What does living with Covid mean?
The Government recently set out its plan for ‘Living with Covid-19’. Dawn Hodgkins examines what this means for independent practitioners.
The Government’s ‘Living with Covid-19’ document sets out how it will balance the competing aims of removing Covid restrictions, while also continuing to protect people most vulnerable to the virus and ‘maintaining contingency capabilities to deal with a range of possible scenarios relating to the pandemic’.
But for independent healthcare practitioners and providers, what does ‘living with Covid’ mean in terms of their ability to deliver vital healthcare services and keep patients safe?
While there are many unknowns about how testing, self-isolation and infection prevention and control (IPC) guidance will continue to develop in the coming months, here is a rundown of what we know so far and some of the issues practitioners and providers will need to grapple with.
Requirement to self-isolate
One of the key commitments in the Government’s ‘Living with Covid-19’ strategy is removing the legal requirement to self-isolate following a positive test – though adults and children who test positive will continue to be advised to stay at home and avoid contact with other people.
This is a notable change in the policy around testing and self-isolation. Given the importance of keeping healthcare settings Covid-free, both NHS England and the UK Health Security Agency (UKHSA) have stated clearly that healthcare staff who test positive for Covid should not attend work until they have had two negative lateral flow test results taken 24 hours apart, with the first test not taken before day five after their initial positive test.
Of course, in practice, ensuring that both staff and patients are clear that they should not access or use healthcare premises if they have tested positive or think they have Covid will be a challenge with this more liberal testing and isolation policy.
Perhaps one of the most controversial elements of the Government’s plan is the intention to end the provision of free universal symptomatic and asymptomatic testing for the general public from 1 April.
This is a significant change and while the Government’s report states that limited symptomatic testing will be available for a ‘small number of at-risk groups’ as well as for social care staff, as I write, it remains unclear what testing will be available for healthcare staff delivering both NHS and private care as well as those needing treatment.
Further clarity
Getting further clarity of this will be key, as access to Covid testing by both patients and healthcare staff will be critical both in stopping the spread of the virus as well as providing reassurance to patients and giving them confidence that everything is being done to ensure their care is as safe as possible.
While these two changes were a key plank of the Government’s ‘Living with Covid-19’ strategy, there do, however, remain a number of other key questions healthcare practitioners and providers will need answers to in the coming months.
For patients requiring treatment, both the pre- and post-surgery protocols will need to be considered.
Currently, best practice states that, where possible, surgery should be delayed for at least seven weeks following a Covid infection, with the exception of those needing urgent treatment or where the risk of delaying surgery are particularly great.
But with both NHS and independent healthcare providers facing a significant increase in complexity and demand, and growing backlogs of patients – not to mention Covid variants becoming less severe – there are questions over whether this approach remains appropriate.
With testing and self-isolation regimes being eased for the wider populations, which make it more challenging to understand the numbers of patients who have had Covid, ensuring clear guidance is in place for patients on what precautions they need to take before and after treatment will be vital. This is particularly important for those who are older and more vulnerable.
Infection control
Looking at broader infection and prevention control measures, with the retreat of the virus, it its likely that guidance will increasingly be made at more local and regional levels.
Independent providers and practitioners should make sure they are plugged into local discussions about this.
Reflecting the new ‘Living with Covid-19’ environment we will be working in, the Government has also announced it intends to consult on updating the code of practice on the prevention and control of infections which applies to all health and social care providers registered with the Care Quality Commission.
As part of that consultation, the Government will also be looking to strengthen requirements for healthcare professionals to be vaccinated for Covid.
Compulsory vaccination
While the Government has revoked regulations making vaccination a condition of deployment (VCOD) for health and care professionals, the issue has not gone away and there will remain a real focus both from organisations and from professional regulators to encourage as many healthcare workers as possible to get vaccinated.
Coronavirus has shown itself to be particularly unpredictable, producing many twists and turns over the last two years.
It is vital that all healthcare providers and practitioners remain vigilant in keeping it at bay. But with cases firmly on the downward trajectory at the time of writing, we are definitely moving into a new phase – balancing both the need to keep patients safe and ensuring as many people are treated as possible, given the growing backlog of care.
This will not always be easy to navigate, but the Independent Healthcare Providers Network (IHPN) will be working hard to ensure the views of independent providers and practitioners are fully plugged into conversations so the sector can continue to do its best for the millions of patients they treat every year.
Dawn Hodgkins (right) is director of regulation at the Independent Healthcare Providers Network