On 21 February 2022, the Government published the “Covid-19 Response: Living with Covid-19” guidance, which set out a plan to live with covid-19, while protecting people at higher risk of serious illness. In March 2023, the Government announced further changes towards managing covid-19 like other respiratory illnesses. New changes from 1 April 2024 are the next stage in delivering this approach.
The latest changes are an important milestone in our journey to living with covid-19. After several years of dedicated resources and focus, covid-19 is now recognised as an established and ongoing health issue in the UK, and the approach to managing it will now be even further aligned with other established respiratory pathogens. Protecting people at higher risk remains the Government’s priority.
Vaccines for those at higher risk of serious outcomes from covid-19 remain central to the Government’s approach. Last autumn’s covid-19 vaccination campaign saw over 70% of all people aged over 65 years living in England receive a covid-19 booster. In care homes, over 80% of residents received a booster, providing vital protection over the winter months. Today, due to a combination of immunity acquired from natural infection or vaccination, covid-19 is now a relatively mild disease for the vast majority of people.
This spring, a covid-19 vaccine will again be offered to those most at risk of serious illness, in line with advice from the Joint Committee on Vaccination and Immunisation. The NHS will also offer more people access to covid-19 treatments, expanding the eligible cohort from the existing 3.9 million people to an additional 1.4 million people at the highest risk of severe illness.
The continued effectiveness of vaccines and treatments to protect people at high risk means that we can transition to an approach where covid-19 is managed in line with other respiratory illnesses, such as flu. From 1 April 2024, changes will be made to covid-19 testing to align with other respiratory infectious diseases.
Testing from 1 April 2024
While the virus causing covid-19 continues to evolve, new variants have not required a return to large-scale public testing. Given the high levels of vaccination among groups at higher risk, wider access to treatments and the reduced impact of outbreaks, the Government are now able to remove some of the highly targeted testing that remains in place from the height of the pandemic.
From 1 April 2024, routine provision of free covid-19 lateral flow device (LFD) tests for the management of outbreaks in higher risk settings will come to an end in England. However, free testing to determine the cause of an acute respiratory infection outbreak, where deemed appropriate by a local UK Health Security Agency (UKHSA) health protection team, in higher risk settings will remain to test for a wide range of respiratory viruses.
Routine asymptomatic covid-19 LFD testing on discharge from hospital into care or hospice settings will also end to align with the approach for other respiratory illnesses, though NHS trusts will have local discretion to re-introduce this or other forms of testing as clinically appropriate following risk assessment, involving local authority public health teams, UKHSA health protection teams and care providers as necessary in decision making.
Acute health providers should have trusted processes in place with local care home and hospice providers to facilitate safe discharges, as set out in the hospital discharge and community support guidance. Together with the care home or hospice, hospitals should assess the risk in the period before planned discharge, seeking advice on proposed changes to testing arrangements from local authority public health teams or UKHSA health protection teams if needed.
Care providers and hospices will also continue to have the ability to discuss and raise any concerns about discharge arrangements through existing local mechanisms. Where a care provider or hospice is providing services commissioned by a local authority or the NHS and has concerns about a planned discharge that cannot be resolved with the acute hospital provider, this includes the ability to contact the relevant commissioner.
Limited testing, including symptomatic testing of staff working on in-patient wards focused on treating profoundly immuno-compromised individuals, will continue in line with locally derived protocols to protect those most at risk. Symptomatic testing of patient-facing hospice staff who work closely with people who are at high risk from severe outcomes if suffering from covid-19 will also continue as outlined in guidance, in line with similar NHS settings.
The cohort of people eligible for covid-19 treatments can continue to access free covid-19 LFDs from their local pharmacy. These people, who are at highest risk of becoming seriously ill, are encouraged to test in order to gain timely access to treatments. A full list of those who are eligible, and information on how to access tests, is available on the NHS website.
Guidance on a range of infection prevention and control measures in adult social care has now been combined with acute respiratory infection guidance and has been updated to reflect these changes. This guidance, as well as guidance for hospices and other non-clinical settings, has been updated to reflect the latest evidence and expert consensus. It is technical guidance to support settings in operationalising the changes to the services they are directly responsible for from 1 April 2024.
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.
The future approach to pandemic preparedness
The covid-19 pandemic has highlighted the public health and economic risks posed by pandemics. The Government are continuing to work closely with partners to reduce the impact of a future pandemic. Together, UKHSA and the Department of Health and Social Care are developing plans to prevent and/or respond efficiently and effectively in the event of a pandemic.
These plans will build on learning from covid-19, and the findings of the covid-19 inquiry, once published. The exact nature of a future pandemic may vary, and so preparedness is considering all modes of transmission and tackling “Disease X” in readiness for unknown future threats.
The Government have already taken steps to prepare and develop capacity to respond, including through the Moderna-UK strategic partnership and the Vaccines Development and Evaluation Centre. Through UKHSA, we retain strong surveillance systems, world-leading genomic sequencing capabilities, and stronger baseline data and analysis functions that will help detect and characterise pandemic threats.
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