Covid-19: Testing programme for NHS workers must not discriminate, report warns

All NHS workers should be given the same access to covid-19 swab testing to avoid variation in access for different groups, a report on the ethics of testing has said.

In a report published on 21 July, Cambridge University’s Healthcare Improvement Studies (THIS) Institute made a number of recommendations to ensure that the covid-19 swab testing programme for NHS workers was carried out ethically.1

The report said that it was important at a national level to avoid any unwarranted variation in access to swab testing. And at a local level testing should not discriminate against particular groups, “including the more socio-economically disadvantaged, where BAME [black and minority ethnic] staff may be over-represented,” it said.

It also made recommendations on the use of swab testing to decide whether a staff member should return to work. It advised that the principles behind these decisions should be explicit. “Offer clarity in guidance about under what circumstances a negative test result is sufficient basis for requiring people to work, while acknowledging the tensions in seeking to ensure safe staffing levels,” it advised.

Mary Dixon-Woods, THIS institute director, said, ‘We’re used to thinking about ethical issues in the context of patients. This work shows the value of thinking deeply about the ethical concerns that can arise for staff too.

“Questions about choices and control over testing and how the results are shared and used really matter to staff and may affect different groups differently. These questions matter too for patient safety and for public health.”

“But there are no easy answers to any of this,” she added. “Our report offers an ethical framework with practical and actionable recommendations to help guide good practice nationally and locally to support continuous improvement for covid-19 swab testing for NHS workers. It also identifies the special considerations owed to potentially disadvantaged or marginalised groups.”