Covid-19: should dental practices still ask staff to self-isolate?
The government’s announcement on the 21st February that all Covid-19 restrictions will end on the 24th February, including the requirement for self-isolation following a positive test, raises many questions for those working in healthcare. This article considers the approach that dental practices can take to mitigate against Covid-19 and how staff should be managed now that the law has changed.
What are the rule changes?
From 24th February 2022:
1. The legal requirement to self-isolate following a positive test ends.
2. Fully vaccinated close contacts no longer need to test for 7 days.
3. Non-vaccinated close contacts no longer need to self-isolate.
4. Self-isolation support payments, national funding for practical support and medicine delivery services will end.
5. Contact tracing will end.
6. Legal obligation for employers to advise their employees that they are required to self-isolate ends.
7. The Covid-19 provisions within the Statutory Sick Pay and Employment and Support Allowance regulations will be removed.
From 1st April 2022:
1. Remove guidance on voluntary Covid-status certification and remove NHS Covid pass.
2. Update guidance on steps that individuals should take to minimise contact with others (TBC).
3. Remove free Covid-19 testing for England.
4. Remove health and safety requirement for every employer to consider Covid-19 in their risk assessments.
5. Replace current working safety guidance with new public health guidance (TBC).
As of the 22nd February, the government have provided no specific guidance as to how Covid-19 infection should be managed by staff in particularly vulnerable services, such as adult social care, healthcare, and prisons and places of detention. It seems unlikely that detailed guidance will be forthcoming in the next 2 days.
What can dental practices do to manage the risk?
Determine what the practice policy will be, for example:
a. Will staff be asked to continue to take Covid-19 tests?
b. If staff test positive for Covid-19 will they be asked to stay away from the practice?
c. Will staff be paid for continuing to self-isolate after the legal-requirement ends?
Can practices continue to mandate regular testing?
Yes. Healthcare workers have been asked to test for Covid-19 routinely over the last 18 months. It would be a reasonable requirement to ask the dental team to continue with regular testing. Whilst the legal requirement to self-isolate will end, the government guidance remains:
Adults and children who test positive will continue to be advised to stay at home and avoid contact with other people. After 5 days, they may choose to take a Lateral Flow Device (LFD) followed by another the next day – if both are negative, and they do not have a temperature, they can safely return to their normal routine.
From 1st April free Covid-19 testing for England will be removed. If practices wish to continue to mandate testing thereafter, they will need to pay for the costs of that testing.
Can staff be forced to stay away from the practice if they test positive for Covid-19?
Yes. In the same way that a member of the dental team can be asked to leave work if they are suffering from any communicable disease, they can be asked to stay away from the premises in the event that they test positive for Covid-19. However, the practice cannot require them to ‘self-isolate’.
Indeed, dental practices should be extremely cautious about asking staff to attend the practice if they have tested positive for Covid-19 or are exhibiting symptoms, despite the removal of the legal requirement. To do so, may well put the practice in breach of CQC regulations and a nurse or dentist in breach of the GDC Standards. Further, staff members that are asked to attend the practice with Covid-19 may well put the practice at risk of claims for breach of health and safety legislation from other employees.
If a staff member is asked to stay away from the practice in the event of a positive test, what should they be paid?
If a staff member has Covid-19 then they should be treated in accordance with the practice’s existing contractual obligations on sick pay. Policies can be amended to include a requirement for them to remain away from work until they are testing negative (in accordance with the guidance) and to confirm that pay will cover asymptomatic Covid-19.If your contract only offers SSP then any staff member with symptomatic Covid-19 should be paid in line with the statutory requirements. The difficulty will arise when a staff member is asked to stay away when they are asymptomatic.
The government have removed the Covid-19 provisions for eligibility for statutory sick pay in the event that an individual is required to isolate as a result of Covid-19 infection. This means that those with asymptomatic Covid-19 will no longer be able to claim SSP for self-isolation. The general principal is that if an employee is ready and willing to work, there is a duty to pay wages. However, what if they are ready and willing but shouldn’t come to work, as to do so could harm others?
Practices will therefore need to consider how to manage the pay of those without symptoms, who have been asked not to come to work:
1. Provide full pay for the period of ‘isolation’. If the practice chooses this option, they will need to ensure that testing is properly undertaken, and that the employee returns to work at the earliest possible date. Practices may wish to consider paying for staff members to undertake a PCR test to mitigate against deliberate absenteeism. Bear in mind that there would be nothing to stop the employee from carry on as normal away from the practice. Further, you may also want to consider paying staff with symptoms full pay so that you are treating all staff equally.
2. You could implement a policy where you agree to pay asymptomatic staff the same rate as SSP even though they are not legally entitled to it. You would then be treating staff the same as those with symptoms.
3. Decide not to pay staff who are asymptomatic. However, this is likely to mean staff lie about test results and come into work in any event.
Whatever the practice decides to implement, it is important to draft a clear and comprehensive policy so that staff know what to do and what, if any pay, they can expect to receive.
Written by Julia Furley