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Covid-19: Fully vaccinated NHS staff may not need to self-isolate

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1830 (Published 19 July 2021) Cite this as: BMJ 2021;374:n1830
  1. Gareth Iacobucci
  1. The BMJ

NHS and care staff in England who have been told to self-isolate will be permitted to attend work in “exceptional circumstances” if they are fully vaccinated and return a negative PCR test, the government has announced.

The measure is being introduced to alleviate pressure on services after a sharp rise in absences of staff who have been told to self-isolate. The change in policy covers staff who have been contacted as a close contact of a case of covid-19 by NHS Test and Trace or who have been advised to self-isolate by the NHS covid-19 app.

To qualify, staff must have received two doses of covid-19 vaccine and a negative PCR test result and to have had daily negative lateral flow test results for a minimum of seven and maximum of 10 days, the Department of Health and Social Care said. Staff should not work with clinically extremely vulnerable patients or residents, as determined by their employer, the department added.

The waiver should apply only where a staff absence may lead to a “significant risk of harm,” and careful consideration should be given to the risk of onward transmission versus the risk to the delivery of critical services, the department said.

Decisions should be made “on a case-by-case basis, and only after a risk assessment by the organisation’s management,” it added. Each case must be authorised by the employer’s local director of infection prevention and control, their lead professional for health protection, or their local director of public health.

The health and social care secretary, Sajid Javid, said, “The government has backed healthcare services at every turn through this global pandemic, and these new rules will fortify our collective defences against this awful virus, by allowing fully vaccinated frontline NHS and social care staff to continue to work when needed.”

Staff who are permitted to attend work in these circumstances will remain under a legal duty to self-isolate as a close contact when not at work and will continue to receive self-isolation reminders.

Saffron Cordery, deputy chief executive of NHS Providers, said that NHS trust leaders welcomed the “pragmatic” measures as a response to the increasing number of NHS staff having to isolate, which was affecting the NHS’s ability to function. “The mitigations outlined will help trusts do everything they can to protect patients and staff from acquiring covid-19 while allowing them to deliver vital NHS services,” she said.

But Danny Mortimer, chief executive of NHS Employers and deputy chief executive of the NHS Confederation, said that the policy had divided health leaders. “On the one hand they are worried about their capacity to support patients safely and quickly, particularly given that many staff will already be away for parts of summer as they take overdue annual leave that is owed to them; but on the other hand the last thing they would want to do is expose their patients and colleagues to an increased risk of catching the virus, so the need for local review and discretion here is important,” he said.

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