Antibody testing programme letter: 25 May 2020


Classification: Official
Publication approval reference: C0553


  • Regional Directors, NHS England and NHS Improvement
  • EPRR Regional Leads
  • CEOs of NHS Trusts / Foundation Trusts
  • GP Practices and Primary Care Networks

25 May 2020

Dear Colleague,

Antibody testing programme roll out for NHS staff and patients

This letter requests that all systems commence antibody testing as soon as their
laboratory capacity permits, as set out in the circumstances below. The antibody
testing programme will provide information on the prevalence of COVID-19 in
different regions of the country and help better understand how the disease spreads.
This will work alongside PCR testing which confirms whether or not someone
currently has the virus.

It is important to reiterate that the science is currently uncertain and a positive test
result for antibodies only means than an individual has had COVID-19. There is
currently no evidence to show it means someone cannot be re-infected with the
virus, or pass it on to others, or have protective immunity. All infection prevention
and control measures must continue to be in place irrespective of the presence of
antibodies. Public Health England are conducting a study to establish whether
antibodies detected by this test do indicate immunity to COVID-19.

For NHS staff

Each NHS region is coordinating its own specific arrangements to roll out antibody
testing to NHS staff. The test is a venous blood test, which will be taken by a qualified member of staff and processed through NHS pathology networks. The test should progressively be offered to NHS staff who want it, including those working on NHS premises but not directly employed by the NHS, working for the NHS but not on NHS premises, and those in primary, community, and mental health care including community pharmacists. Regions should plan to test members of staff who want the test as quickly as they can, starting early this week as soon as pathology networks are ready to begin processing samples. The likely staff groups to test first are in acute Trusts in which prevalence has been highest. Over the next few weeks, additional trained phlebotomists need to be deployed where required, and venepuncture training is being offered to those returning to service who require it.

All samples must be identified as a member of NHS staff, as we need to report to the Department of Health and Social Care the number of NHS staff tested and the results that are positive for COVID-19 antibodies. Staff must be given information about the test, and asked to sign a consent form. The result will be returned from the local NHS pathology network as soon as possible (within 24 hours). Results should be communicated to the individual and should not go on the employment record. GPs should be able to access the result via the local laboratory reporting system if required and according to local protocols. Whatever the result of the test for antibodies, all staff must still follow all the Personal Protective Equipment (PPE) and infection control guidance.

We await further scientific guidance and decisions from DHSC as to whether staff
will be tested once, or whether this will be a rolling programme with repeat testing
offered to staff. As soon as this guidance is available, we will share it with you.#

For NHS patients

The antibody test will be available for clinicians to use in their routine management of
NHS patients as appropriate. In circumstances where there is not a specific clinical indication for the test, the Secretary of State has additionally decided that it may be offered to NHS patients already having their blood taken and who want to know whether they have been infected with COVID-19. Appropriate consent should be obtained and documented in the patient record. The result will be available to clinicians alongside other test results, and it is their responsibility to inform the patient of the result and that a positive test does not indicate immunity to COVID-19.

We will write later this week with more details of the next stage of our PCR testing programme for symptomatic and asymptomatic NHS staff, which will complement the Government’s Test and Trace programme.

Kind regards

Pauline Philip | National Director For Emergency & Elective Care, NHS England & NHS Improvement

Prof Steve Powis |  National Medical Director, NHS England & NHS Improvement