COVID-19 Lateral Flow Test (LFT) Asymptomatic Staff Testing FAQs

These are the specific FAQs related to the use of lateral flow antigen tests in Northern Ireland Health and Social Care. For all questions on HR processes following a positive test and related isolation questions, please refer to your organisation’s guidelines.

 

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Administering the test 

 

Q1. What type of test are we rolling out? 

Healthcare workers are being offered lateral flow antigen testing, using either packs of 25 tests (the Innova SARS-CoV-2 Antigen Rapid Qualitative Test) or packs of 7 tests (the Department of Health and Social Care (DHSC) COVID-19 Self-Test (Rapid Antigen Test).

Information on how to use these tests is available at: www.pha.site/LFDtest (when using packs of 25 tests) and www.gov.uk/guidance/covid-19-self-test-help (when using the packs of seven tests).

 

Q2. What is the specificity and sensitivity of this particular test? 

The government has published its latest research on these tests. This can be found here www.ox.ac.uk/news/2020-11-11-oxford-university-and-phe-confirm-high-sensitivity-lateral-flow-tests-following.

 

Q3. Who administers the test?  

The test is self-administered. An instruction video and written instructions, including on interpretation of results, are available for staff to learn to self-administer their test. 

 

Q4. Is the test mandatory or voluntary? 

Tests are voluntary, but staff should be encouraged to be involved in regular testing to benefit their colleagues and patients. 

 

Q5. Which staff members in healthcare will have access to lateral flow antigen tests? 

Asymptomatic testing is being made available to all patient-facing healthcare workers in Northern Ireland. Lateral flow tests are being made available to asymptomatic staff delivering primary care, some secondary care HSC Trusts and the Northern Ireland Ambulance Service. Other organisations are participating in different kinds of testing to lateral flow, e.g. LAMP testing.

 

Q6. Doctors on their foundation programme move between HSC organisations, how should their testing programme work? 

All foundation year doctors in relevant organisations should be included, as they are patient facing. If they move to another organisation and still have a supply of tests, they should keep these tests and use them while working at the next organisation, unless provided with another means of asymptomatic testing. For new starters, if they don’t already have tests from a previous employer, they should be provided with tests if they are working in the relevant trusts/ primary care setting.

 

Q7. Should students on placement in a heathcare organisation take place in testing?

Students on long-term placement should get tested through this method. Those on short-term placement should get tested through existing university mechanisms.

 

Q8. How frequently should a contractor/temporary worker be working in an organisation to be included in testing?

Staff who are patient facing and are regularly working in your organisation should be included in the testing.

 

Q9. Should staff members continue testing after they’ve received the COVID-19 vaccine? 

Yes, staff should continue to test even though they have had the vaccine. 

 

Q10. Can these tests be used for patients? 

No. These lateral flow antigen tests are solely for asymptomatic patient-facing staff delivering Health and Social Care services.  

 

Q11. Can staff use the tests for their symptomatic family members? 

No. Staff and family members who have symptoms should access PCR tests in the normal way. 

 

Q12. Can other members of a household who are also carrying out LFT testing share test kits?

No. Other members of a household who have received a test kit from their employer or through another testing programme should use the kit issued to them. Likewise, the healthcare staff members should only use the kit issued to them. This is to ensure adequate supplies are available for groups carrying out testing and that test kits are only used for the purpose for which they are issued.

 

Q13. How frequently should staff be tested? 

Staff should test themselves twice weekly every three to four days to fit with shift patterns and leave requirements; for example, Wednesday and Sunday, or Monday and Thursday.  

 

Q14. When should staff test? 

Staff should be asked to perform the test before attending work, leaving enough time before the start of their shift to alert their employer who may need to arrange cover, should their lateral flow test be positive. 

 

Q15. Where should staff test? 

Staff should conduct the test at home if possible. 

 

Q16. Should staff continue swabbing during annual leave? 

Staff may continue to swab while on annual leave of longer than a week, but it is not a requirement. 

 

Q17. What should staff do with the used test kits? 

Staff can safely dispose of the test items in their normal household waste but should pour any residual buffer solution away first. 

 

Q18. What happens if the buffer solution is accidentally consumed? 

As set out in the manufacturer’s safety instructions, the buffer solution is not hazardous; however, if accidentally ingested, a medical practitioner should be informed.  

