Coronavirus (COVID-19): staying at home

Health and social care staff who work in face-to-face settings

On this page:

• who this guidance is for
• staff members with symptoms of respiratory infection
• staff members with ositive LFD test for COVID-19
• contact of a confirmed case of COVID-19

Who this guidance is for 

This guidance applies to health and social care staff who work with patients and service users in a face-to-face setting.

In terms of social care, the following roles would be considered service user face-to-face roles:

• members of staff or volunteers who are regularly in a social care setting (for example, a care home or adult day care centre) and provide close, personal care and support
• this includes cleaners, catering, and support staff but does not include office-based staff members who do not enter these settings or directly care and support people
• in the context of an individual’s own home (including sheltered or very sheltered housing), staff includes those who provide close, personal care or support to the individual such as those staff working in care at home or as personal assistants, but not, for example, maintenance staff

Who it does not apply to

This guidance only applies to staff who work in face-to-face settings with patients and service users. It does not apply for example to:

• office-based staff 
• maintenance staff working in someone's own home

Instead, you should follow the stay at home guidance for the general population. The 'stay at home' guidance also applies to staff working in the other non-clinical emergency services and national critical infrastructure.

Staff members with symptoms of a respiratory infection including COVID-19

Anyone who has symptoms of a respiratory infection and a high temperature or does not feel well enough to go to work is advised to stay at home and avoid contact with other people as set out in the ‘Stay at Home’ guidance. Further advice on other actions, to take outside of work are provided in this guidance.

In addition, health and social care staff who work with patients and service users in a face-to-face setting, who have symptoms of a respiratory infection and a high temperature or do not feel well enough to attend work, are advised to take a lateral flow device (LFD) test as soon as they feel unwell. The result of the LFD test should be reported to their line manager.

If the LFD test result is negative, they can attend work if they are clinically well enough to do so and they do not have a high temperature.

If the staff member works with patients whose immune system means that they are at higher risk of serious illness despite vaccination, they should discuss this with their line manager who should undertake a risk assessment.

If they are still displaying respiratory symptoms when they return to work, they should also speak to their line manager who should undertake a risk assessment.

On returning to work, the staff member must continue to comply rigorously with all relevant infection control precautions and personal protective equipment (PPE) must be worn properly throughout their shift and remain vigilant for symptoms.

Symptoms of COVID-19, flu and other common respiratory infections include:

• continuous cough
• high temperature, fever or chills
• loss of, or change in, your normal sense of taste or smell
• shortness of breath
• unexplained tiredness, lack of energy
• muscle aches or pains that are not due to exercise
• not wanting to eat or not feeling hungry
• headache that is unusual or longer lasting than usual
• sore throat, stuffy or runny nose
• diarrhoea, feeling sick or being sick
• increased confusion, delirium

Staff members who receive a positive LFD test result for COVID-19

If staff receive a positive COVID-19 test result, regardless of whether they have symptoms, they should not attend work for a minimum of 5 full days. Staff working with patients and service users in face-to-face settings can return to work when they have had 2 consecutive negative LFD test results (taken at least 24 hours apart). Those not working in such settings do not require testing before going back to work, as long as they feel well and do not have a high temperature.

The first LFD test should only be taken 5 days after the day their symptoms started (or the day their first positive test was taken if they did not have symptoms); Day 0 is the date of the onset of symptoms.

If both LFD test results are negative, they may return to work immediately after the second negative LFD test result, provided they meet the criteria below:

• they feel well enough to work, and do not have a high temperature
• a risk assessment is done and consideration is given to redeployment (if they work with individuals whose immune system means that they are at higher risk of serious illness despite vaccination), until 10 days after their symptoms started (or the day their first positive test was taken if they did not have symptoms)
• they continue to comply with infection control precautions and personal protective equipment (PPE) is worn and disposed of correctly

If the day 5 LFD test is positive, they should continue to test daily until they have received two negative LFD test results, taken 24 hrs apart. If the staff member’s LFD test result is positive on the 10th day, they should discuss this with their line manager who may undertake a risk assessment to facilitate a return to work.

If staff working with patients and service users in face-to-face settings are feeling well enough to return to work but are still displaying respiratory symptoms, they should also speak to their line manager who should do a risk assessment

Staff who are contacts of a confirmed case of COVID-19

People who live in the same household as someone with COVID-19 are at a high risk of becoming infected because they are most likely to have prolonged close contact. People who stayed overnight in the household of someone with COVID-19 are also at high risk.

If a staff member is in a household or overnight contact of someone who has had a positive COVID-19 test result it can take up to 10 days for infection to develop. It is possible to pass on COVID-19 to others, even with no symptoms.

Patient-facing healthcare staff who have had overnight or household contact with someone should discuss ways to minimise risk of onwards transmission with their line manager.

This may include considering:

• redeployment to lower risk areas for patient/client-facing staff, especially if the member of staff works with patients whose immune system means that they are at higher risk of serious illness despite vaccination
• working from home for non-patient-facing staff
• limiting close contact with other people especially in crowded, enclosed or poorly ventilated spaces

Whilst they are attending work, they must continue to comply rigorously with IPC measures and wear the appropriate PPE for the setting they are in.

Symptom vigilance is important. At any point, if the member of staff develops symptoms, they should follow the advice for staff with symptoms of a respiratory infection, including COVID-19, as outlined above.

For other testing queries, please see DL (2022) 32.