On 21 February 2022, the Government published, “Covid-19 Response: Living with Covid-19” which set out the plan for living with covid-19. This response has enabled the country to manage covid-19 like other respiratory illnesses, largely due to the continued effectiveness of vaccines and improved treatments. Our approach to managing covid-19 from April 2023 continues this important work.
The overwhelming majority of people in the UK now have some protection against covid-19 through vaccination and/or previous infection, but the virus will continue to evolve and variants which are immune-evading may still occur. The Government will therefore maintain a range of capabilities to protect those at higher risk of severe illness. It will also retain proportionate situational awareness through surveillance, and maintain proportionate critical resilience for the future, for example a holding of lateral flow tests, should a dangerous new wave or variant emerge.
Proportionate scale back of testing
Appropriate levels of testing will remain to support diagnosis for clinical care and treatment and to protect very high-risk individuals and settings. Lateral flow device (LFD) testing continues to be effective in detecting positive results, including of new variants, providing better value for money than polymerase chain reaction (PCR) testing at this stage of the pandemic as well as rapid results. LFDs will be used except where there is a specific clinical or epidemiological need to use a PCR test.
From April 2023 the Government will continue to fund and provide diagnostic PCR testing as part of the standard clinical management of individuals requiring covid-19 treatment (similar to other respiratory viruses) and LFD testing in the following situations:
Adult social care settings and hospices: symptomatic testing of care home residents to support access to therapeutics and for specific clinical need, symptomatic testing for staff working in hospices (which care for individuals unlikely to respond to vaccination), and outbreak testing for care homes and similar settings.
NHS settings: symptomatic testing for staff on wards caring for patients at the highest risk from covid-19 (who are least likely to mount an immune response to vaccination due to their current condition or treatment), symptomatic testing of some patients in hospital where needed to inform decisions such as ward transfers, outbreak testing and testing of all patients on discharge not care settings as appropriate.
People who are eligible for covid-19 treatments in the community: to enable access to antiviral treatments.
Individuals who live in high-risk closed settings: highly targeted outbreak testing and testing to support clinical care in settings such as prisons (and other places of detention), and homelessness, domestic abuse refuge and asylum seeker accommodation.
In line with this stage of the pandemic, routine asymptomatic and symptomatic staff testing in all settings will end. Individuals will follow the standard guidance for the population based on illness severity and symptoms. The guidance is available here:
The Government will maintain essential covid-19 surveillance activities in the community, primary and secondary care, and in high-risk settings, which will enable the evaluation of the effectiveness of vaccination against a range of clinical outcomes, to inform vaccine deployment, and appropriate disease management. This will be underpinned by the continuation of genomic sequencing to detect and assess severity and vaccine effectiveness against new variants in surveillance studies and where PCR testing has been performed in secondary care on a proportionate basis.
The Government will retain proportionate capability for testing use in the event of a covid-19 wave or variant that results in a significant increase in pressure on the NHS. Laboratory infrastructure and a stock of LFDs will be maintained to provide resilience to respond, allowing for a period of additional testing for individuals at higher risk of severe respiratory illness across the NHS and the care sector. A more comprehensive response can be scaled up, should this be needed.
Guidance published on 1 April 2022 for individuals in the community with symptoms of covid-19 or respiratory illness continues to set out the actions we can all take to help reduce the risk of catching covid-19 and passing it on to others.
Guidance on covid-19 specific testing regimes for the NHS, adult social care and other high-risk settings will be updated to reflect the latest advice from public health experts. This guidance will be published for settings to implement from 1 April 2023.
The covid-19 vaccination programme continues to reduce severe disease across the population, while helping to protect the NHS. Covid-19 vaccines remain available to eligible groups, and the Government will continue to consider the advice of the Joint Committee on Vaccination and Immunisation (JCVI) on future vaccine selection and booster programmes for those at greatest risk.
UKHSA is committed to work with devolved Governments to take forward the testing programme in each nation from April 2023. While UKHSA will procure and distribute tests on behalf of devolved Governments, it will continue to be up to each nation to decide their own testing policy.
The Government will continue to work together with our partners to keep all these measures under review.