GP practices have been warning for some time that with high levels of COVID-19 in circulation since the bulk of COVID-19 restrictions were scrapped in July, soaring numbers of staff in self isolation were affecting their ability to maintain services.
London GP Dr Farzana Hussain warned on Twitter this week: 'Small practices completely creaking! One GP isolating and only me on site today. Very hard for lots of partners to take leave. The small practice model may be ending with the pressures of the pandemic.'
GPonline reported last month on practices warning their workforce had been decimated by the loss of staff forced to self isolate. However, the BMA warned against plans for an exemption for NHS staff from self isolation rules last month, calling the move 'desperate and potentially unsafe'.
COVID self isolation
With more than three quarters of the UK adult population now fully vaccinated against COVID-19, the government is set to lift the requirement for people identified as a close contact of a positive COVID-19 case to self isolate from Monday 16 August, providing they are double jabbed or aged under 18.
Guidance for NHS staff updated this week says anyone identified as a close contact should initially take PCR test unless they have recently had COVID-19, but can continue to work as long as they take daily lateral flow tests before starting work over a 10-day period.
For staff who work with clinically vulnerable patients, a risk assessment should be carried out and consideration given to 'redeployment' for a 10-day period, the advice says.
The guidance says: 'From 16 August, staff members notified that they are a contact of a COVID-19 case are not required to self-isolate if they are fully vaccinated. They should inform their line manager or employer immediately if they are required to work in the 10 days following their last contact with a COVID-19 case.'
If staff develop symptoms they should follow stay at home advice and take a PCR test, but the advice says 'the majority of fully vaccinated health and social care staff will be able to continue in their usual role'.
Close contacts with no symptoms are advised to 'immediately arrange for a PCR test, either through their workplace arrangements or via the NHS Test and Trace service, and the result of this PCR test should be negative prior to returning to work'.
The guidance adds: 'Following the negative PCR result, the staff member should undertake a lateral flow device antigen test every day for the 10 days following their last contact with the case - even on days they are not at work.
'If a staff member has had a SARS-CoV-2 infection in the past 90 days, they should not have a PCR test and should only undertake daily LFD antigen tests. On days the staff member is working, the LFD antigen test should be taken before starting their shift, and the result should be negative.
'The staff member should comply with all relevant infection control precautions and PPE should be worn properly throughout the day. If the staff member works with patients or residents who are highly vulnerable to COVID-19 (as determined by the organisation), a risk assessment should be undertaken, and consideration given to redeployment during their 10 day self-isolation period.'
For unvaccinated or partially vaccinated staff, self isolation rules continue unchanged.
Commenting on the changes, UK Health Security Agency chief executive Dr Jenny Harries said: 'Thanks to the huge success of the vaccine programme, we are able to ease self-isolation requirements for double jabbed people and under-18s. It is important that close contacts continue to come forward for a PCR test, in order to detect the virus and variants of concern.
'Although two doses of vaccine will greatly reduce your own risk of becoming unwell with COVID-19, it is still possible to contract the virus and pass it to others. So if you develop symptoms at any time - vaccinated or not - you should get a test and be very careful in your contact with others until you have received a negative test result.'