Coronavirus (COVID-19): staff testing in NHS Scotland
Guidance on testing of NHS Scotland staff, to reduce the potential spread of COVID-19.
Patient facing healthcare workers (HCWs) should continue to test twice weekly using a lateral flow device (LFD).
As set out in DL(2022)07 weekly asymptomatic PCR testing pathway has now ceased. Any patient facing HCWs who previously accessed this pathway are now asked to test twice weekly using LFD in line with the asymptomatic HCW LFD testing pathway.
The scope of the healthcare worker pathway includes the following roles, please note testing should only be undertaken by workers who are patient facing:
- 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
Contents
Read more in the following sections:
- isolation exemption/ close contact testing
- symptomatic testing (include testing positive and returning to work)
- training materials
- recording test tesults
- IRIC reporting for defective test kits or one which cause adverse events
- data to be collected when LFD tests are issued to staff
- students on clinical placements
- visiting care homes
- if you can’t use a nasal swab
- disposal of Lateral Flow Devices (LFDs)
- testing kits specifications (latex/halal/vegan)
- more information
- primary care-specific information
- archived guidance
Isolation exemption/ close contact testing
There is more information and materials on COVID-19 on NHS Inform.
Symptomatic testing (include testing positive and returning to work)
To align with the Testing Transition Plan, the previous self-isolation guidance has been replaced. This revised director’s letter sets out updated guidance for health and social care staff who develop symptoms of respiratory infection; those with a positive test for COVID-19; and those who have a household member or overnight contact who has tested positive for COVID-19.
See DL(2022)12 for further details.
Training materials
Please ensure you are using the appropriate Instructions for Use for each LFD testing product, as instructions differ slightly between products.
LFD training materials including instructional videos and instructions are on the TURAS website.
Recording test tesults
Healthcare workers are reminded to record positive, negative and inconclusive LFD test results via NSS testing portal. Healthcare workers should only enter Orient Gene results as a registered user.
When recording test results on the online portal, please ensure you enter the lot number provided on the outer cardboard packaging of the test kit, not the ID Number printed on the individual test cassette.
Any staff member who needs support undertaking the test should be provided with appropriate support and training and, where possible, observed on the first occasion. If a staff member is unable to perform the test, employers should enable testing by other technologies where possible.
IRIC reporting for defective test kits or one which cause adverse events
For the Orient Gene 7s LFD test kits only, the manufacturer’s instructions for use (IFU) should be followed. However, please note the following important departures from the IFU for the healthcare worker pathway in Scotland.
- the Orient Gene IFU directs users to contact the MHRA via the yellow card scheme if they are harmed by a lateral flow device. In Scotland the appropriate pathway is to notify NSS IRIC.
Data to be collected when LFD tests are issued to staff
Employers, including independent contractors, should establish local processes to ensure the following information is collated when the LFD test kits are issued to staff members:
- LOT number (written on the test kit)
- number of LFD kits distributed
- date of distribution
- site / event distribute
Students on clinical placements
Students on placement (including those in primary care settings) who are working in patient facing roles are included in the LFD testing programme. Students on placement will require to collect their test kit and be provided with information on how to access training materials on the first day in the placement setting. Students may require more support and may prefer to test themselves in the workplace. Boards should take this into account in their local delivery plans.
Visiting care homes
Care homes will not require professional visitors who are testing via this pathway to undertake additional testing on arrival at the care home, however, visiting professionals may be asked to confirm that they are participating in the testing programme. It should be noted that LFD testing of professional visitors is not a mandatory requirement but a recommended one, and thus entry should not be refused on this basis as long as the correct PPE is worn and infection prevention and control principals are adhered to (as per national guidance).
If you can’t use a nasal swab
The Orient Gene LFD test requires nasal swabbing only. If nasal swabbing is unsuitable for you (for example because you suffer from nosebleeds or other adverse effects, or have nasal piercings), boxes of 7 Innova LFD tests can, in these circumstances, be used for throat only swabbing.
To access boxes of 7 Innova LFD tests, please first discuss with your health board LFD Testing Lead, who can order Innova branded kits from National Services Scotland (NSS). You should continue to ensure that you record your results on the healthcare worker online result recording portal.
Disposal of Lateral Flow Devices (LFDs)
Disposing of a used LFD test at home
LFD tests can be disposed of in domestic waste as normal (the extraction tube holder is reusable, so please do not discard). Regardless of whether the test is negative or positive, it should not be disposed of as clinical waste (i.e. in an orange bag) due to the presence of the test chemicals.
