Isolation exemptions for health and social care staff
The following is a summary of the policy guidelines on isolation exemptions for health and social care staff relating to Covid-19.
What are the policy changes for health and social care staff?
Due to significant disruption in service there may be occasions where it is necessary to ask health and social care staff who have been identified as a close contact of someone who has tested positive for Covid-19 if they are willing to return to work within the self-isolation period in specific circumstances and in line with Public Health Scotland (PHS) guidance.
In order to return to work certain requirements which are summarised below must be met:
- staff participation in this policy is voluntary and staff must be given sufficient information in discussion with the responsible manager to make an informed choice before agreeing to return to work
- all other options for securing staff resource have been exhausted in line with local business continuity planning
- an individual risk assessment/checklist to determine suitability to return to work is completed
- returning staff are not resident with the person who has tested positive for Covid-19
- the staff member is fully vaccinated at least two weeks prior to returning to work and is symptom free
- the staff member has a PCR test performed and has a negative result prior to returning to work
- the staff member performs a daily LFD test, records results and informs manager up to day 10 from Covid exposure - results must be recorded on the NSS Covid testing portal
- the staff member agrees to minimise social contact outwith work situations up to day 10 from Covid exposure
The flexibility to wear an FFP3 mask for staff returning from self-isolation does not constitute a change to previous issued policy on the provision of PPE. These masks should only be used pursuant to a risk assessment and to assist with alleviating any overwhelming concern of the staff member in question.
There is no evidence that FFP3 masks provide additional source control protection (i.e. additional protection to the people whom the mask wearer is caring for or in contact with), as compared with fluid resistant surgical masks (FRSM).
What is the evidence that supports the policy changes?
- PHS have undertaken a detailed review of the evidence and balance of risks to staff and those they care for and support and have concluded that where mitigations are in place, staff can return to work with low risk
- PHS advise that with the mitigations of double vaccination, no ongoing exposure to Covid case, no symptoms, PCR and ongoing LFD testing in place, the risk is extremely small (bordering on negligible) and far outweighed by the risk to service users and the wellbeing of staff where there are severe and significant staff deficits
- a British Medical Journal study of health care support workers and household contacts showed that vaccine was effective at preventing spread
- vaccine studies have shown that vaccines are effective against the delta variant, particularly two weeks following completion of second vaccine
- lateral flow tests are effective at picking up delta variant
What staff can expect from their employer
- that the staffing risk has been escalated to the most senior level and is such that there is a significant risk to the care and safety of service users and wellbeing of other staff
- that all other business continuity contingency planning to manage major service disruption due to staff availability has been exhausted and decisions and actions recorded prior to enacting this policy
- that staff who are requested to return to work are informed that it is voluntary and are provided with information to make an informed decision about returning and can discuss any concerns they may have
- that an individual risk assessment/checklist is completed in discussion with the staff member prior to staff returning. This should record vaccination status, PCR results, identifies that staff have no Covid-19 symptoms and records provision of LFD testing kits
- that staff are supported to record daily LFD results on the NSS Covid testing portal
- that returning staff are not deployed to where the risk of Covid related infection is particularly detrimental to patient/service user outcomes e.g. severely immunocompromised, elective surgery, social care service users with complex needs or who were in the shielding categories
What employers should expect from staff
- that they should have read this information to familiarise themselves with the policy and are, having made an informed and voluntary decision, willing to return to work in response to significant service disruption
- that they participate in completion of the risk assessment and discussion with manager prior to return to work
- they undertake a PCR test (from local Health Board or through NHS Inform) and provide result to employer prior to returning to work. These are also available from the UK Government website
- that they agree to perform daily LFD tests and inform employer of results up to 10 days from exposure (to the person who has tested positive to Covid-19)
- that they adhere to IPC procedures ensuring appropriate use of PPE at all times
- that they refrain from work, inform manager and book a PCR test if symptoms develop or if a positive LFD result is obtained
- although mitigations of additional testing significantly reduces the risk of transmission it is not risk free and therefore staff should minimise the number of contacts outwith work situations and avoid crowded places and public transport as much as possible