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COVID-19: SWABBING

National portal for all: Getting tested

Guidance on coronavirus testing, including who is eligible for a test and how to get tested.
Includes:

– Who can be tested
– Employer referral for essential workers
– Testing Process

Swabbing training

View the training video

Care Home swabbing: National and local routes

Swabbing webinar: 11-09-2020

*Please note the local pathway flow has been updated to include HCC Monitoring officer involvement. See below for the updated flow.

Please note the information for the webinar was correct as of the 11th September, but please make sure you keep up to date with HCPA newsletters where information on this area is updated.

Asymptomatic testing

Guidance released in July outlines a process for regular asymptomatic testing in care homes.
 

  • Testing for staff is to be every 7 days using national portal swabs
  • Residents are to be tested every 28 days using national portal swabs
  • If there is a positive result, then all negatives should be retested 4-7 days from the date of the received result (this is to reduce the likelihood of a false negative test) using the local pathway
  • The home should re-swab all negative residents and staff after 28 days of the last positive result to check that the outbreak has concluded using national portal swabs
  • Any positive results should note be retested for 6 weeks

Pathways

The pathways to follow, following one or more COVID-19 positive cases (staff and residents)

Local pathway processes

If you are not sure at any point, please contact the provider hub on 01707 708108
or email assistance@hcpa.info Monday – Friday, 9am – 5pm

Using the Swabs

  • The local swabs are distinguished from the national portal swabs by their red caps

  • Please make sure you label each swab correctly so they can processed by our local labs
  • Can you also add the name of the care home onto the PHE Covid19 Primary Testing in the top right hand corner
  • This must include:
    • Name of the care home
    • DOB
    • NHS number
    • Name of patient

National portal update

Result

Working to return to 72-hour results window, but it currently has delays. If you haven’t received your results before your next round of testing begins, please continue testing as planned.

 If you receive unclear/void results, please retest immediately. For staff, this should be as part of their weekly testing routine, but for residents, this will require an additional test.

MULTIPLE REGISTRATION PORTAL – If you receive this message “Sorry, there is a problem. Your test kits have not been registered.” re-register the tests one by one using the single registration option, when re-registering the test, if you see an error message which says, “Test kit already registered”, this means this registration was successful the first time, despite the error message.

Reminder

When you apply, please enter the total number of staff and residents in your Care Home. We will then send you 28 days of test kits to perform weekly staff testing, and resident testing every 28 days.

You are then able to apply for more test kits 21 days after we send you your test kits, which is the date that we email you to confirm their delivery date and the number of test kits that have been dispatched.

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Click here to view current swabbing FAQ's

