11/26/2021 | Press release | Distributed by Public on 11/26/2021 13:30
What NHS trusts must do to provide managed quarantine accommodation for nurses arriving in England to work for the NHS if they've passed through red-list countries.
South Africa, Botswana, Eswatini, Lesotho, Namibia and Zimbabwe moved onto the red list at 12.00 midday Friday 26 November.
A temporary flight ban is in place and all travellers who have been in these countries must quarantine and take tests.
This guidance set out the standards required for NHS trusts to provide managed quarantine accommodation ('hospital managed quarantine') for internationally recruited nurses who are taking up immediate employment in the NHS in England, and who are from or travelling through red-list countries. The exemption does not cover nurses already employed by the NHS or nurses returning from abroad for any other reason (for example, holiday or visiting family).
These nurses are exempt from red-list hotel managed quarantine (also known as 'managed quarantine service' or MQS) if compliant NHS trust-arranged accommodation can be used for the duration of their quarantine period (you'll find details on the length of quarantine related to testing in the 'Testing' section of this document).
Trusts may choose not to use the exemption and to fund MQS as an alternative. If a trust cannot provide compliant accommodation, MQS must be used. We encourage trusts to work on a regional basis to provide compliant trust-arranged accommodation where possible.
NHS trusts are responsible for the safe and effective quarantine of all nurses in hospital managed quarantine and must ensure adherence to these guidelines.
Assessment that accommodation adheres to these standards needs to be signed off by the trust's Infection Prevention and Control (IPC) lead and Director of Nursing. Ongoing compliance must be reviewed on a monthly basis. If changes to the provision of accommodation or standards required means accommodation becomes non-compliant, the trust must not accept further nurses for hospital managed quarantine until compliance is achieved.
When nurses are recruited as a cohort and travel together from and/or through red-listed countries, they may be considered a 'travel group'. This means they will be able to quarantine together and share facilities. Regardless of cohort sizes for flights, on arrival in the UK, travel group numbers should be minimised and be no larger than 6 individuals, as smaller group sizes reduce the risk of many nurses being delayed from starting work should a member of the travel group test positive for COVID-19. All recommended control measures (including maintaining social distancing, wearing face coverings and handwashing) will be required within a travel group throughout quarantine.
The legal exemption from hotel MQS is set out in regulations.
It only covers nurses coming from or travelling through red-list countries to take up immediate NHS employment in England.
Eligibility does not extend to family or dependents. If nurses are bringing children or family, the family unit as a whole will need to quarantine in an approved hotel (MQS).
The red list of countries is regularly updated - check the GOV.UK website regularly to make sure you know which countries are affected.
As well as following the guidance in this document, nurses will need to comply with all other guidance on managing the COVID-19 risk. Government guidance is subject to change - always refer to the latest guidance on GOV.UK.
Relevant guidance includes, but is not limited to:
Coronavirus (COVID-19) testing before you travel to England
Fill in your passenger locator form
(COVID-19) Coronavirus restrictions: what you can and cannot do (post-quarantine)
Before departure the trust will need to provide the nurse with a letter setting out their eligibility for the exemption, for the benefit of Border Force officials on arrival. This letter should include the following details:
A template letter will be sent to trusts to ensure the information is complete and in the same format. Border Force will ensure that the details on the letter match the passport, visa and Certificate of Sponsorship that the nurses will show on arrival.
It is vital that all details are accurate to ensure the nurse has no problems entering the country. Border Force may contact Trust International Recruitment leads directly to confirm planned employment and check details to mitigate fraudulent use of this exemption. Please ensure up-to-date contact details are provided, including out of hours contact details if possible.
Nurses must be able to travel from the airport to hospital managed quarantine accommodation in COVID-19 secure private (including trust-owned) transport. Coaches or minibuses are to be used as preference to ensure easier social distancing from the driver and, where relevant, other travel groups. Private cars or taxis can be used on an exceptional basis.
Trusts may want to work together on a regional basis to plan transport for travel groups (nurses that are recruited as a cohort and travel together - no greater than 6 per group). More than one travel group may travel on the same coach as long as done so in adherence with guidance outlined below.
Nurses must go straight to meet the trust representative/driver on arrival at the airport. They must not use facilities once through immigration control.
Details of the standards required for secure travel can be found in Coronavirus (COVID-19): taxis and PHVs.
Main points are:
Internal flights must not be used by nurses coming from or travelling through red-list countries
Hospital-managed accommodation for quarantining nurses must be private or trust-provided accommodation and the building must be used exclusively for quarantining. Commercial hotels must not be used.
The accommodation must provide individual en-suite bathroom facilities and individual food facilities for nurses quarantining alone. Where accommodation has communal areas (bathrooms, kitchens) and provisions for travel groups (groups of no more than 6 nurses that are recruited as a cohort and travel together), the communal areas (bathrooms, kitchens) must only be used by one self-contained travel group.
Trusts may want to work together on a regional basis for quarantining travel groups of nurses arriving together to maximise use of the accommodation available.
Wherever possible, accommodation buildings should house only nurses quarantining from red-list countries or nurses quarantining from non-red-list countries. If this is not possible, clearly defined floors/areas of buildings should be identified for red-list and non-red-list quarantine.
One-way systems should be put in place to ensure appropriate separation and social distancing while entering and leaving quarantine accommodation.
All quarantining accommodation must have individual ventilation systems (for example, room or window fan coil units that do not recirculate to other parts of the building) or windows that open (safely).
Nurses who have completed quarantine must be in separate accommodation from quarantining nurses.
