coronavirus

COVID-19 (coronavirus) FAQs

Our frequently asked questions about COVID-19 and work

Find out how to protect yourself, what you should expect from your employer and what to do if you have concerns.

 

The information below has been compiled by RCN advisers in public health, infection control, and employment relations. We'll be updating it as the situation develops - so please do check back often.

We are working hard in these challenging times to keep you updated. If you can't find what you are looking for please see our Get help page or contact us and we will get back to you as soon as we can.

 

COVID-19 testing

Looking for information about getting tested? Please see the UK government guidance.

The below list is non-exhaustive. Please speak to your employer about any concerns and keep up to date with any local reporting procedures and policies.

KN95 face masks

KN95 face masks must not be used as PPE for work as their effectiveness can not be assured. Read the Health and Safety Executive’s health and safety bulletin (June 2020) for more detail.

If you have worn KN95 face masks at work at any point during the pandemic, we recommend you keep a record of this using your workplace’s incident reporting procedure (i.e. datix or equivalent). If your workplace is continuing to use KN95 masks despite this safety alert, please follow our PPE – are you safe? guidance. If you need further support, call us on 0345 7726100.

Non-sterile gowns (Flosteril FLO-MED-8130)

Flosteril FLO-MED-8130 non-sterile gowns do not meet minimum standards for fluid resistance. Providers are asked to check their stocks and quarantine any unused gowns. Read the full alert.

Phillips Respironics V60 ventilator

Read the full alert for action to be taken to avoid potential unexpected shutdown leading to complete loss of ventilation.

Remdesivir for patients hospitalised with COVID-19 (adults and children age 12 and over)

Read the full alert for action to take in light of increased demand for remdesivir.

Thermal cameras and temperature screening products

Please see Medicines and Healthcare products Regulatory Agency (MHRA): Don't rely on temperature screening products for detection of coronavirus (COVID-19).

Type IIR mask from Cardinal Health

Please see the MHRA alert: Masks: type IIR from Cardinal Health – destroy affected lots.

Will my entitlements to annual leave change during the COVID-19 pandemic?

No. Existing contractual and statutory entitlements to annual leave and holiday pay will continue to apply throughout the COVID-19 pandemic. The only change relates to the carrying over of unused statutory annual leave. The government has amended the Working Time Regulations, which means that workers will be entitled to carry over any unused statutory holiday entitlement for two years.

If you have taken annual leave and have not been paid your normal holiday pay, you need to raise the issue with your employer and ask the reason for this in writing. This should be done before contacting the RCN for further advice. If you have your employer’s written response but you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100

For NHS staff, entitlement to annual leave is outlined in section 13 of the NHS terms and conditions of service handbook, further information on taking annual leave is available in the NHS guidance on managing annual leave for the COVID-19 period. For other staff, entitlement to annual leave should be outlined in their contract of employment.

All workers, wherever they work, have a right under the Working Time Regulations to at least 28 days paid annual leave a year (pro rata for part time staff). This is the equivalent of 5.6 weeks of holiday but can include public holidays.

Please see our information about annual leave entitlements

 

Can my employer ask me to cancel my annual leave?

The RCN expects employers to protect the health, safety and well-being of all health and care staff during the emergency period. This includes ensuring that nursing and other health care staff can take paid annual leave, as well as being able to take rest periods and breaks during shifts. If you work in the NHS, please see their guidance on managing annual leave for the COVID-19 period.

The RCN is calling on all health and care employers to put in place appropriate arrangements which ensure that: 

  • Wherever possible, booked annual leave should be honoured. Guidance issued by the DHSC in England confirms that employers should only consider cancelling an individual’s pre-agreed annual leave in exceptional circumstances. This should be a last resort, having engaged sensitively with the individual and in consultation with local staff side representatives. 
  • The equality impact of any decision is considered. 
  • Any restrictions on staff taking annual leave are staggered so all staff get to take leave. This has been specifically recommended by the NHS in Scotland.
  • Any restrictions are prioritised in line with the needs of maintaining essential services, following consultation and agreement with local staff sides and trade union representatives. 

DHSC guidance for England also reminds employers that they should give the appropriate statutory notice to cancel annual leave and consider whether compensation is appropriate for any out of pocket expenses that a staff member may incur as a result of cancelling their holiday plans. 

If your line manager is trying to cancel your annual leave you need to raise the issue with your HR Department or a more senior manager and ask the reason for this in writing. You should also raise it with your local RCN representative if you have one. This should be done before contacting the RCN for further advice. If you have your employer’s written response but you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100.

Can employers re-designate bank holidays as normal working days?

The UK government has not introduced any legislation or guidance which annuls or delays bank holidays. Some NHS services, including acute hospitals and primary care, may decide to respond to the COVID-19 pandemic by deciding to run some or all services at weekday service levels during bank holidays. 

In these instances, where possible, we expect organisations to approach their local staff side or trade union representatives to clarify which services this will affect and consult on communications which will go out to staff on this matter. Wherever possible, organisations should maintain staff goodwill be seeking volunteers rather than requiring staff to work on bank holidays. 

Staff covered by NHS terms and conditions who are required to work on bank holidays, should be paid the appropriate bank holiday rate as set out in the NHS terms and conditions of service handbook. Their leave should also be credited with the public holiday so it can be taken at a later date. 

If staff would normally not have worked the bank holiday (without having needed to book it off) or usually work shifts and had booked it off, the normal notice requirements for cancelling leave would apply. 

If you are being asked to work bank holidays and weekends as part of a move to a full seven day service during the pandemic you will be entitled to unsocial hours payments as set out in section 2 of the NHS terms and conditions of service handbook
   
For staff working in an NHS organisation, if you are being asked to cover bank holidays or weekends as overtime then section 3 of the handbook will apply. 

All NHS staff are entitled to the full allocation of bank holidays, so if you are asked to work a bank holiday then you will be entitled to that day back as set out in the handbook. 

For staff working in primary care (including GP practices), entitlement to pay (including enhancements) when working on public holidays will depend on your contract of employment. However, the RCN expects employers not to seek to vary contractual entitlements during the pandemic. If you have concerns regarding bank holidays you need to raise the issue with your HR Department or a more senior manager and ask the reason for this in writing. This should be done before contacting the RCN for further advice. If you have your employer’s written response but you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100.

