Revised UK infection prevention and control guidance

Classification: Official
Publication approval reference: B1173


  • Trust CEOs
  • Trust directors of nursing
  • Trust medical directors
  • Trust chief operations officers
  • Trust DIPCs
  • Trust IPC leads
  • CCG directors of nursing
  • CCG medical directors
  • Regional IPC leads
  • Regional chief nurses
  • Regional medical directors


  • Regional directors
  • Regional operations directors

24 November 2021

Dear Colleagues,

Revised UK infection prevention and control guidance

To support the safe and efficient management of patients with suspected or proven COVID-19 or other respiratory diseases through the winter, the UK Health Security Agency (UKHSA) has published revised UK infection prevention and control (IPC) guidance. This guidance is available at:

This revised guidance reaffirms the measures needed to protect staff and patients, specifically universal use of face masks for staff and face masks/coverings for all patients/visitors in health and care settings, and additional transmission-based precautions for COVID-19 and other respiratory infection patients. This guidance supports efficient delivery of NHS services to meet wider patient needs, via the return to pre-COVID-19 social distancing and standard IPC measures for patients who do not have infectious respiratory diseases.

The main changes/updates are:

  • Removal of the three COVID-19 specific care pathways (high, medium and low) to facilitate optimal local implementation of the guidance by organisations/ employers. The use of, or requirement for care pathways should be defined locally.
  • Further information for organisations/employers to support maximum workplace risk mitigation based on the ‘hierarchy of controls’.
  • Universal use of face masks for staff and face masks/ coverings for all patients/visitors to remain as a key IPC measure within health and care settings over the winter period.
  • Recommendation that physical distancing should be at least 1 metre (increasing whenever feasible to 2 metres) across all health and care settings, and remain at 2 metres where infectious respiratory patients are being cared for/managed.
  • Screening, triaging and testing for SARS-CoV-2 should continue over the winter period. Testing for other respiratory pathogens will depend on the health and care setting according to local and country specific testing strategies, frameworks and data.

This guidance is applicable to all healthcare settings in England and we urge you all to implement these revised measures, subject to local risk assessment as advised in the guidance. This revised UK IPC Guidance incorporates the guidance on elective pathways published by UKHSA on 27 September, available at:

Thank you for your continued commitment and leadership in ensuring excellence in IPC to support the safe and efficient delivery of NHS services.

Yours sincerely,

Ruth May | Chief Nursing Officer, England

Professor Stephen Powis | National Medical Director