SectionGuidanceAnswerLinks
Re-testing*When should I retest staff or residents who test positive?If the resident is positive, has been self-isolated for 14 days and is no longer showing any symptoms, (clinically improved and fever free for 48 hours) then you do not need to retest. The resident can come out of self-isolation. Residents who have previously tested positive for Covid19 should be exempt from re-testing within a period of 90 days. If after the 14 days, the resident continues to show symptoms (other than a cough or loss of smell / taste) or signs, the resident should be clinically reviewed and remain in isolation until the clinical review has been undertaken. If they have been cohorted with other individuals, the other residents’ follow-up period recommences from the date of last exposure. They should be isolated for 14 days. Staff, if asymptomatic, should be exempt from testing for 90 days from their initial illness onset unless they develop new symptoms, in which case they will need retesting. If a resident or a staff member then tests positive, this may be due to the ongoing infection. If they are asymptomatic then please contact the Health Protection Team on 0300 303 8537 for advice. If they are symptomatic then they will need to isolate again for 10 days.
Re-testing*What happens if a staff member or resident tests positive after the 90 days?If a staff member or a resident tests positive after 90 days this may be due to the ongoing infection. If the staff member is asymptomatic then please contact the Health Protection Team on 0300 303 8537 for advice. If the staff member is symptomatic then the staff member will need to isolate again for 10 days.
Re-testing*When undertaking follow up testing, what day is day one? Day one is counted as the day the swab was taken. For example, if the swabbing was undertaken on a Monday and a result came back positive, then all residents and staff who tested negative will need to be swabbed between Thursday and the following Monday (day 4- day 7).
Whole Home Swabbing*How do I access the swabs to complete whole home swabbing?Asymptomatic testing is delivered by Department of Health and Social Care. Until the 31 August, only homes that have a registration of 65+ or dementia can access swabs through the national portal. It is important that homes do register on the national portal to access the swabs. However, the delivery of swabs to care homes is being prioritised in areas which is nationally of concern. From 31 August, all other adult care homes will be able to register to access to the swabs. Testing will then be rolled out from 7 September.
Outbreaks*How long do we wait before we can declare an outbreak is over?The Covid-19 outbreak can be declared over firstly once no new cases (staff or residents) have occurred in the 28 days since the appearance of symptoms in the most recent case, or if case is asymptomatic then the date the swab was taken. All residents should have completed their 14 days isolation period. And secondly to confirm the outbreak is concluded, please order swabs via the national portal and swab all residents and staff. If the results are negative, then the outbreak can be defined as having concluded. Staff who have previously tested positive will be exempt from re-testing within a period of 90 days and residents for a period of six weeks from their initial onset of symptoms or test result (if asymptomatic). Therefore, depending on when the individual developed symptoms/tested positive, they may be excluded from this whole home test at 28 days after the last case. When the outbreak has been declared concluded the home should complete a post outbreak deep clean of the Home.
Swab testing*What will testing for Covid19 tell me?The test will only tell you whether the individual has or does not have COVID19 at the time the swab is taken. It will not tell you whether the person has had Coronavirus previously or whether they will develop it later on.
Resident testing*Do we have to swab all residents even if they are distressed? If a resident does not have relevant mental capacity, for example, to make necessary decisions (including care, treatment and residence decisions), staff will need to consider the legal, decision-making framework offered by the MCA. The Department of Health and Social Care has issued guidance on the use of the MCA and Deprivation of Liberty Safeguards during this period. It can be found here: https://www.gov.uk/government/publications/coronavirus-covid-19-looking-after-people-who-lack-mental-capacity Care home staff will need to consider the MCA and this guidance, when making decisions for people who lack the relevant mental capacity to make them. This includes residents who cannot make their own decision about testing. If a person lacks capacity to provide consent to be tested for COVID-19, the decision maker should where necessary make a ‘best interests decision’ under the MCA. When doing so, they must consider all the relevant circumstances and should make a record of their decision. This must be undertaken in relation to the individual and should never be determined in relation to groups of people. Additional time may be required to make the best interest’s decision in these situations. If the resident is symptomatic you should isolate them for 14 days. Any residents that are not swabbed must be isolated for 14 days. Click here
Resident testing*What happens if a swab is void/inconclusive or there is no result from the swab? If this happens, the test will need to be retaken
Resident testing*Is there any training available on how to swab?A youtube video has been produced which shows how to carry out nasal and throat swabs for residents: https://www.youtube.com/watch?v=1l0jcv37WzI&feature=youtu.be Care practitioners and nurses who will be swabbing residents in care homes should complete the online care home swabbing competency assessment before carrying out swabbing. Individuals can register at https://genqa.org/carehomes or care home managers can create an organisational account by contacting info@genqa.orgClick here