Nurses in quarantine must have:
From testing on day 2 (when the nurse takes their pre-flight test) to the end of the quarantine period, nurses must follow all control measures in place to minimise the risk of spreading COVID-19.
Nurses quarantining in hospital-managed accommodation must:
Nurses quarantining in hospital accommodation must not:
Trusts will want to make sure nurses are aware of their personal responsibility to quarantine effectively and to follow control measures following pre-flight testing. Full guidance is provided in How to quarantine when you arrive in England.
Failure to follow these responsibilities may result in disciplinary action for the nurse concerned.
Trusts should refer to the full guidance on cleaning, laundry and waste services: COVID-19: cleaning in non-healthcare settings outside the home.
Rooms and communal areas must not be cleaned by trust or contracted staff when occupied. Nurses will be responsible for cleaning their own rooms and communal areas. Trusts must provide:
If laundry services are not provided for in quarantine accommodation, the trust will need to provide a laundry service for collection and return to the accommodation, ensuring that:
Note that laundry collected during a nurse's stay should be:
General waste should be double bagged and disposed of with normal rubbish.
Waste from a self-contained travel group that is suspected of having, or confirmed to have, COVID-19 should be put in a plastic rubbish bag, double bagged and tied. This should be securely stored for 72 hours and then disposed of with normal rubbish.
Any waste from clinical consumables should be treated as clinical waste.
Waste should be disposed of in accordance with regulations via appropriate services with full compliance of safe COVID-19 best practice protocols.
Nurses must take a coronavirus (COVID-19) test and get a negative result during the 3 days before travel to the UK (read Coronavirus (COVID-19) testing before you travel to England for more details).
Nurses quarantining in hospital accommodation must take COVID-19 PCR tests on day 2 and day 8. These are the tests ordered at the time of booking travel and are not to be provided by the trust. For more information, read Providers of day 2 and day 8 coronavirus testing for international arrivals.
Nurses must take a COVID-19 test on or before day 2 of the quarantine period. The day of arrival in England is to be treated as day 0 (the day after arrival is day 1). This first test is designed to help identify any potentially harmful variants of COVID-19 at the earliest opportunity.
If a nurse gets a positive result from the day-2 test, they:
Nurses must take a COVID-19 test on or after day 8, unless they got a positive result from their day-2 test.
A positive test result from the day-8 test will mean the nurse needs to quarantine until day 19. The self-contained travel group will also need to quarantine until day 19 or even longer if anyone in that bubble tests positive during that time.
Anyone who becomes symptomatic should be able to access a PCR test for diagnostic purposes and needs to be enabled by the trust for them to access NHS Test and Trace.
Once a nurse has quarantined for 10 full days (where day 0 is the day of arrival) and received a negative result to both day-2 and day-8 tests, and are well, they may leave quarantine.
Test to release is not allowed.
Nurses must not leave quarantine to post their tests. Trusts will need to make arrangements to safely provide, pick up and process these tests from the quarantine accommodation.
If a nurse in quarantine receives a positive test result and/or develops coronavirus symptoms, they and any other nurses in the same self-contained travel group should follow PHE guidance for households with possible or confirmed coronavirus (COVID-19) infection.
If a travel group is quarantining for additional days as a result of one (or more) nurse testing positive, any other nurses who become symptomatic should be tested. Any member of the travel group who has not tested positive needs to quarantine for an additional 10 days.
Please ask them to notify the named trust contact so that additional support and advice can be provided.
Following quarantine, internationally recruited nurses will be eligible for twice weekly lateral flow testing along with the rest of the workforce.
A welcome pack to provide information and practical support to nurses during their quarantine should be supplied on arrival. The welcome pack should:
Trusts will need to provide appropriate wellbeing support to the newly arrived nurses. This will include but not be limited to:
Trusts should provide newly arrived nurses with information about the COVID-19 vaccine. For those nurses who have not yet received vaccination for COVID-19 in their home country, arrangements should be made to receive COVID-19 vaccination as soon as possible following completion of quarantine.
NHS staff do not require an NHS number or GP registration to receive a vaccination and should never be denied one on this basis, either when presenting for a vaccine in person, or through the design of booking systems. Please take immediate action to ensure this is not the case in your organisation.
If a staff member does not have an NHS number, employers should vaccinate now, record locally via a paper system and ensure vaccination is formally documented later. We are working on a longer-term solution, but employers should not wait for this before vaccinating.
At all times hospital and contract staff engaging with quarantined nurses must ensure that they are adhering to COVID-19 social distancing rules and must have the correct personal protective equipment (PPE) available to them and be advised how to put on and take off ('don and dof') PPE safely.
Staff must be provided with personal held alcohol gels.
The trust will need to ensure they have an agreed fire evacuation plan developed (and adhered to in the instances of an emergency evacuation) with specific measures to ensure social distancing (2 metres distance apart) where possible during any evacuation and at assembly points.
Once safe, nurses should return to quarantine as soon as possible, with social distancing measures (2 metres distance apart) in place where possible, to continue the quarantine programme.
If the accommodation cannot be used the nurses should first be taken to a safe place to keep them dry and warm with refreshments. This may be a local church, community hall, government building, nearby open hotel conference room etc (the decision/plan would depend on how far the guests need to be taken away from the impacted area). There is also a reactive transport plan in line with transport requirements set out earlier.
All documents and fire records are to be updated accordingly.
Added content explaining that South Africa, Botswana, Eswatini, Lesotho, Namibia and Zimbabwe moved onto the red list at midday on Friday 26 November. A temporary flight ban is now in place and all travellers who have been in these countries must quarantine and take tests.
First published.