For staff working for independent employers the re-designation, or changing, of public holidays will depend on your individual contract. Staff not covered by NHS terms and conditions should check their contract of employment for their annual leave and holiday pay entitlements. If your existing contract makes provision for public/bank holidays and conditions related to those days (e.g. pay or additional leave), you are not obliged to accept a change to your existing contract. However, employers can cancel booked leave if they give the appropriate statutory notice. If you have concerns regarding bank holidays you need to raise the issue with your HR Department or a more senior manager and ask the reason for this in writing. This should be done before contacting the RCN for further advice. If you have your employer’s written response but you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100. 

I’m being bullied by my manager/colleague. What do I do?

Our position on bullying and harassment is clear: staff must be able to do their jobs without fear of bullying or harassment from colleagues, patients or third parties in any form. Everyone should be treated with dignity and respect at work. Any form of bullying and harassment of health and care staff in the workplace, be that from managers, co-workers, patients or members of the public, is completely unacceptable.

Throughout this pandemic, health and care staff may be experiencing and feeling high levels of anxiety and stress. It is crucial for all employers to ensure that all health and care staff providing patient care, whether they are a registered health professional, student, volunteer, or agency worker, can do so in safety. 

Comprehensive advice on practical steps you can take is available in our bullying and harassment advice guide

Am I allowed to car share for work purposes, for example when visiting patients in the community?

We expect all health and social care staff to comply with the government’s stay at home guidance if they feel unwell, or meet the requirements for self-isolation. This will reduce the risk of transmission in shared vehicles. 

Every employer has a legal responsibility under health and safety legislation to carry out risk assessments during this pandemic. This includes risk assessing and advising staff in relation to:

  • sharing vehicles when travelling to and from work
  • sharing vehicles when travelling to provide care at patients’ residences.

When preparing a risk assessment, employers should balance risks and benefits of sharing vehicles with the need to support and protect lone workers.

If you have concerns about cardiopulmonary resuscitation (CPR), please see our guidance on CPR and PPE.

To help control the spread of COVID-19, additional cleaning and disinfection will be needed.  For larger spaces a number of cleaning options are available, such as fogging and the use of vapour.

It is important to note:  

  • COSHH risk assessment must be undertaken and measures identified to reduce the risk of exposures must be implemented.
  • Staff must be trained and competent in the use of equipment.  
  • Staff must be aware of Infection Prevention and Control (IPC) procedures and agreed protocols.
  • Cleaning of care equipment must be as per manufacturers guidance/instructions.  
  • Alternative cleaning agents/disinfectant products may be used with agreement of the local IPC team or the Health Protection Team (HPT). 

If you have any concerns, please see our guidance on raising concerns.

If you experience any adverse effects and need support, contact us on 0345 772 6100.

For more information please see the HSE guidance on disinfecting premises during coronavirus outbreak and the UK Infection prevention and control guidance

See our clinical guidance pages for information and advice on issues including:

You may have concerns about possible exposure to COVID-19 in your workplace or in your personal life, for example after travel. For work-related concerns, contact your local infection prevention control lead, follow their advice and alert your manager. If you are not aware who your infection prevention control lead is, check your local policy or ask your manager.

For other queries, find more information on the NHS website which is continually being updated by the government.

Where relevant, please also see our information on 'underlying health conditions' below.

If you have concerns about exposure and cardiopulmonary resuscitation (CPR), please see our guidance on CPR and PPE.

The UK governments have made financial provision in the event that eligible health care workers sadly die as a result of exposure to COVID-19 at work. These are known as Coronavirus Life Assurance schemes and are detailed in rules set out by health ministers under their delegated powers.

England

A one-off lump sum 'coronavirus life assurance' payment of £60,000 will be payable in the event of the death of a health and social care sector worker (who worked in a publicly funded service) who dies and it is likely that they contracted COVID-19 in the course of their work. Payment is made into the estate of the deceased. This is a new benefit that will apply for the duration of the pandemic.  It will be paid in addition to any other life assurance staff may have e.g. through an occupational pension scheme like the NHS Pension or Local Government Pension Scheme. 

If you are a member of the NHS Pension Scheme your survivors will also receive the life assurance benefits you are entitled to under scheme rules. These are usually a lump sum plus an ongoing payment for a surviving partner and any dependent children. 

Scotland

The survivors of NHS staff who die as a result of COVID-19 exposure at work will receive coronavirus life assurance benefits including a lump sum of twice the workers annual salary plus an ongoing pension payment for a surviving partner and any dependent children. If the worker is in the NHS Pension scheme, their coronavirus life assurance benefit will be reduced by the amount of life assurance they receive from the NHS Pension scheme.

If a publicly funded social care worker dies without death in service cover in their contracted pension arrangements, the Scottish Government will provide a one-off payment of £60,000 to a named survivor.

Northern Ireland

We are still awaiting an announcement and continue to press for a benefit to be put into place.

Wales

At the time of writing the rules for workers in Wales have not yet been published, however they are expected to mirror the rules in England. We’ll update this page as soon as possible.

What are the eligibility criteria?

In England, your survivors/estate will be eligible for the £60,000 payment if you:

  • work in a publicly funded health role (including bank/agency staff, students on paid placement, GP Practices and returners) or 
  • work in a publicly funded social care role (including adult social care provided by local authorities)

and

  • contracted COVID-19 in the course of your work, and
  • worked in a workplace exposed to COVID-19 in the two weeks before you first experienced symptoms, and
  • COVID-19 is deemed to be the whole of main cause of death (either on the death certificate or other formal reporting).

The payment is made at a flat rate regardless of your length of service, working hours, pension scheme membership or immigration status.

If you do not meet the all of the above criteria, your family may still be awarded a payment at the discretion of the Secretary of State / Minister for Health and Social Care - for example if you are a student on a non-paid placement or a volunteer. This may be especially relevant where COVID-19 is not listed on the death certificate but was a compounding factor.

In Scotland, your survivors will be eligible for the life assurance payments if you:

  • are a permanent, fixed term, bank or locum employee of an NHS body (e.g. Health Board, Common Services Agency, Healthcare Improvement Scotland or GP practice), and
  • you have worked in an environment exposed to COVID-19 and
  • have COVID-19 stated as a factor on your death certificate (or where COVID-19 exposure at work is held to be partly attributable by nature of the work undertaken)

If you are an existing member of the NHS Pension scheme in Scotland you will be eligible under this scheme but your benefits will be reduced by the amount you receive from the NHS Pension scheme life assurance.

