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Reducing healthcare-associated COVID-19 infection is a top priority. Today, the NHS has set out plans for testing of NHS staff. This includes continuing to prioritise testing of all NHS staff with symptoms, asymptomatic regular testing of staff in situations where there is an incident, outbreak or high prevalence and regular surveillance testing across all staff. Under the risk-based approach advised by clinical experts, we are continually reviewing clinical evidence to ensure regular testing of asymptomatic staff is undertaken where appropriate. The CMO’s advice is that this is currently best done through a survey, which monitors prevalence in NHS staff. This survey, which will be expanded over the coming months, helps us to determine where wider asymptomatic staff testing is needed. Clinical advice is to focus intensive asymptomatic testing in those areas or settings identified to have high prevalence. This dynamic approach which responds to risk is essential as when prevalence is very low, the risk of misleading results is higher and this can undermine the value of testing. We will continue to keep clinical advice under review.
I also want to clarify a point on the predominant reason for the minority of positive cases that do not go into the NHS test and trace scheme. On June 17th I set out that they are largely in-patients in hospital and therefore testing and tracing in the normal sense does not apply. Testing and tracing is different for hospital in-patients than for the general public, as contact tracing is usually done by the hospital rather than by NHS Test and Trace contact tracers. Local hospital infection control teams are often best placed to do the contact tracing for inpatients as these individuals may not be in a position to be able to communicate their contacts and hospitals will have a clear list of patients on wards, staff and shift patterns. This is standard practice for other infections. The data from these hospital in-patients do enter the NHS Test and Trace system. Positive cases who are not contacted by the contact tracing system are either those who do not respond to repeated attempts to make contact (through phone, SMS and email contacts) or for whom NHS Test and Trace has incorrect contact details. Further data will be set out by NHS Test and Trace tomorrow in the normal way.