Publish date: 12 October 2022
COVID-19 guidance is changing constantly. To help keep you up to date we’ll provide regular updates with summaries of the latest guidance and links to key Trust standard operating procedures (SOPs).
Staff and managers may find it helpful to use this update as part of regular staff meetings or huddles.
Re-introduction of universal masks
COVID-19 prevalence is increasing resulting in outbreaks and cases within the Trust. Therefore, from today (12 October 2022), the use of mandatory masks will be re-introduced across all patient-facing areas as set out below.
Patient facing (clinical) areas - this includes any indoor area accessible by patients or members of the public - wards, reception areas, corridors, all communal areas within the hospital, walk in centres or community clinic areas and domiciliary care settings. Masks must be worn by all staff in these areas, at all times. Masks may be removed in remote, off ward administration office areas, providing these areas cannot be accessed by patients or members of the public.
Visitors will not be mandated to wear masks but encouraged to access masks as a personal choice, as well as alcohol gel, at all hospital, clinic and ward entrances (see further detail below).
Office areas will not be mandated to wear masks, but they will continue to be supplied for any staff who wish to wear them. Staff must be diligent with hand hygiene and ensure workspaces are cleaned in between each use.
Staff working in other healthcare settings, including acute trusts, should be compliant with local policies within these organisations.
COVID-19 patient testing
NHS England guidance has changed to update COVID-19 testing requirements in periods of low prevalence. Within the Trust, routine COVID-19 patient asymptomatic testing was stepped down from 5 September 2022. This includes:
- Testing on admission, and on days 3 and 5 to 7 ceased.
- Testing following AWOL or overnight leave ceased.
Testing will continue in these situations:
- On admission, one single polymerase chain reaction (PCR) test only, for patients identified with severe immunosuppression or higher risk of infection. This is defined within COVID SOPs and also in this link
- For patients discharged to a care/nursing home or other hospital, if required.
- Symptomatic testing to continue for any patient with symptoms consistent with COVID-19 infection during admission or throughout their stay.
- Outbreak and contact testing to continue as advised by infection prevention and control (IPC) team.
- Patients transferring from LUHFT into Longmoor House will receive a pre-admission PCR test.
Testing guidance relates to periods of low prevalence, therefore is subject to review during periods of increased prevalence. Please see updated patient testing SOP for further detail, including which require PCR or LFD test, and how to record on the clinical record system.
Asymptomatic staff testing - twice weekly Lateral Flow Device (LFD) testing
From 31 August 2022, staff were not required to undertake twice weekly asymptomatic LFD testing. This follows the Government announcement regarding “pause” for asymptomatic NHS, adult and social care staff testing. Staff will still need to undertake twice weekly LFD asymptomatic testing if they are identified as a household contact. Please see SOP for further details.
Staff will also need to continue with asymptomatic LFD testing if working in a COVID outbreak ward as part of outbreak testing. Symptomatic staff will still be required to undertake testing.
There are no changes to reporting or ordering, LFDs remain available via the Government portal
Distancing in clinical areas
Clinics can revert to pre-COVID-19 safe distancing. There’s no requirement to allow a safe distance in clinics or walk in centres.
Visiting can return to pre COVID arrangements
This means that:
- There will be no limit to the number of visitors that patients can receive from an IPC perspective. However, at Longmoor House this will be limited to two people at the patient’s bedside
- There will be no requirement to use booking systems that were introduced specifically during the COVID pandemic
- There will be no requirement for patients to wear masks, or safe distance, unless advised by the IPC team (for example, if the patient has an infection risk).
Good hand hygiene should be encouraged prior to and after the visit.
Visitors will not routinely need to wear face masks
Unless:
- They are visiting a patient who is vulnerable and at higher risk of infection
- They’ve been risk assessed or advised by the IPC team (for example, if the patient has an infection risk)
- It’s personal choice or need, including if they are vulnerable and at higher risk of severe infection.
Masks will be available in all Trust sites for visitor’s use.
Visits should continue to take place in designated visiting rooms as per pre COVID. Visiting a ward that is in outbreak will be by exception and must be discussed with the IPC team prior to taking place.
Return to face to face meetings in the Trust - including training
There will be no restrictions on staff or patient face to face meetings across the Trust. Mask use will not be required unless staff/patients use them as their preference. We continue to strongly advise a common-sense approach when using rooms, including avoiding overcrowding, and the use of natural ventilation such as opening doors and windows to allow air circulation.
Key COVID-19 Standard Operating Procedures
Admission and isolation
Admission and testing procedures have been replaced with patient testing SOP as described above. Any patient testing positive for COVID will continue to require a period of isolation. Please read the SOP for further guidance.
Guidance for stepping down isolation
The patient isolation period for COVID-19 can be reduced from ten days if specific criteria is met. Patients can be tested using LFDs at day five of their isolation period, and require two consecutive negatives tests, commencing from days five and six. Nb. This has changed as was previously commencing on day six. Please read the SOP for further guidance.
Contacts of COVID-19 in our inpatient settings
If inpatients are identified as a contact of a positive COVID-19 case, they are no longer required to isolate if they remain asymptomatic, but they are required to follow advice. This includes twice weekly testing and avoiding contact with those who are at greater risk. Please read the SOP for further guidance.
Section 17 leave and AWOL
Patients returning from a period of AWOL or taking Section 17 leave during the day or overnight, do not require testing or isolation on return. Nb. This has changed as those taking leave overnight or AWOL, had been required to test. Public health advice should also be followed. For further information, please read the SOP.
Managing and testing a patient with suspected respiratory infection
The list of symptoms has extended to suspected COVID-19 infection. The SOP also advises on when to take an Influenza swab.
Guidance for staff with COVID-19 and other respiratory infection
An extended list of symptoms, together with temperature or feeling unwell, requires a COVID-19 test and exclusion. The SOP provides detail on when staff can return to work, if testing COVID-19 negative, and also if testing positive. This includes LFD testing from days five and six of positive result or symptoms.
Reintroduction of group therapy sessions, clinics and gyms
The SOP details guidance on limitations and advice when mixing service users from different wards, such as avoiding service users from wards with active or suspected COVID-19 infections.
Managing patients with Aerosol Generating Procedures (AGPs)
The list of AGPs has been reduced and now excludes continuous positive airway pressure (CPAP), high flow nasal oxygen and cardiopulmonary resuscitation (CPR). Use of high-speed drills in dental services remains. Also, the use of respiratory equipment is now only required when undertaking AGPs for suspected or positive COVID-19 patients. Read the SOP for details.
Your questions answered
Do you have questions? The latest COVID-19 guidance, along with risk assessments and further COVID-19 SOPs, can be found on YourSpace.