Details on the payment for social care workers have not yet been published.

How would my surviving family apply for this?

Your family should make contact with your employer who will initiate the application, discuss claim forms and any necessary documentation checks. The coronavirus life assurance schemes are being administered by the relevant NHS Pension scheme administrators.

Will this lump sum payment be taxable?

No, but it may be counted as part of your estate for inheritance tax purposes.  It will also be treated as capital for means tested welfare benefit payments from the Department for Work and Pensions (DWP) (e.g. Universal Credit and tax credits).

Where can I find more information?

NHS and Social Care Coronavirus Life Assurance Scheme (England) 
NHS Scotland Coronavirus Life Assurance Scheme 
Northern Ireland: arrangements to be confirmed
Wales: scheme rules not yet published 

The RCN will provide support and assistance to the families of members who die due to COVID-19 to ensure that they receive the payments they are entitled to. Should they encounter any problems with the applications they should contact RCN Direct on 0345 722 6100.

Do I need to wear PPE to undertake verification of death? 

The RCN guidance on DNACPR and verification of death includes the need to wear PPE as an element of standard infection control precautions. Find out more at COVID-19 guidance on DNACPR  and verification of death.

Correct use of body bags

Nurses involved in verification of death or ‘laying out’ of patients must comply with standard infection control precautions and the appropriate use of PPE.

As the practices for caring for the deceased vary according to local, cultural and religious context, communication with key stakeholders is imperative, particularly with religious representatives and to also ensure that changes to standard practice are adhered. Transparent conversations with societal leaders led by local health and care providers is essential to maintain trust between organisations and the community.

Viewing, hygienic preparations, post-mortem and embalming are all permitted by professionals experienced in handling bodies of deceased persons, if appropriate precautions are followed, as detailed in the HSE, AAPT (Association of Anatomical Pathology Technology) and RCPath (Royal College of Pathologists) guidance.

Mourners should not take part in any rituals or practices that bring them into close contact with the body of an individual who has died from, or with symptoms of COVID-19. 
 
Some members are reporting a shortages of body bags and are unsure how to care for deceased patients who may or have COVID-19. There is differing guidance across the 4 countries on this issue. 

In Scotland, Wales and England, where the deceased was known or suspected to have been infected with COVID-19, there is no requirement for a body bag, and viewing, hygienic preparations, post-mortem and embalming are all permitted when undertaken by professionals trained in handling bodies of the deceased.

Read the full guidance  
 
In Northern Ireland, guidance states those in direct contact with deceased bodies should use or observe the following: 

a. A cloth or mask placed over the mouth of the deceased when moving them to help to prevent release of aerosols. 
b. A zipped, leak-proof body bag which has had their exterior surface decontaminated using an appropriate detergent/disinfectant. The use of a body bag brings practical advantages of reducing prolonged exposure (including possible bodily fluids) from the transportation and moving of the deceased throughout their journey.

Read the full guidance

Last offices - care given after death

During the COVID-19 pandemic, care after death (last offices) including personal care, may be carried out by nursing staff who are not normally requested to complete this within their scope of practice. In some circumstances nursing staff may be redeployed into a role where this procedure is expected. Their line manager ultimately has responsibility to ensure the relevant support and competencies are in place and that staff members feel confident in carrying out last offices.

When undertaking care after death, the following considerations must be made:

  • The principles of delivering dignified and compassionate care following death remain in place, including consideration of the individual’s spiritual and cultural beliefs.
  • Last offices should be performed according to local policy.
  • In line with UK Infection prevention and control guidance, PPE must be worn whilst performing last offices for individuals with either suspected or confirmed COVID-19

Please see our guidance on redeployment and the NHS England guidance on care after death for more information. 

What should I expect from my employer?

Employers should ensure that all nursing staff are provided with factual information on COVID-19, the steps being taken to identify and manage suspected cases and what nursing staff can do to protect themselves, including reinforcing hand hygiene

Please refer to your relevant national public health / NHS guidance. Information can also be found on our COVID-19 page.

Staff who may be required to deliver clinical care to affected patients should have the necessary skills and experience, and be provided with training and information on any additional infection prevention and control measures needed to work in such environments, including putting on and taking off personal protective equipment (PPE) safely. Employers should make sure staff have access to the appropriate PPE. Please see our guidance personal protective equipment (PPE) and COVID-19 for more information. 

Employers are responsible for complying with all health and safety standards, contractual and statutory employment rights as well as equality rights.

How can I protect myself at work?

Your employer should be carrying out risk assessments and putting measures in place to minimise the risk of exposure by following current public health guidelines on the provision and use of PPE, as well as supplies of alcohol hand gel where appropriate.

You should also be given information and training on the risks of exposure and how to minimise your risk. If you’re required to use PPE, you should be given training on how to properly use this.

The situation is changing daily and the number of cases in the UK is increasing rapidly. Make sure you follow workplace guidelines and safety procedures and practice good hand hygiene. 

Please refer to your relevant national public health/NHS guidance and visit the UK government website for the most up-to-date guidance for health care professionals on the assessment and management of suspected UK cases. 

Information can also be found on our COVID-19 page. If you feel your organisation is not providing the right support, see the section below on raising concerns.

What other safeguards should my employer be putting in place?

Rest breaks are very important, even more so at times like this, as fatigue can lead to mistakes and increase the risk of infection. The duty is on your employer to ensure staff can take regular breaks and monitor working hours to prevent the onset of mental and physical fatigue. Wearing protective clothing for long periods can be uncomfortable and hot so, as well as rest breaks, it is also important for staff to keep hydrated. Please see our guidance personal protective equipment (PPE) and COVID-19 for more information. 

Staff employed under NHS terms and conditions can find more information on our page COVID-19 employment guidance for NHS staff.

Other RCN members, including those working in general practice, through employment agencies and in the independent sector, should check their contract of employment and local policies in the first instance, or contact their employer or local occupational health service, for information and advice.

If you are struggling financially as a result of COVID-19, the RCN Welfare Service has guidance on entitlements or benefits that may be available to you, advice on what to do if you're struggling with your rent, mortgage, or creditors, and how to access further support.