 

Q19. If staff are already regularly being tested through existing regimes – such as participation in COVID-19 studies – should this be replaced by lateral flow tests? 

If staff are participating in research studies where the frequency of testing is not weekly (e.g. fortnightly or monthly) they should also undertake twice-weekly LFD self-testing.  For example, staff members participating in the SIREN study and having qRT PCR testing every two weeks should also be part of the twice-weekly LFD testing if they are a patient-facing member of staff. If staff are already enrolled in another testing regime, this should not be replaced by the lateral flow tests unless agreed by your organisation.

 

Q20. What about LAMP testing – I thought this was being used for asymptomatic staff testing?

LAMP testing is being introduced in a number of Health and Social Care organisations for consideration for asymptomatic staff testing.

 

Q21. Will this testing regime remove the need for staff who have been exposed to a positive Covid-19 case to self-isolate?  

No. Government self-solation advice should be followed at all times. This test does not remove the need to self-isolate. 

 

Q22. Can tests be used as a response to COVID-19 outbreaks? 

Should an outbreak be declared in your organisation, testing regimes should be discussed in line with your normal organisational response. 

 

Q23. Is there advice on giving staff time back from undertaking the test at home?  

The test should take no longer than 5 minutes to undertake, with a 30-minute wait for results. 

 

Q24. Do I have to share my result if I am going into a care home? 

Visitors to care homes should continue to follow the care home policy for use of PPE and other infection prevention and control measures. If you have been tested, please share your negative result with the care home manger.          

 

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Pack size of test kits supplied

 

Q25 Why are there different box sizes of test kits?

Two different box sizes of lateral flow test kits have been made available for use in testing healthcare staff in Northern Ireland. The test kits contain either 25 or 7 lateral flow tests. Considerations of available stocks and the method of delivery and replenishment to organisations have been taken into account when deciding which healthcare staff groups receive which box size. Staff should use the test kit supplied to them by their employer.

 

Q26 Are the 25 and 7 unit size test kits different to each other?

There is no difference in the sensitivity of the tests when administered. However, there are slight differences in the materials provided (e.g. how the buffer solution is included) as part of the test kit in the box, and the instructions for use are specific to the test kit. Staff should follow the instructions for use provided to them with their test kit. In the case of the 25 unit size test kit this is a separate set of instruction materials to those in the box and is available at - https://www.publichealth.hscni.net/sites/default/files/2021-01/Lateral%20Flow%20self-swab%20instructions%20final%2021.01.pdf

 

Below are FAQs specifically relating to the box size containing 25 lateral flow tests.

 

Q27. What is the shelf life of the extraction (buffer) solution once opened?

The shelf life of extraction solution is 2 years, even after it is opened. 

 

Q28. How do I get additional bottles of extraction (buffer) solution as I don’t have any left (due to spillage etc.) but I still have kits left in my box of 25 kits?

Additional bottles of extraction solution are not available for distribution, if you have run out of extraction solution your organisation will need to provide you with a replacement box of 25 test kits. 

 

Q29. Why is the testing method different from that described in the manufacturer’s original instructions for use? 

We are recommending the swab is used and the sample taken in a different way to the instructions for use, with more rotation of the swab at a lower level of penetration, to enable easier self-administration of the test. This is based on advice from experts. The manufacturer has been informed of the planned use of the tests for self-administered asymptomatic staff testing by healthcare workers. 

 

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Reporting the test result 

 

Q30. How should the results of these tests be reported? 

Staff are asked to record all results (positive, negative, invalid / void) from lateral flow devices. The results from the lateral flow antigen test will be documented at home by the individual using the NHS Digital online platform. Staff can access the NHS Digital platform on www.gov.uk/report-covid19-result

Note that staff working in Northern Ireland but resident in the Republic of Ireland should enter their employer organisation postcode for the home address postcode on the digital portal.

 

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Acting on the test result 

 

Q31. What happens if staff get a positive result? 

Staff should inform their manager of a positive result in the normal way. Staff should arrange a confirmatory PCR test via the established testing routes. Staff in secondary care can arrange a test through their local Trust testing arrangements. Other staff can access a test through the National Testing Programme – www.gov.uk/get-coronavirus-test.  The staff member and their household should self-isolate as set out in government guidance: www.publichealth.hscni.net/covid-19-coronavirus/covid-19-information-public/when-self-isolate-simple-guide

 

Q32. What happens if a test is negative, but staff have coronavirus symptoms?  

