules come into effect?

The new rules apply from Monday 19 July.

Is the government going to introduce similar measures for other sectors?

We believe so. At the press conference yesterday, the Prime Minister said that he wanted to protect staffing for crucial services, including: supplies of food, water and electricity; supplies of medicines; the running of trains; border protection and 'defence of our realm'. 

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Jennie Harris, UK Health Security Agency Chief Executive

"With the number of cases continuing to rise, it is imperative that we do everything we can to manage this virus and support our 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."”