See COVID-19 and your finances for more details.

If you're a student, see our advice here.

The Coronavirus Job Retention Scheme is a temporary government scheme to support employers whose operations have been severely affected by coronavirus (COVID-19). The government expects that the scheme will not be used by many public sector organisations, as most should continue to provide essential public services. This means the scheme may not be relevant to members working in the NHS, but some members working for independent employers or those working via an employment agency may benefit from the scheme.

The scheme allowed employers to ‘furlough’ employees (place them on a leave of absence) and then claim for 80% of the employees’ usual monthly wage costs, up to £2,500 a month. From August 2020 employers still using this scheme have been asked to contribute towards these costs. The scheme will run until the end of October 2020 and employers are no longer able to place employees onto furlough - unless that employee has been furloughed under the scheme previously.

How do I apply for the scheme?

The scheme is now closed to any employee who has not previously been furloughed for at least three weeks before the end of June 2020. Employees who are currently on furlough can remain on furlough until the end of October 2020 unless their employer decides they should return to work sooner. Employees who have previously been furloughed for three weeks or more can be furloughed again if their employer wishes. Any subsequent periods of furlough do not need to last for three weeks, and employers can furlough eligible employees as many times as they wish before the scheme ends (assuming the employee agrees to this). 

Employees and workers do not have an automatic right to be furloughed - it remains a decision for employers and agencies to take whether to furlough staff based on the needs of their business. Each time you are furloughed you and your employer need to agree it in writing (an email exchange may be enough to count as this written agreement). If you have returned from furlough and think you would benefit from being furloughed again then in the first instance you should speak to your manager about the scheme, details of which can be found on the government website.

What is 'part time furlough'?

If you are furloughed under the scheme, your employer now has the option to place you on furlough for only part of your working week and to ask you to work the remainder of your working hours. For this to happen you and your employer would need to agree which days/hours you will be at work and which will count as furlough. If you agree to this then you will be expected to work as normal for the hours you are not furloughed (and will receive full pay for those hours) and will be paid through the furlough scheme for the remainder of your working time. It is important that if you are on part time furlough that you only undertake work for your employer for the hours you are expected to be at work and that you do not undertake any work for them during the hours you are being paid through the furlough scheme.

I was shielding previously - does my furlough now need to end?

If you were shielding in line with public health guidance or were staying home due to an individual in your household shielding, your employer may have placed you on furlough. Now that shielding is ending in some parts of the UK, some employers may be asking employees to return to work from furlough. It remains your employer’s decision when to furlough you through this scheme and the do have the discretion to keep you on furlough until the scheme ends in October 2020 if they wish.

If you were shielding and on furlough, you employer should conduct a risk assessment before you return to work. If this risk assessment indicates it may not be safe for you to return, or you do not believe it is safe, then you may wish to discuss with your manager whether the will extend your furlough. If your manager insists that it is safe for you to return to work and you do not agree, you should seek RCN support by raising your concerns with your local RCN representative or by contacting RCN Direct on 0345 772 6100.

Before reading this section, please ensure you have also read the 'Furlough: the Coronavirus Job Retention Scheme and eligibility' information above.

How long would I be furloughed for? 

The scheme will end at the end of October 2020. If you are currently on furlough, there is currently no maximum or minimum time you can be furloughed within this period.

From August 2020 employers have been asked to meet part of the costs of the scheme for all employees still on furlough.

If you are currently on furlough and are concerned about being unable to return to work, for example because you do not yet have childcare available, then you should make your employer aware of these issues and discuss them with your manager in the first instance. 

What will I be paid while on furlough?

If you are furloughed then your employer will only receive 80% of your normal pay from this scheme. This will be calculated based on your pay before the scheme was introduced in March 2020. It will then be for your employer to decide whether to only pay you this 80% or whether to top up your pay to the full amount. The RCN encourages all employers to consider paying our members their full salary not just the 80% they receive from the government whenever they can afford to do so. If you are furloughed then you should speak to your manager about how much you are going to be paid.

Employees who are furloughed for part of their working time and are working their remaining hours as usual should receive full pay for the hours they work, even if they only receive 80% for the hours they are on furlough. Please note that while at work you should be paid based on your current salary, but for any hours for which you are on furlough your pay is calculated based on the average amount you were being paid before scheme was introduced.

What if I don’t have a fixed salary or work through an agency or bank?

If you earn a variable amount each month, for example because you are a bank worker, an agency worker or on a zero hours contract, you can still be furloughed and paid through this scheme. The government guidance explains how your agency or employer should calculate your average earnings for the purpose of this scheme. To retain their eligibility for pay protection under the Coronavirus Job Retention Scheme, bank and agency workers must not take on any work through their bank/agency in their period of furlough.

If you are an agency worker working via an umbrella company then it would be the umbrella company that would need to decide whether to furlough you and use this scheme, not your agency. If you work agency shifts but are classed as self-employed for tax purposes, then you are not eligible to be furloughed. There is separate government support for the self-employed so you may want to investigate whether you are eligible for this.

Do I still pay tax and National Insurance while I am furloughed?

If your employer decides to make use of this scheme then they would pay you as normal through their payroll system, including deducting income tax, National Insurance, and where appropriate, pension contributions. It would then be your employer’s responsibility to claim this money back from the government through the scheme.

Do I accrue annual leave while I am furloughed?

The guidance states that a furloughed employee continues to accrue annual leave in line with their contract. However, agency workers and those on zero hours contracts accrue holiday based on time worked. If you are furloughed by an agency, you cannot work for that agency and therefore may not be able to accrue annual leave during the furlough. The guidance to employees who have been furloughed says that you can choose to take some of your accrued annual leave while on furlough if you want to. This would mean that any furloughed worker only receiving 80% of their normal pay would have this topped up to 100% of their normal pay while they are using their annual leave.

Can I still work while I am furloughed?

If an employer or agency furloughs you then you cannot undertake any work for that organisation for the duration of the time you are furloughed. If you are on part time furlough then you should only undertake work for your employer for the hours you are expected to be at work, and not any of the hours for which you are furloughed.

If you work for more than one employer/agency then it may be possible to be furloughed by more than one organisation at the same time, since each one would only be claiming based on the amount that they usually pay you.