Disposing of a used LFD test in clinical settings
Any swabs, cartridges and devices associated with LFD testing are likely to be contaminated with liquid chemicals. This waste is not clinical, neither is it infectious waste, therefore it must not be placed in an orange bag, nor disposed of via the clinical waste route.
Due to the liquid chemical content it must be treated by municipal incineration i.e. ‘Energy from Waste’ from waste facilities. It is necessary for this waste to remain ‘visible’ in the waste management chain in order to prevent mishandling or inappropriate treatment (for example, landfill); therefore, where possible, it should be placed in a clear bag.
Where clear bags are not available you should speak to your local waste management team to agree an appropriate approach to achieve the desired treatment route (i.e. incineration). You will need to speak to the general waste contractor and ensure that this segregated waste is taken to energy from waste facilities, this may require separate arrangements to be made from other waste you produce. This may mean agreement to use other types of non-clinical waste bags such as white, black or other bags, as long as it is labelled as non-hazardous, chemically contaminated waste.
Testing kits specifications (latex/halal/vegan)
Latex
Both Innova and Orient Gene swabs (LFD kits) are latex free. The swabs are also supplied in sterile packaging, labelled as sterile, to protect from exposure to latex within the external environment. This means that if testing staff handling the test kit are wearing latex gloves there should be no impact on the swab itself. If any part of the swab packaging looks damaged in any way, please do not use the test and report this via the appropriate channel.
Some PCR testing swabs - while not containing latex– may have been manufactured in areas that have previously handled latex. This applies to those kits that have been distributed via the Department of Health and Social Care (DHSC) across care at home/housing support services. The PCR kits affected will have a warning clearly stating this and we advise, although the risk is minimal, that staff who have a latex allergy do not use these kits. Where this arises we suggest that staff contact their employer in the first instance. Alternative LFD kits can be provided.
Halal
No animal products have been used in the production of the swabs that come into direct contact with the individual using the test. The thin paper like material inside the LFD is coated with antibodies from animal cells.
No direct contact will be made between the person and this material. The monoclonal antibody technology present in our lateral flow devices are necessarily generated from animal cells. This is in common with other tests of this kind, including commercially available pregnancy tests. It is for individuals to make their own decisions based on their religious practises or dietary choices.
Vegan/ animal testing
The monoclonal antibody technology present in both Innova and Orient Gene lateral flow devices are necessarily generated from animal cells. This is in common with other tests of this kind, including commercially available pregnancy tests.
The swab itself does not contain animal products. During development, at no time have any component parts in the Innova or Orient Gene test kits been tested on animals. The Vegan Society advises vegans avoid using products made from animals as far as is practicable and possible and vegans should never stop taking prescribed medications without first talking to your doctor.
More information
If you work in the secondary care sector please contact your testing single point of contact (SPOC) for further information.
Primary care-specific information
Independent contractors are responsible for allocating test kits to staff and ensuring appropriate training is provided. This is supported by resources developed by NHS Education for Scotland (NES).
Those working in Primary Care (General Practice, Dentistry, Pharmacy, Optometry) who require further information pertaining to the programme, or would like to report any problems with the tests (e.g. clinical incidents, spurious results), should send their query to the following email address - PrimaryCareLFDTestingSupport@gov.scot. Any queries or concerns regarding delivery of test-kits (e.g. late delivery, damaged tests) should be sent to nss.CovidTestingPortalCare@nhs.scot.
Provision of test kits to independent contractors
All independent contractors will receive supplies of LFD test kits based on an estimate of patient-facing staff numbers. Test kits will be provided directly to individual premises for onwards distribution to staff. If insufficient test kits are provided, or if there are excess kits not being used, NHS National Services Scotland (NSS) should be contacted by phone on 0800 008 6587 or by email at nss.CovidTestingPortalCare@nhs.scot.
For reassurance, information on individuals choosing to participate or not participate in testing is protected under data protection, however, business-level information about whole practices which decide not to participate may be subject to an FOI request.
Testing access for Primary Care locums
In the first instance, locums should access testing via the practice or pharmacy with which they have an ongoing relationship. Independent contractors can order test kits from nss.CovidTestingPortalCare@nhs.scot for providing to locums, if necessary. Locums working in an Out of Hours Hub will also be able to access supplies of test kits within these environments.
Recording primary care staff tests on the online portal
Primary Care staff should select “Primary Care including Independent” on the online portal as the most relevant reason for taking the test. They should then select the area they work in from the drop down list. If you work in more than one location, you should select your primary working location from the drop down list on the online portal. You should still provide your current working location even if you are not employed by the relevant NHS Board.
Archived guidance
Relevant documents and guidance (July 2020) have now been archived, but if required can be accessed on the gov.scot archive.
Twice weekly Lateral Flow Device (LFD) Testing
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