Symptomatic residents *If I have a resident showing symptoms of COVID-19, how do I arrange for them to be tested? If a resident is showing symptoms of COVID-19 and it is your first case or your first case since your previous outbreak had concluded, then please contact Health Protection Team on 0300 303 8537. As part of the outbreak, swabbing should be arranged following the flow chart and Table 1 at the end of this document. . A risk assessment will be undertaken and at this point, the cell may advise whole home testing of staff and residents. We would encourage all care homes to keep the swabbing excel spreadsheet up to date of all staff and resident, to help speed up the process. Names that don’t require swabbing can then be removed before emailing over to huc.admin@nhs.net. Once the spreadsheet has been received, testing will take place within 24 hours and results should be returned within 36 hours (based on courier collection dates). Please ensure that the resident is promptly isolated in their own room with ensuite facilities. The door to the room should be kept closed and ideally the bed should be positioned in the room 2 metres from the doorway and all IPC control measures have been implemented
Symptomatic residents *If a resident test positive, do I need to retest the resident at a later date? If the resident is positive, has been self-isolated for 14 days and is no longer showing any symptoms, (clinically improved and fever free for 48 hours) then you do not need to retest. The resident can come out of self-isolation. Retesting a COVID-19 positive individual during the period of self- isolation is not recommended. However, if the individual is retested during the 14-day isolation period and the result is negative, you must continue to follow the existing guidance and the individual must be self-isolated for 14 days. If after the 14 days, the resident continues to show symptoms (other than a cough or loss of smell / taste) or signs, the resident should be clinically reviewed and remain in isolation until the clinical review has been undertaken. If they have been cohorted with other individuals, the other residents’ follow-up period recommences from the date of last exposure. They should be isolated for 14 days.
Positive results*What does it mean if a resident tests positive again?Repeat positives should be regarded as part of the original infection for a period of 6 weeks and therefore during this time do not need to be isolated beyond the initial 14 days.
Positive cases*I have completed whole home testing and I have some positive cases, what shall I do? Please inform your HCC monitoring officer and if this is your first case or your first case since your previous outbreak had concluded, then please contact the Health Protection Team on 0300 303 8537. Please ensure that the resident is promptly isolated in their own room with en-suite facilities. Ideally the bed should be positioned in the room 2 metres from the doorway and all IPC control measures have been implemented. The testing you have to do is outlined in the pathways, please follow this pathway and send the spreadsheet to huc.admin@nhs.net
Residents transferring settings *If the resident has a negative test result and has come from another setting e.g. acute hospital or community does the resident still need to self-isolate? All residents being discharged from hospital or interim care facilities to the care home, and new residents admitted from the community, should be isolated for 14 days within their own room. This should be the case unless they have already undergone isolation for a 14-day period in another setting, it is advisable that you then isolate new residents for a further 14 days. If new residents are admitted part way through an isolation period, they should as a minimum complete the remaining isolation period within their own room in the care home.
Residents transferring settings *Do residents moving from the community coming into the care home need to be tested? Prior to the resident moving into the home, testing should be arranged for the individual and test results received before they move into the home. This should be accessed up to 48 hours prior to planned discharge. The resident should be kept in isolation for 14 days even if they test negative and have no symptoms and monitored for signs and symptoms of Covid-19. Please consult this table for details: https://www.hcpa.info/wp-content/uploads/Residents-transferring-settings-31072020.docxClick here
Whole home testing or asymptomatic testing *How do I access asymptomatic testing for my care homes? Asymptomatic testing can be accessed for all care homes via the national portal: https://www.gov.uk/apply-coronavirus-test-care-home. Remember to book the courier collection by 7pm the day before, through this weblink: https://carehomecollect.co.uk/ who will come to collect the kits and take them to a lab for processing and undertake the testing on the day of the courier collection. It is important that staff watch a video on how to carry out nasal and throat swabs for residents: https://www.youtube.com/watch?v=1l0jcv37WzI&feature=youtu.be Care practitioners and nurses who will be swabbing residents in care homes should complete the online care home swabbing competency assessment before carrying out swabbing. Individuals can register at www.genqa.org/carehomes or care home managers can create an organisation account by contacting info@genqa.org Click here
Whole home testing or asymptomatic testing *What happens if I have any problems with the national portal? For example, the swabs have not arrived, or I have not received my test results? If you need any support, please contact the Coronavirus Testing Call Centre on 0300 303 2713 (07:00 to 23:00 every day). If you have any issues with accessing swabs or booking your courier please escalate it through: scas.Covid19TestingComplaints@nhs.net copying in acs.covid@hertfordshire.gov.uk
Whole home testing or asymptomatic testing *How often do we need to swab?Guidance from NHS E says that asymptomatic testing should be undertaken weekly on all staff and every 28 days for residents. If there is a positive result then repeat testing on all residents and staff who had negative results should be undertaken 4-7 days afterwards through the local pathway To help this process can you please ensure that the swabbing spreadsheet is updated with all residents who were negative, that need to be swabbed and then sent over straight to huc.admin@nhs.net If a resident is showing symptoms of COVID-19 in between this period and it is your first case or your first case since your previous outbreak had concluded, then please contact Health Protection Team on 0300 303 8537.
