New NICE guidance drops blanket two-week isolation rule prior to elective care

A rule that required all patients in England attending hospital for elective care to self isolate for two weeks before their procedure has been dropped under new NICE guidance.

New recommendations around admissions for elective care (Photo: Morsa Images/Getty Images)
New recommendations around admissions for elective care (Photo: Morsa Images/Getty Images)

The original rule was introduced by NHS England under guidance for re-starting elective care in May. However, NICE's new guideline now advises that patients attending hospital for any planned procedure, including diagnostic tests and imaging, should follow strict social distancing and hand hygiene measures for 14 days before their appointment or admission.

Patients admitted for procedures involving anaesthesia or sedation should also undertake a SARS-CoV-2 test within three days before admission and then self isolate from the day of the test until they are admitted.

However, NICE does recommend that patients who are at greater risk of contracting COVID-19 or becoming severely ill as a result of the coronavirus should be advised to consider self isolating for 14 days before their procedure.

Rather than a blanket national approach, NICE has recommended that local areas should decide on policies relating to testing and self isolation ahead of any planned care if local transmission rates of COVID-19 increase.

Flexible approach

NICE said that the guidance aimed to promote 'a flexible approach based on individual circumstances and the type of procedure and aims to support the prompt recovery of elective care, while advocating shared decision-making, balancing the risks and benefits'.

The guidance also says that patients should be warned that their treatment or care is likely to be postponed if they test positive for SARS-CoV-2, have symptoms of COVID-19 or have been told that they need to self isolate after being in contact with someone who has COVID-19.

The NHS Confederation welcomed the move, highlighting that some patients had been put off from coming in for planned treatment because of the rule that required them to self isolate at home for 14 days, particularly if they had work commitments. It is understood that this had hampered hospitals as they attempt to tackle the huge backlogs that have developed as a result of the pandemic.

Dr Layla McCay, director at the NHS Confederation, said: 'It is right that this policy is adjusted so that more decisions can be made locally, taking into account the patient’s personal circumstances, staffing, estates, cooperation with other health and care organisations, and local variations in infection rates, all while adhering to testing, hand hygiene and social distancing requirements.

'The NHS faces a huge challenge in getting through the millions of planned procedures that had to be paused and that have built up as part of our initial response to containing the spread of the disease. More decisions on resuming services should be deferred to local leaders.'

The two-week self isolation rule for children being admitted for elective care was relaxed earlier this month after the Royal College of Paediatric and Child Health agreed a change in the recommendation with NHS England.

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