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Covid asymptomatic nurses with positive day 10 LFT can return to work



Nurses and other healthcare workers who are asymptomatic but still returning a positive LFT result on day 10 of their Covid isolation period should be risk assessed to return to work, according to new guidance.

An NHS England letter sent to healthcare services over the weekend confirmed that new UK Health Security Agency (UKHSA) guidance temporarily suspending confirmatory PCR tests following positive LFTs also applies to healthcare staff.

Under the general UKHSA guidance, which comes into force from tomorrow, those testing positive for Covid via LFT will be required to self-isolate immediately without needing a confirmatory PCR.

Those with symptoms must still take a PCR test and self-isolate while awaiting the result and if it returns positive – whether or not they test negative via LFT.

Since last month, healthcare staff in England can return to work from day seven of their isolation period if they test negative twice via LFT 24 hours apart and providing they continue to test negative daily until day 10 and are medically fit to do so.

Those who continued to test positive on day 10 were asked to continue daily lateral flow testing and not return to work until they received a negative test result.

However, NHS England said that healthcare staff who continue to test positive via LFT on day 10 should now be risk assessed ‘with a view to return to work’ if they are asymptomatic.

The letter said: ‘Building on UKHSA advice, if the staff member’s LFD test result is positive on the 10th day AND the person has no symptoms, they should have a local risk assessment with a view to return to work depending on the work environment. 

‘We are aware that with current staff absence levels, organisations will at times need to risk assess isolating staff to allow them to return to work on a balance of risk basis (for those who remain LFD positive on or after day 10).’

The likelihood of a positive LFT after 10 days in the absence of symptoms is ‘very low’, it added.

UKHSA’s guidance for healthcare professionals has been updated to reflect the new advice.

NHS England also said that as well as reporting positive LFTs for contact tracing, healthcare staff should report their absence ‘in line with the employer’s sickness absence policy’.

The letter added that primary care organisations should ‘continue’ one-to-one conversations with staff who have refused Covid jabs to ‘understand and address their questions and concerns’.

All staff should continue to carry out and report results of twice-weekly LFTs, alongside ‘robust local monitoring’ of test results, and should be offered ‘continuous learning’ regarding the latest IPC guidance including via ‘refresher’ events, it said.

NHS England last month told GP practices they can access a ‘significant contingency supply’ if they are struggling to get hold of tests.