If you have been placed on furlough leave and want to start a new job (e.g. in the NHS, on the staff bank), you need to check this with your main employer. HMRC have confirmed that employees are permitted to work for another employer while furloughed provided their contract allows that. Therefore, please check with your main employer before agreeing to undertake additional work elsewhere. 

See below for answers to your questions about self-isolating, shielding and underlying health conditions.

Our redeployment page also offers advice for staff with underlying health conditions.

For more information and resources for staff with ill health or disability issues - including to speak to other members with lived experience of disability at this time - visit our Peer Support Services pages.

Employers should have policies to support employees working at home, whether permanently or because they are being asked to due to the current pandemic. These policies should cover a range of issues - from health and safety to patient confidentiality and GDPR issues. Employers should support staff to ensure compliance with these policies i.e. by providing resources for secure storage if confidential documents are being held at home.

If you are an NMC registrant, you will also need to be aware of your professional responsibilities and accountability in line with the NMC Code. You should raise any areas of concern with your employer.

Useful information is also available from NHS Employers and from ACAS.

See our Immigration Advice Service pages.

What incidents do I need to report?   

You should follow your existing organisational policy and guidelines on reporting patient safety and clinical incidents. 

The RCN is encouraging members to report incidents relating to potential breaches in health and safety requirements which have led to exposures to COVID-19. Examples include a lack of personal protective equipment (PPE), defective PPE or not being fit tested for FFP3 masks.

Where possible provide as much evidence as you can, including witnesses and where able to do so upload photographs. If this is not possible, you should keep your own records e.g. photographs.    
The Health and Safety Executive (HSE) describes an incident as a: 

  • near miss - an event not causing harm, but has the potential to cause injury or ill health (in this guidance, the term near miss will include dangerous occurrences), or an
  • undesired circumstance - a set of conditions or circumstances that have the potential to cause injury or ill health, e.g. untrained nurses handling heavy patients.     

The RCN believes that lack of appropriate or sufficient PPE (including where shortages lead to re-use of PPE designated for single use) and issues around lack of training or fit testing for PPE are examples of undesired circumstances which should be reported. See our PPE guidance for more information.

Being deployed to an area and not receiving appropriate training to carry out your role safely would also justify an incident report, as it is an undesired circumstance - as would not being trained in how to don and doff PPE safely. 

See our PPE guidance and guidance on raising concerns for further information on escalating issues relating to PPE 

Reporting psychological harm 

The RCN would also encourage members to report any work-related harm to their psychological health including work related stress and cases of violence, bullying and harassment or abuse.   

If you don’t feel able to complete an incident form or are worried about confidentially, log your concern in writing with your occupational health provider who can support you to make your manager aware of the problem. 

You should never be discouraged or victimised from completing an incident form. If you are please see our bullying and harassment guide for more information.

If you have an RCN representative in your workplace let them know about any incidents or injuries at work, so that they can follow up with your employer and offer you any necessary support, especially if you are off work as a result of an incident or injury.   

An incident form also provides a useful record should you go on to develop any health conditions as a result of any workplace incidents.  

Find out more in our accidents and work and personal injury guide.

What happens if something goes wrong?

You might be concerned about what protections are in place if something goes wrong in the course of your work during the COVID-19 pandemic. This is where your professional indemnity becomes relevant. 

The term ‘professional indemnity’ is sometimes used to describe two different types of cover: clinical negligence cover, and representation for workplace issues.

When we talk about indemnity, we’re referring to clinical negligence cover, i.e. the cover that pays out if a patient is harmed and makes a claim for compensation against a practitioner or health care provider.

Clinical negligence cover 

If you are providing any NHS-funded care (regardless of your employer) you are covered by a government-backed indemnity scheme in England and Wales. Entry onto these schemes is automatic. In Scotland and Northern Ireland there are slightly different arrangements for GP services. 

To provide further reassurance, legislation confirms that indemnity will be provided for those who are responding to the COVID-19 emergency across the four countries, and will include those who backfill posts as well as front line staff.

NHS Resolution has published details of the Clinical Negligence Scheme for Coronavirus (CNSC), including a list of frequently asked questions.

If you’re employed outside the NHS, your indemnity cover is provided by your employer. If your employer is refusing to provide cover for you, please contact us on 0345 772 6100.

If you’re self-employed and involved in non-NHS work, you’ll need to make other arrangements. Find out if the RCN indemnity scheme covers you.

Representation for workplace issues

Aside from indemnity cover for clinical negligence claims, you may also be concerned about support with workplace issues such as disciplinary action, inquests or NMC referrals. Unions like the RCN provide this to their members as a benefit of membership. Some Medical Defence Organisation cover includes this service as well.

If you’re an RCN member and need our help, visit Get help to see the full range of support is available to you. If you’re not an RCN member, find out more about membership.

I can see clinical waste bags piling up awaiting collection - what do I do?

Waste is generated as a result of health and care practice/processes. There are clear responsibilities for both the ‘producer of the waste’ (the member) and the organisation responsible for the management of waste produced.  

UK guidance, Health technical Memorandum (HTM) 07-01 is the overarching guidance for health care organisations to manage waste. This document provides a framework for best practice waste management to enable healthcare organisations/other waste producers meet their legislative requirements and minimise waste production.

The term clinical waste is commonplace in all health care environments including community settings, and is defined within the Controlled Waste (England and Wales) Regulations 2012 as waste from a health care activity that: 

  1. contains viable micro-organisms or their toxins which are known or reliably believed to cause disease in humans or other living organisms,
  2. contains or is contaminated with a medicine that contains a biologically active pharmaceutical agent,
  3. is a sharp, or a body fluid or other biological material (including human and animal tissue) containing or contaminated with a dangerous substance (based on regulations for the classification, packaging and labelling of dangerous substances) [summarised].

Waste generated as a result of providing care to suspected or confirmed patients with COVID-19 falls into the category of clinical waste (Category B waste) as defined by the COVID-19 waste management standard operating procedure. It is the responsibility of the person generating the waste (e.g. a nurse, HCSW, midwife) to categorise the waste correctly and place it in the correct waste receptacle (bin).

Who is responsible for the management of waste, specifically safe storage?

It is the responsibility of managers to ensure that health care waste is stored securely so as to prevent the escape of waste, harm to the environment and harm to human health. Failure to do so is a breach of the statutory duty of care. This applies to storage at the point of production and bulk storage areas whilst awaiting transport for onward disposal.  

