Updated UK Health Security Agency guidance on NHS staff, student and volunteer self-isolation and return to work following COVID-19 contact

Classification: Official
Publication approval reference: C1500


  • ICS and STP leads
  • All CCG Accountable Officers
  • All NHS Foundation Trust and Trust Chief Executives, Medical Directors, Chief Nursing Officers and Chief People Officers/HR Directors
  • All PCNs and all GP practices
  • All Community Pharmacy
  • All NHS primary care dental contract holders
  • All Primary Care Optometrists and Dispensing Opticians
  • All Pathology Incident Directors

Copy to:

  • Chairs of ICS and STPs
  • All CCG Chairs
  • Chairs of NHS trusts and foundation trusts
  • All Local Authority Chief Executives
  • NHS Regional Directors
  • NHS Regional Directors of Commissioning

15 December 2021

Dear colleague

Updated UK Health Security Agency guidance on NHS staff, student and volunteer self-isolation and return to work following COVID-19 contact

The government has announced the move to Plan B in England in response to the emerging risks of the Omicron variant. Full details of Plan B can be read in Coronavirus: how to stay safe and help prevent the spread.

The UKHSA has also updated its COVID-19: management of staff and exposed patients or residents in health and social care guidance to reflect self-isolation changes when in contact with a confirmed or suspected Omicron variant case.

This letter provides a summary of the latest guidelines and applies to all staff including substantive clinical and non-clinical roles, bank staff, contractors and suppliers; students working in all facilities, settings and organisations delivering NHS care and volunteers working in settings with patients.

If a staff member develops any of the symptoms of COVID-19, however mild:

  • they should follow the stay at home guidance and arrange to have a PCR test either through their workplace arrangements or the Test and Trace service, as soon as possible
  • if at home (off-duty), they should not attend work whilst awaiting their PCR test result and should notify their employer or line manager immediately
  • if at work, they should inform their employer or line manager and return home as soon as possible
  • if a staff member receives a positive SARS-CoV-2 PCR test result, they must self-isolate for 10 days
  • if a staff member’s self-reported SARS-CoV-2 LFD antigen test result is positive, they should self-isolate immediately
  • they should arrange to have a follow-up PCR test as soon as possible, either through their workplace arrangements or the  Test and Trace service and should continue to self-isolate whilst awaiting their PCR test result
  • if the follow-up PCR result is positive, the staff member must continue to self-isolate.

Staff who receive a negative PCR test result can usually return to work providing they are medically fit to do so.

Staff who do not have COVID-19 symptoms, but have a positive PCR test result, must stay at home and self-isolate.

Staff who are contacts of someone confirmed COVID-19 positive:

  • must stay at home and self-isolate if not fully vaccinated
  • if fully vaccinated (i.e. have received two vaccine doses and are 14 days post second vaccination) should arrange a PCR test and can return to work if it is confirmed negative (if positive, isolate for 10 days). If negative, should complete daily lateral flow tests before attending work each day for 10 days and should seek a repeat PCR in the event of any positive LFD test.

It should be noted that the definition of fully vaccinated for staff may be changed in by the UKHSA to include having had a booster vaccine; therefore, NHS organisations are encouraged to make sure staff are offered a booster as soon as possible and encourage those staff who are not yet vaccinated to take up the evergreen offer.

To support colleagues and to protect our patients and services, NHS providers and primary care organisations are asked to continue to ensure that:

  • 1:1 conversations continue with any member of staff or student who has not had both doses of the vaccine
  • robust local monitoring processes are in place for regular staff and student LFD and where available, LAMP testing, with Board level assurance/organisational leadership and oversight
  • staff (even if vaccinated) continue to carry out asymptomatic (twice weekly) LFD and where available, LAMP testing, and reporting results so that we identify and isolate cases of the virus early and help keep staff and patients safe
  • staff report the results of their twice weekly asymptomatic tests whether positive or negative at https://www.gov.uk/report-covid19-result
  • covid-related sickness absence is recorded correctly using the drop-down options in ESR where that is available, to ensure we develop an accurate picture
  • staff are offered continuous learning regarding UKHSA’s IPC guidance with access to refresher education events for all staff and students including those colleagues who may not have access to traditional information cascades

In addition to the crucial roll out of the vaccine booster programme and systematic patient and staff testing, the consistent application of IPC measures remains the most effective defense against the entry and spread of COVID-19 in healthcare settings.

Thank you for your ongoing support.

Yours sincerely

Prerana Issar NHS | Chief People Officer

Ruth May | Chief Nursing Officer, England

Dr Nikita Kanani | Medical Director for Primary Care