Staff testing*I have a member of staff that is showing symptoms, how do I refer for them to be tested? Staff testing is available for any staff that are showing symptoms. The care home can refer staff through the gov.uk website for local testing sites: https://www.nhs.uk/conditions/coronavirus-covid-19/testing-and-tracing/ask-for-a-test-to-check-if-you-have-coronavirus/ Symptomatic staff who test positive for Covid19 or who have an inconclusive test result, and symptomatic staff who have not had a test, can: • return to work no earlier than 10 days from symptom onset, provided clinical improvement has occurred and they have been afebrile (not feverish) without medication for 48 hours and they are medically fit to return • if a cough or a loss of, or a change in normal sense of smell or taste is the only persistent symptom after 10 days (and they have not had a fever for 48 hours without medication), they can return to work if they are medically fit to return (these symptoms are known to persist for several weeks in some cases) All members of a household shared with the individual should self-isolate for 14 days from the day the individual’s symptoms started. Remember to include other staff who work in the home setting and live together in shared accommodation. However, if any household member develops symptoms of COVID-19, they should isolate for at least 10 days from the onset of their symptoms, in line with the stay at home guidance. Click here
Staff Testing*Local symptomatic staff testingReferral form: https://www.hcpa.info/wp-content/uploads/Key-worker-referral-form-v7.docx Full details (updated 21/10/20): https://www.hcpa.info/wp-content/uploads/Testing-for-key-workers_21-October-002.docxClick here
Staff Testing*What happens if a staff member is exposed to a confirmed case outside of work or contacted by NHS Test and Trace? The staff member should self-isolate for 14 days straight away. If the staff member gets symptoms, then they should be tested by booking in at one of the local test sites via the gov.uk testing portal or requesting a home test kit. If the staff member remains asymptomatic then they should self-isolate for 14 days from the date of exposure. The home will need to risk assess for any other staff they have been in contact without PPE. Guidance from Department of Health and Social Care have outlined 3 potential scenarios where ‘close contact’ occurs: • a staff member who has been caring for a person who has tested positive for COVID-19 or who has symptoms of COVID-19 while the staff member was wearing appropriate PPE. Staff will not need to isolate in these cases, but these contacts will be escalated to the local public health team for further advice if needed • a staff member who has been caring for a person who has tested positive for COVID-19 or who has symptoms of COVID-19 while the staff member was wearing appropriate PPE, but the PPE has been breached. The member of staff will need to isolate for 14 days in line with the advice to the general population (see advice above for examples of PPE breaches) • a staff member who has been in contact with anyone else who has tested positive for COVID-19 whether at work (most likely a colleague in communal areas) or in the community. The member of staff will need to isolate for 14 days in line with the advice to the general population Further information can be found here: https://www.gov.uk/government/publications/coronavirus-covid-19-admission-and-care-of-people-in-care-homes/coronavirus-covid-19-admission-and-care-of-people-in-care-homes#section-5-advice-for-staffClick here
Flow chart and more information*More information and flow chart for Outbreaks of Covid19 in Care homesFor further information and links, including the flow-chart for Outbreaks of Covid19 in Care homes, please click here: https://www.hcpa.info/wp-content/uploads/Swabbing-care-home-FAQs-030820.pdfClick here
Storage*How long can swabs be stored?Swabs can be stored for up to 24 hours in refrigerated conditions. Swabs that arrive after 24 hours, will still be tested but their accuracy may reduce. Therefore, when you know the day you are going to commence the swabs, please arrange collection as soon as possible.
Key Contacts*Not sure which pathway to use and which swabs to usePlease call your HCC monitoring officer or contact the HCPA Provider Hub on telephone 01707 708108 or email assistance@hcpa.info
Key Contacts*Where do I submit my swabbing form to for the local outbreakHuc.admin@nhs.net - Referral form can be found here: https://www.hcpa.info/wp-content/uploads/outbreak-testing-referral-form.xlsx
Key Contacts*Swabs have not arrived when they were meant to - East and North Herts Homes: hct.urgentviralswabbing@nhs.net - Herts Valley Homes: clcht.covid19@nhs.net
Key Contacts*Swabs arrived by there are items missing - East and North Herts Homes: hct.urgentviralswabbing@nhs.net - Herts Valley Homes: clcht.covid19@nhs.net
Key Contacts*Swabs need collecting or have not been collected within the time agreed - East and North Herts Homes: hct.urgentviralswabbing@nhs.net - Herts Valley Homes: clcht.covid19@nhs.net
Key Contacts*It has been 72 hours, but I do not have any test results. Please call your HCC monitoring officer or contact the HCPA Provider Hub on telephone 01707 708108 or email assistance@hcpa.info
Key Contacts*National Portal Swabs have not arrived, or the test result are delayed 0300 303 2713 (07:00 to 23:00 every day). If you have any issues with accessing swabs or booking your courier please escalate it through: scas.Covid19TestingComplaints@nhs.net copying in acs.covid@hertfordshire.gov.uk
Which area am I in?*East and North Herts or Herts Valley?East and North Herts homes area: North Herts, Stevenage, WelHat, East Herts and Broxbourne, Herts Valley homes area: Hertsmere, St Albans, Three Rivers, Watford and Dacorum