Where waste accumulates and is deemed excessive members should:

  • refer to their local employer’s waste policy 
  • report the issue to their line manager or waste manager (if present)
  • complete an incident report if the issue is unresolved.

Capacity for the management of clinical waste across the health and care system is limited at times due to the amount of waste generated as a result of the pandemic.  The communication/feedback of issues relating to waste management/co-ordination can be found in the NHS COVID-19 waste management standard operating procedure (England).

During these challenging times, you may be finding it difficult to maintain your mental health and wellbeing when coping with so much uncertainty and turmoil at home and at work.

For tips and resources on self care and looking after your mental health during the COVID-19 outbreak, see COVID-19 and your mental wellbeing for more details.

If you need further emotional support, you can access the RCN Counselling service, who are operating as normal to support members during this time.

You may also find these resources helpful:

NHS Pathways

Rest, Rehydrate, Refuel

Time and space

OpenLearn: Understanding depression and anxiety

e-Learning for Healthcare: Introduction to Mindfulness

Scotland:

Turas Learn: Psychosocial mental health and wellbeing support for staff

Where can I find information on pregnancy and the care of pregnant women?

Please see our clinical advice under Pregnancy and fertility care.
 

I am returning to midwifery practice but I need to refresh my skills. What support is available?

Health Education England (HEE) has developed a module specially for returning midwives.
The RCN has also created a new Return to Practice (RTP) network to support nurses working in health and social care who are returning to work during the COVID-19 pandemic. Further information is also available from the NMC on temporary registrants and returning to practice.

I am a student midwife, will I be able to complete my programme?

In March 2020, the NMC introduced emergency programme standards for nursing and midwifery students, to enable flexibility in programme completion during the COVID-19 crisis.
This was in recognition of the important contribution that students make and the impact of changes on their studies. Read the NMC's guidance for students and educators here.

This announcement was followed by the publication of guidance from Health Education England (HEE) on how students could support the NHS during the COVID-19 outbreak, and what this would mean for them. It also provides information for employers on job descriptions and bandings. Read more about the deployment of student midwives during the COVID-19 emergency and see our student section below.

If you have concerns about your placement, speak to your course tutor or Lead Midwife for Education (LME) in your Higher Education Institution (HEI), who will be able to guide you through the process.

The process of registration and revalidation is managed by the NMC. Please see their guidance how we are continuing to regulate. If you have any additional questions please contact the NMC directly

If you have been asked to witness a patient's will, please see the 'signing legal documents during the course of your employment' section of our advice for witnesses.

The RCN recognises that these are unprecedented times and nursing support workers may be required to make adjustments to their normal day to day duties.

The principles of accountability and delegation can be applied to the nursing support workforce and this includes health care assistants, assistant practitioners, trainee nursing associates and nursing apprentices. 

Health service providers have a duty to ensure that they meet their legal requirements to provide a safe working environment for nursing support workers to fulfil their delegated responsibilities. 

Am I still accountable if a task has been delegated to me by a registered nurse (RN)?

Yes, providing you have agreed to accept it, verbally or by deed. The RN may be in overall charge of the nursing care, however, may need to appropriately delegate to others, according to delegation frameworks/guidance in the four nations.

If you are unable to carry out the delegated task inform the RN in order to protect yourself, your patients, the organisation and even the delegator. If you are still unsure, always seek further advice or clarification. It is advised that you may want to observe a task before asking to do it under supervision, to give you the necessary skills and knowledge you need.

It is important that you have an understanding of local policies and for you to keep your skills and competencies under constant review through regular meetings, debriefing sessions with your line manager and through clinical supervision. 

Further resources to support practice are available here:

First steps: accountability and delegation

First steps: supporting medication administration

Medicines management 

Learning resources for HCAs, APs and TNAs

Northern Ireland:

NIPEC Delegation Decision Framework

Scotland:

Turas learn: Delegation

Turas Learn: Making delegation safe and effective: information for support workers in health and care settings in the context of COVID-19 outbreak

Wales:

Health Education and Improvement Wales: All Wales Guidance for Delegation

When am I personally accountable for my practice as an employee?

You are accountable if you accept the responsibility to perform a task. As a nursing support worker you need to be sure that you have the ability to competently perform tasks allocated to you and you are working within your scope of competency, which includes your job description and terms and conditions. You must inform a senior member of staff if you are unsure.

I am more involved in end of life care during the COVID-19 pandemic. What do I need to know?

Nursing support workers in all settings must be supported - which includes relevant and adequate training, guidance and support - in order to provide the best possible end of life care. Due to COVID-19 there will be an increase in numbers of people with palliative and end of life care needs. This will include those who have also become palliative during the pandemic and those who have been impacted by changes to the health and care services. The RCN has developed palliative and end of life care information to support all of its members.  

Dignity, respect and compassion must remain at the core of the delivery of end of life care. As far as reasonably possible, people’s cultural, religious and spiritual beliefs should be explored and respected. However, as the pandemic increases this may not always be possible. You must inform your team leader or line manager if you do not have the relevant skills, education, competencies and resources to support end of life care. 

Further resources to support practice are available here: 

Fundamentals of end of life care

First steps: end of life care

Health Education England: End of life care for all

MindEd: End of life care and bereavement

Open Learn: An introduction to death, dying and grief

The Six Steps Programme: Six steps to success in end of life care

Scotland:

Turas Learn: Palliative and end of life care

Wales:

Social Care Wales: End of life care

What if my employer asks me to move from my normal role? 

Please see our guidance on redeployment for more information.

Further resources 

Northern Ireland:

Northern Ireland Social Care Council

Public Health Agency

Department of Health

Scotland:

Scottish Social Care Council: Codes of Practice

Turas Learn

Wales:

NHS Wales: Code of Conduct and Code of Practice

Social Care Wales: Codes of Practice and guidance

NHS Wales: All Wales Induction Programme

I'm working extra hours outside the NHS. What are my entitlements?

Overtime and TOIL arrangements should be detailed in your contract of employment and/or employer's policy. Please check with your employer for more information about how additional working hours will be allocated, recorded and recouped.

I’m working extra hours in the NHS. What are my entitlements? 

