Coronavirus (COVID-19): staff testing in NHS Scotland

Changes from 28 September 2022 for all healthcare workers

Clinical advice on a four UK nation basis is that the remaining asymptomatic patient facing healthcare workers (HCWs) testing can now be paused.

There is consensus that we are now in a downward trajectory from the most recent wave, with prevalence and other epidemiological indicators improving. In addition, vaccination continues to offer protection against hospitalisation and harm across all ages groups. However, changes to testing will be kept under clinical review.

Based on this advice, asymptomatic healthcare worker testing can now be paused with immediate effect. 

Healthcare workers can pause testing immediately and do not need to use up their existing supplies of lateral flow devices (LFDs).  It is recommended that healthcare workers keep a residual stock for testing should they develop respiratory symptoms, but also in the event that clinical advice indicates that testing should resume.

More information on the pausing of asymptomatic healthcare worker testing can be found in a letter from the Chief Nursing Officer and Chief Medical Officer (DL (2022) 32.

Ongoing symptomatic testing for staff working in patient-facing roles providing close personal care and support

There is no change to the guidance for staff working in patient facing roles who are symptomatic; if staff have respiratory symptoms then they should undertake a LFD test, and if positive, isolate for a minimum of 5 days. After 5 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).

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 completed 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 current infection control precautions
• 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

Those not working in such patient facing roles do not require testing before going back to work, as long as they feel well and do not have a high temperature.

Groups within scope of this guidance

The scope of the healthcare worker pathway includes the following roles:

• NHS Scotland staff
• primary care independent contractors - general practice, dentistry, optometry and pharmacy 
• hospice staff
• visiting professionals to a care home
• students on clinical placements