Key worker symptomatic swabbing local route

COVID-19 testing service for eligible Hertfordshire public sector key workers or their household contacts with suspected coronavirus symptoms will be available from today (Monday 14 September).

The testing service is run by Central London Community Healthcare (CLCH), and supported by Hertfordshire Community Trust (HCT).  It will be available at Harpenden Memorial Hospital from 14 September, and will initially be open from 9am – 5pm on weekdays, with weekend opening from 9am – 2pm starting on Saturday 26 September.

The testing service is only for a tightly defined group of public sector key workers or their symptomatic household contact with one or more symptoms of COVID-19.  These have been defined as a high temperature, a new continuous cough or a change in or loss of sense of taste or smell.

Eligible key workers can refer themselves, or their symptomatic household contact, with one of these symptoms by completing and emailing a referral form to Herts Urgent Care (HUC). HUC will check the referral form and that the keyworker criteria apply, and register the individual. That will trigger an email to CLCH, who will contact the individual with appointment details. An ID check will be carried out at Harpenden Memorial Hospital before the test is administered, so it is essential that valid ID is taken.

Please note: an appointment is required. Do not turn up without an appointment as you will not be tested.

The test results will be sent to HUC, who will inform the key worker via text.  Please wait for the text from HUC rather than contacting them for results.

It is important for everyone, including key staff, to stay at home and self-isolate as soon as they or anyone else in their household shows any signs of having COVID-19. People with symptoms must stay at home for 10 days from the start of symptoms or until the test comes back negative. People living with someone with symptoms must stay at home for 14 days from the start of the symptoms, or until the affected person’s test comes back negative.

» Read more about how long to self-isolate
» More details on what to do in light of your test results is available