Any change to your working patterns should be agreed with you, in accordance with your employer's policies and your contract of employment. 

Overtime entitlements are set out in section 3 of the NHS terms and conditions of service handbook

Systems should also be put in place to ensure that you can take TOIL as soon as possible after you accrue it. Where TOIL cannot be taken within 3 months, managers are responsible for ensuring payments are made, as set out in section 3.5 of the NHS terms and conditions of service handbook

Please check your employer’s policy for more information about how additional working hours will be allocated, recorded and recouped.  

I am a band 8 or band 9 nurse. What are my entitlements? 

It is expected that managers will need to work additional hours to support their teams respond to the pandemic. 
 
NHS staff at bands 8 and 9 are not usually eligible for overtime when they work beyond their contracted hours. However, the RCN is calling on all UK governments to ensure that all NHS staff receive overtime payments for hours worked beyond full-time contracted hours.

The Scottish Government issued a variation order confirming that the bar on entitlement to overtime payments for staff employed on bands 8 and 9 (section 3.6 of the National Handbook) and for Executive and Senior Managers (ESMs) should be waived in Scotland for the course of the pandemic.

The Health Department for Northern Ireland has made a temporary amendment to Agenda for Change terms and conditions to allow overtime to be paid to bands 8 and above, where required for additional duties relating to COVID-19.

In England, the NHS Trade Unions and NHS Employers have issued guidance to NHS employers outlining the issues that should be included in local policies on overtime during this period – including payment for additional hours for bands 8-9.

The Welsh Government have confirmed that Welsh NHS organisations have discretion to pay overtime at time and a half to these bands where the additional activity relates specifically to the management of COVID-19.

The RCN believes that where local policies are agreed, overtime payments for band 8-9 staff should be calculated on the same basis as for staff on bands 2 to 7.

See section 3 of the NHS terms and conditions of service handbook.  

What if I’m pregnant?

The Royal College of Obstetricians and Gynaecologists (RCOG) has issued updated information for pregnant women and their families. Please see in particular the RCOG, RCM and FOM joint statement on Occupational health advice for employers and pregnant women.

The RCN expects employers and occupational health departments to carry out (or review) pregnancy risk assessments for all pregnant workers. The assessment will look at your role, your work environment and the context of your health (including any underlying conditions). It must highlight any potential risks and steps to be taken to remove the risk of harm to you and your unborn child.

The clinical advice from the RCOG’s joint statement on Occupational health advice for employers and pregnant women states that ‘social distancing is particularly important for all pregnant women who are 28 weeks and beyond, in order to lessen their risk of contracting the virus’. Employers should take this into account when carrying out the risk assessment.

Where the risk can't be removed, your employer should look at suitable alternative work, including home working, the use of a single office or redeployment in line with health and safety standards.

If suitable alternative work is not available then you should be suspended on full paid leave for as long as necessary to protect your health and safety, or that of your unborn child. Employers who do not undertake risk assessments or organise suitable alternatives may be breaching the Management of Health and Safety at Work Regulations 1999 (MHSW).

If you have any concerns, discuss these with your line manager in the first instance. You may also wish to discuss the matter with your GP, midwife and Occupational Health department. It is important to contact RCN Direct on 0345 772 6100 if you feel at risk.  

Can I be made to start my maternity leave early?

If you’re being asked to take early maternity leave you should inform your employer that pregnant staff cannot be required to start maternity leave early. The only requirement to start maternity leave early is if a worker has a pregnancy-related illness in the 4 weeks before their baby is due.

If your employer cannot offer you suitable alternative work, including moving to a different work area or working from home you should be medically suspended on full pay. The statutory right to medical suspension pay applies to employees across the UK who have been in their job for one month and the right lasts for 26 weeks. 

If you’re being forced to take early maternity leave notwithstanding the above, you should contact RCN Direct on 0345 7726100.

What if I have concerns about how coronavirus is being handled in my workplace?

Organisations should have effective procedures in place to allow nursing staff and their representatives to raise any concerns in relation to equipment, policies and processes for managing COVID-19 at the earliest opportunity.

Nursing staff should feel able to raise concerns without detriment and should receive timely feedback on their concerns. If your concerns remain unresolved, refer to our raising concerns guidance and speak to your line manager. You can also call RCN Direct for advice on 0345 772 6100.

What is the role of RCN safety representatives?

RCN safety representatives should be kept informed of measures being taken to protect staff and there should be mechanisms in place that allow safety representatives to raise concerns with senior managers, health and safety, or infection control leads on behalf of staff. 

Members who are concerned should speak to their local RCN safety representative and/or contact RCN Direct on 0345 772 6100.

Please see our guidance on redeployment.


Can I refuse to treat a patient with COVID-19?

You should speak to your manager about your concerns in the first instance and consult our guidance around refusal to treat.

I work for a hospital bank and want to cancel my shifts. What do I do?

Speak directly to the staff bank and read your bank contract to check the process you’re required to follow. Try to give the staff bank as much notice as possible to enable them to cover your shift. Make sure you keep records of who you speak to and when.

What’s the RCN’s position on retired nurses returning to work to help with the response to COVID-19?

Retired nurses are being encouraged by the UK and devolved governments to return to clinical practice to support the COVID-19 response. However, this is a matter of personal choice and they need only return to work if they choose and feel able to.

Will returning to work have an impact on my NHS Pension if I have retired?

In short – no.  Following representations from the RCN, the UK government has included helpful measures in the emergency Coronavirus Bill that relate to the NHS Pension (in all UK countries). This means that the three NHS Pension schemes (England and Wales, Scotland and Northern Ireland) are amended during this period so that any restrictions on returning to work are suspended. These restrictions are usually on the number of hours worked or salary earned. The requirement for members of the 2008 and 2015 schemes to reduce their earnings in order to draw down from their pension has also been suspended.

*NB - NHS earnings and NHS pension payments will still be subject to income tax at the usual rates. 

Find out more at the NHS Business Services Authority website.

Will I need to inform my NHS Pension administrator if I return to work under this initiative?

Your employer should make any necessary notifications.

All NHS Pension administrators (England & Wales, Scotland and Northern Ireland) are operating under their business continuity arrangements in order to provide a full service to scheme members and pensioners during this time. However, some non-critical processes may take more time as their workforce is reduced as staff have to work from home, are self-isolating or unwell. They are also supporting employers who may need to change some of their administrative processes due to other pressures.

