All patient-facing staff in primary care will be asked by NHS England to ‘test twice-weekly using self-administered nasal swabbing’. Results will be reported through an online form, with positive tests to be followed up with a PCR test.
However, rollout of the tests has been questioned by doctors amid concerns over the potential for staff to be forced off work by false positive tests – and with concerns over the high rate of false negatives in trials of the test.
GPonline reported last month that routine testing would be rolled out to primary care staff – but the government was unable to provide a timetable for rollout beyond hospital staff at that stage.
Lateral flow test
NHS England has now confirmed practices will be invited to order tests from this week via Primary Care Support England (PCSE), with a window for orders to be placed remaining open until 30 December.
Designated sites delivering COVID-19 vaccination will receive ‘separate deliveries of lateral flow testing devices for vaccinator staff’ – and do not need to order test kits for those staff, although they can order extra tests for other patient-facing staff if needed.
In a bulletin sent to primary care staff on 15 December, NHS England said the rollout of lateral flow antigen testing alongside PCR testing ‘aims to reduce further transmission and enhance the resilience of NHS services, by improving virus detection’.
However, questions have been raised over the effectiveness of lateral flow testing. A government policy paper published last month said that the test used in a mass testing trial in Liverpool was 76.8% effective ‘in ideal hands’ but that sensitivity would be lower in ‘operational conditions’.
The policy paper said that in the ‘field evaluation’ in Liverpool lateral flow tests picked up just five in 10 of the coronavirus cases detected by PCR tests – and only seven in 10 cases with ‘higher viral loads, who are likely to be the most infectious’.
The government says that the tests can be expected to return around four false positives for every 1,000 tests.
GP practices were also offered the chance to order self-testing PCR kits for use by staff and family members from last month.