Advice for health and care staff on respiratory viruses including COVID-19: guidance

This guidance is for health and social care providers and staff to set out the current testing regime and advice for management of respiratory viruses, including COVID-19. It is informed by public health and clinical advice which takes account the current public health conditions. 

We will keep this guidance under review as prevalence changes and as knowledge of current and future COVID-19 variants increases.

Who does this guidance apply to?

This guidance replaces all previous versions and applies to staff working in close contact with patients and service users. It also applies to prisons and special schools.

Any patient/service user facing staff member who has symptoms of a respiratory tract infection including COVID-19 and/or has a high temperature is advised to stay at home and notify their employer as soon as possible. 

When they no longer feel unwell and do not have /not had a high temperature and are ready to return to work they  may wish to discuss with their employer ways to minimise any  risk as some may still be infectious. This may include undertaking a risk assessment if the staff member works with patients whose immune system means that they are at higher risk of serious illness despite vaccination.

At this time, staff should no longer conduct regular asymptomatic testing. In addition, from the 1st April 2023 routine symptomatic testing will no longer be required or advised for health and social care workers, care home residents, prisoners and staff and residents in special schools. 

Testing will be more clinically led and will continue in the following scenarios for staff, residents in care homes and special schools and prisoners.

Staff in health, social care and special schools eligible for treatments   

Reason for testing - If they are eligible for COVID-19 treatments and have respiratory symptoms or if they are clinically advised.

Test procedure - LFD or PCR. 

Residents in care homes, special schools and prisoners

Reason for testing - If they are eligible for COVID-19 treatments and have respiratory symptoms or if they have been clinically advised.  

Test procedure - LFD or PCR. 

Managing incidents in hospitals, care homes, prisons and special schools

Reason for testing - Infection and prevention control /streaming to manage incidents and outbreaks in closed settings.

Test procedure - PCR. 

Staff who test positive for COVID-19 in any of the above scenarios should try and avoid contact with anyone who is at higher risk of becoming seriously unwell for 10 days after they took the test or started to have symptoms.

Residents and inpatients who test positive should follow Infection Prevention and Control Measures for Acute Respiratory Infections (ARI) including COVID-19 for Health and Care Settings.

People who live in the same household as someone with symptoms of  COVID-19 or other respiratory virus are at the highest risk of becoming infected because they are most likely to have prolonged close contact. 

People who stayed overnight in the household of someone with symptoms of COVID-19 or other respiratory viruses are also at high risk.

Staff who are a household or overnight contact of someone who has had a positive COVID-19 test result or has symptoms for COVID-19 or other respiratory viruses should discuss ways to minimise risk of onwards transmission with their line manager.

This may include considering:

• redeployment to lower risk areas for patient-facing healthcare staff, especially if the member of staff works with vulnerable patients including those who are immunosuppressed meaning  that they are at higher risk of serious illness despite vaccination (gov.uk)
• working from home for non patient-facing healthcare staff
• limiting close contact with other people especially in crowded, enclosed or poorly ventilated spaces

While they are attending work, staff must continue to comply rigorously with all relevant infection, prevention and control procedures. 

If staff develop any symptoms they should follow the advice for staff with symptoms of a respiratory infection, including COVID-19.

In the absence of testing, adherence to the current guidance on Infection prevention and control measures for acute respiratory infections (ARI) including COVID-19 for health and care settings - Wales will be essential. This includes monitoring and reporting of outbreaks, good hygiene practices and the appropriate use of PPE.   

All health and care staff should be familiar with the principles of standard infection control precautions (SICPs) and transmission based precautions (TBPs) for preventing the spread of infection in health and care settings and should implement IPC measures in line with the National Infection Prevention and Control Manual for Wales NIPCM - Public Health Wales (nhs.wales).

It remains the responsibility of the health board or employer to ensure that staff and visitors comply with IPC guidance for health and care settings.