If you have coronavirus (COVID-19) symptoms, please refer to guidance online: www.pha.site/coronavirus. You should book a PCR test via the established testing routes. Staff in secondary care can arrange a test through their local Trust testing arrangements. Other staff can access a test through the National Testing Programme - www.pha.site/cvtestingThe staff member and their household should self-isolate as set out in government guidance: www.publichealth.hscni.net/covid-19-coronavirus/covid-19-information-public/when-self-isolate-simple-guide

 

Q33. At what stage is the Contact Tracing Service informed of the result? 

Contact Tracing may also take place based on a positive LFT result. This stops if a subsequent PCR test indicates a negative test result for the individual.

 

Q34. Should patients who have been in direct care of a staff member who tests positive with lateral flow be tested while the confirmatory PCR test result is pending? 

Your organisation’s protocols for tracing contacts should be followed. 

 

Q35. If a staff member has a positive PCR COVID-19 test, when should they start the lateral flow antigen tests again? 

A staff member who tested positive would recommence home lateral flow antigen testing 90 days after their positive test was taken. The staff member will need to liaise with their employer to track the date at which the retesting should start. 

 

Q36. If I am told to isolate by contact tracers even though I have had the vaccine, do I need to do so?

Yes, continue to take advice and follow instructions given by the Contact Tracing Service.

 

Q37. Do we treat two positive lateral flow antigen test results as an outbreak? 

A risk assessment should be undertaken where there are a number of positive lateral flow test results at the same time. Advice should be sought from occupational health or the PHA (depending on the organisation).  Lateral flow antigen positive test results should be confirmed through PCR testing; if the confirmatory tests are also positive, then normal outbreak 

protocols would apply.  

 

Q38. Can the period of isolation following contact tracing be shortened through use of this testing? 

No. Isolation following notification that a staff member has been in close contact with a COVID-19 case without relevant PPE should be followed as per Contact Tracing Service advice. Please refer to guidance at www.pha.site/ContactTracing  

 

Q39. Is confirmatory PCR testing accessible through pillar 2, and if yes what field should be filled to avoid symptomatic questions? 

You should use whatever PCR route is in use by your organisation. If this is through pillar 2, tick the box that indicates you are a key worker but not part of a pilot, you will then see an option to say ‘I’ve been told to take a Coronavirus test’ on the form.  

 

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Ordering and delivery of test kits 

 

Q40. Do healthcare organisations pay when ordering test kits?

No. Test kits are centrally procured and provided to organisations participating free of charge.

 

Q41. How do HSC Trusts (including NIAS) order test kits?

Lateral flow test kits are supplied to participating Trust organisations and NIAS via the BSO Procurement and Logistics Service. A process has been put in place to deliver test kits supplies and is managed centrally by the Trust organisation.

 

Q42. For HSC Trusts with multiple sites can you confirm they can have tests delivered to multiple sites?

Due to the extent of the logistics required, the BSO Procurement and Logistics Service can only have a single delivery point for each organisation. Trusts will need to deliver the kits to the various sites themselves.

 

Q43. How do primary care contractors order test kits? 

The ordering and delivery process for lateral flow antigen test kits to primary care contractors is managed via the online Salesforce platform that has been put in place by NHS Digital. Primary care contractors are contacted directly by PHA/HSCB to invite them to register on the system. Contractors manage their orders via this portal taking account of staff numbers and stock requirements.  

 

Q44. How many boxes of tests should primary care contractors order? 

Primary care contractors will be able to order enough test kits for each patient-facing member of their staff delivering Health and Social Care services. The Salesforce platform allows organisations to order 2 boxes of 7 test kits per member of staff, at a minimum. This quantity will provide 7 weeks’ worth of tests per staff member.

 

Note that there are some minimum order quantities so smaller organisations will receive a minimum size order. Further information is available upon registration on the platform.

 

Q45. Should the tests be kept in specific conditions; will they require security like Tamiflu did? 

Tests can be stored in typical warehouse conditions; they do not need refrigeration but should be kept out of direct sunlight and not be exposed to heat. They are not expected to require any additional security than other items of equipment deliveries. 

 

Q46. Can organisations procure their own supply of lateral flow tests? 

Lateral flow tests are purchased and provided centrally, and organisations should not purchase them directly from suppliers. 

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