Hospital patients and staff will be in line for a new antibody test, new guidance says, while all patients going into hospital for planned treatment will have to isolate at home for 14 days first.
A new operating framework sent to NHS trusts by NHS England sets out how hospitals should operate as they begin to ramp up normal health services while also caring for people with Covid-19.
Data is also being collected on transmission of the virus in hospitals, to enable trusts to work out which patients are most susceptible to the spread.
The document stresses that medics should continue to carry out virtual consultations wherever possible and patients should only be required to attend hospital where clinically necessary.
But when patients come in for planned treatment, they should first isolate at home with their household for 14 days to reduce their risk of bringing Covid-19 into hospital, the guidance says.
If possible they should also be tested for coronavirus before they come in – a maximum of 72 hours in advance.Only those patients who have no symptoms of coronavirus should be admitted, the guidance adds.
Admitted patients who go on to test positive for Covid-19 or show symptoms should be immediately isolated, according to the plan.
Meanwhile, any patient with symptoms needing urgent and emergency care should be identified as soon as possible, while A&E departments and hospitals should be set up to encourage social distancing.
Hospitals should also “ensure any patient who subsequently tests positive or shows symptoms can be immediately isolated or managed in a Covid+ cohorted area,” the guidance adds.
Regarding testing, the guidance says all patients coming to A&E and who are admitted should be tested.
“For patients who test negative, a further single retest should be conducted between five to seven days after admission,” it says.
Any inpatient who becomes symptomatic, who has not previously tested positive, should be immediately tested, the guidance goes on.
All patients being discharged to a care home or a hospice should also be tested up to 48 hours prior to discharge.
On antibody testing, the guidance says: “Access to antibody testing, as part of the Government’s testing programme, will also begin to be made available to NHS staff and patients during this next phase.
“The results will be used to build our understanding and knowledge of Covid-19 and inform the clinical approach. More details will be set out in due course.”
The new guidance also sets out efforts to minimise the spread of coronavirus between NHS staff, and between staff and patients.
It says staff should continue with good hand hygiene and not touch their faces, should declare all Covid-19-like symptoms, however mild, and wherever possible, reduce movement between different areas.
Social distancing (of two metres) should happen both inside and outside of clinical areas, for example “during work breaks and when in communal areas”, the guidance says.
Public Health England (PHE) and NHS Digital are collecting routine data on Covid-19 transmission in hospitals, which will be made available to NHS trusts at the end of May, it adds.
It will include detail of any factors in patients which affects the spread of Covid-19.