Social distancing and covid testing relaxed to ‘help hospitals treat patients more quickly’

The UK Health Security Agency – part of the Department of Health and Social Care – which has been created to advise on the pandemic and future threats, has recommended three changes to guidance.

The first is that physical distancing reqirements be reduced from two metres to one metre in areas “where patient access can be controlled”. This excludes emergency departments. It will allow some services to remove space restrictions introduced early in the pandemic to prevent spread.

Secondly, testing requirements for elective surgery are set to be relaxed. Patients in low-risk groups who are fully vaccinated, have no covid symptoms and take a negative lateral flow test on the day of their procedure will no longer need to have a negative PCR test and isolate for three days beforehand. This requirement has made elective recovery more difficult. 

Finally, standard cleaning procedures can be restarted in low-risk areas such as elective care, and “enhanced” cleaning — which involves more frequent cleansing of items that are regularly touched — can be discontinued in these areas, the UKHSA said.

Relaxing IPC requirements may help hospitals cope with high emergency care demand and keep up with elective care demand in the face of very long waits, but it risks the spread of covid in hospitals. Analysis by HSJ and others shows nosocomial covid has accounted for substantial infections and death through the pandemic.

No changes have been recommended to covid testing of emergency care patients, who must then be separated into covid-positive and negative-areas, which causes major delays in EDs and reduces effective acute bed capacity.

The UKHSA, which partially replaced Public Health England in April, said the advice “should be used by local acute care providers to allow them to start to make further safe changes to their services, in line with a local assessment of risk”.

Its chief executive Jenny Harries, previously deputy chief medical officer, said: “We have reviewed the existing covid-19 IPC evidence-based guidance and made a series of initial pragmatic recommendations on how local providers can start to safely remove some of the interventions that have been in place in elective care specifically for covid-19.

“This is a first step to help the NHS treat more patients more quickly, while ensuring their safety and balancing their different needs for care.”

A statement from the UKHSA stressed these were “initial” recommendations, although it did not specify when it would be making more.

Health and social care secretary Sajid Javid said he was looking forward to the UKHSA’s assessment “of what further steps can be taken in other healthcare settings, including in primary care”.

“As ever, more people benefit from the protection of our phenomenal vaccination campaign. We can now safely begin to relieve some of the most stringent infection control where they are no longer necessary to benefit patients and ease the burden on hardworking NHS staff,” he said.