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Covid-19: NHS staff express scepticism over promised twice weekly testing

BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4376 (Published 11 November 2020) Cite this as: BMJ 2020;371:m4376

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  1. Abi Rimmer
  1. The BMJ

All 250 000 patient facing NHS staff working in 34 NHS trusts in England will be tested for covid-19 twice a week, starting this week, NHS England and NHS Improvement has said, with full roll out including primary care expected by the end of next week.

Jeremy Hunt, chair of the House of Commons Health and Social Care Committee, has repeatedly called for NHS staff to be tested weekly.1

In a letter to the committee, sent on 9 November, Stephen Powis, the national medical director of NHS England and NHS Improvement, and Chris Whitty, chief medical officer for England, announced that twice weekly testing of staff could begin. “Following further scientific validation of the lateral flow testing modality last week, and confirmation over the weekend from Test and Trace that they can now supply the NHS with sufficient test kits, I am pleased to confirm asymptomatic testing of all patient-facing NHS staff,” the letter said.

The letter refers to the Innova lateral flow device being used for mass testing of the population in Liverpool.2 This test involves a nose and throat swab and provides results in a similar way to an at-home pregnancy test. But concerns have been raised about its suitability for screening purposes because the company’s instructions state that the test is intended only for use on people showing symptoms of covid-19 and that it should be used only by “clinical laboratory personnel specifically instructed and trained in the techniques of in vitro diagnostic procedures.”3

The letter said that staff would be asked to test themselves at home twice a week with results available before they came into work. “Testing twice weekly helps mitigate the sensitivity considerations, and to mitigate the lower specificity, all positive results will be retested via PCR,” the letter said.

Health secretary Matt Hancock echoed the announcement on Twitter. “I’m delighted that we will now be testing all NHS patient-facing staff twice a week, helping to protect those who do so much to keep us safe,” he wrote.4 But many NHS staff responded to the tweet with scepticism. Andy Robinson tweeted, “Twice a week?? I’m a community nurse and I have not had a single covid test since this all started.”5 Another user tweeted, “Strange. Whilst working both frontline NHS and now supposedly employed as a doctor (despite being a med student) I have never had a single routine covid test.”6

Hunt, however, described the announcement as fantastic news. “It will make a huge difference in enabling non-covid services to stay open, give staff the confidence they won’t pass on infections to patients, and reassure patients that hospitals are safe to use,” he said.

The announcement comes after the chief executive of NHS England, Simon Stevens, said at a press conference on 5 November that there were about 30 000 NHS staff who are either off with coronavirus or having to self isolate.

Deputy chief executive of NHS Providers, Saffron Cordery, said that if the testing was reliable it could make a real impact on curbing the spread of infection and help to avoid unnecessary staff absences. But she said that there could also be real difficulties for trusts under major operational pressure that have to manage the risk of losing a number of key frontline staff all at once if a substantial number of tests come back positive at the same time.

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