What will I be paid if I return to the NHS? 

If you were covered by NHS terms and conditions before retiring, you should be paid at the top of the appropriate pay band for the role you are doing, providing you previously worked in that pay band or higher. 

If you return to the same pay band, you should not be paid at a pay point any lower than this. 

If you choose to return to a lower pay band, you should be paid at the top of that band.

What if I want to return to a different role?

If you want to return to a more junior role than the role you retired from, you should be paid the top of the pay scale for that junior role. 

What support will I have from the RCN?

Existing RCN members who are in the Retired category who join the temporary register will receive full support and representation as retired members whilst they are on the temporary register.

Any non members who are retired (and don’t have an active NMC PIN) who join as a retired member (£10 per year or 84p per month), will receive full support and representation as retired members whilst they are on the temporary register.

You can join the RCN online or to discuss your RCN Membership, please call 0345 772 6100 and choose option 1 (Membership) or email membership@rcn.org.uk.

Governments from across the UK have issued guidance on the provision of education and childcare during the COVID-19 outbreak, which includes who is identified as key workers for the purposes of on-going educational provision (where relevant). The RCN expects that students who are working during this period will also be counted as key workers. Despite these measures many members may still be experiencing childcare issues that impact on their ability to work their normal contracted hours. 

Here is the current guidance for each of the four UK countries:

England
Coronavirus (COVID-19): education and childcare
NHS Employers guidance for staff whose children need to self isolate or are affected by school closures (please see the section on caring commitments)

Scotland 
Coronavirus (COVID-19) guidance: education and children

Northern Ireland 
Coronavirus (COVID-19): advice on schools, colleges and universities

Wales  
Education and childcare: coronavirus

What if there isn’t a suitable school/childcare space available for my child? 

If you are a critical worker your local authority should find a setting for you but this may not be your usual school. If you are having trouble demonstrating that you are a key worker, you should ask your employer for a letter to this effect so that you can show to this to your children’s school/local authority.  

If you need to take time away from work to care for your child, your employer should be as supportive and as flexible as possible. You could explore working flexibly or from home, or you could seek to agree a temporary change to your working hours. It is essential that any changes like this are agreed and evidenced in writing, along with how this impacts on your pay.  

You should also check your employer’s policy around carer’s leave, so that you’re clear on what you’re entitled to and how you are to be paid if you take this type of leave. Find out more in our time off work guide

The RCN believes that you should not lose pay as a result of needing to look after your children when school provision is not available. 

Please be aware that this advice does not apply if you are travelling, or returning, to the UK. In this situation, please see the travel issues section below.

The RCN has called on UK governments to ensure that health and care staff do not suffer any financial detriment or loss of pay for being away from work in order to protect public safety.  

In response, governments from across the UK have issued guidance on terms and conditions for staff during the COVID-19 pandemic. This guidance confirms that staff working in the NHS in every country of the UK will be entitled to full pay when self-isolating during the COVID-19 pandemic.

In England, the guidance on pay during self-isolating also applies to staff working for an NHS organisation, an outsourced service or an organisation providing commissioned NHS services.  
  
The RCN is also calling for the following principles to be applied to staff working for any health and care employer, including primary care.  
  
Employment guidance for NHS staff links to all four UK governments’ guidance for more information.

What should I do if I think I have symptoms of COVID-19?

The governments across the UK have issued stay at home guidance for households with possible COVID-19 in EnglandNorthern IrelandScotland and Wales. It applies to health care workers as well as the general public and it is clear that you must self-isolate if you have symptoms or live with someone who does. The risk of spreading the virus to patients, other health care staff or members of the public is high and it is the individual`s responsibility to ensure that every possible step is taken to avoid the spread of the virus both for the sake of health care teams and for the wider population. The Coronavirus Act 2020 came into force on 25 March 2020 and consequences of non-compliance are severe - with individuals risking a criminal record and substantial fines and, if registered with the NMC, the possibility of sanctions including being prevented from continuing to work as registered nurse.

You must continue to follow government advice on isolation and treatment and should seek advice from your employer, your GP or NHS 111 if you are unsure. 

If you are told to self-isolate or fall into a category where self-isolation is recommended, you should follow your employer’s emergency preparedness procedures or other local procedure for notifying your employer of your absence. 

Do I have to self isolate if I have been exposed to COVID-19 at work?

The UK government guidance provides advice on the management of staff, and patients or residents in health and social care settings according to exposures, symptoms and test results. There may be further information specific to each country in the United Kingdom, as this guidance was written by Public Health England (PHE) primarily for an English health professionals. The information states that this guidance “should be considered alongside local risk assessment and local polices – these are guiding principles and there may need to be an individual risk assessment based on staff circumstances, for example for those working with individuals who are immunocompromised.” 

Managers should remain the first point of contact for a health or social care worker who is unsure whether they are fit to work.

As contact tracing arrangements are variable across the four nations of the UK, further information is available from Health Protection Scotland, Public Health Wales, or Public Health Agency in Northern Ireland. This guidance should also be followed regardless of the results of any COVID-19 antibody testing. 

Working from home when self-isolating

If you are self-isolating, but are otherwise well enough to work, you should agree with your line manager whether working from home is possible. Your line manager should consider the work that can be done remotely, and organisations should consider developing/updating their local homeworking policies. 

If I need to self-isolate, will this affect my other entitlement to annual leave or special leave? 

No. If you work in the NHS, or for organisations providing commissioned services for the NHS, UK governments have agreed that if staff need to self-isolate in line with the official stay at home guidance, they will be entitled to special leave on full pay. This special leave should be recorded separately by your employer and it will not affect your entitlements to annual leave, or to your entitlements to carers’ leave or special leave set out in your employers’ local policies. 

It is possible that staff will require more than one period of self-isolation. Government guidance makes clear that self-isolation will not be discouraged, and the arrangements above will apply to each period of self-isolation.

I need to self-isolate but my employer is not supportive. What do I do? 

The stay at home guidance applies to health and care staff the same as the general public. In accordance with this guidance, people must self-isolate if they have symptoms or live with someone who does. 

If you are not supported by your employer to remain at home as per the guidance, inform your manager in writing that you are following UK government guidance and need to stay away from work. You should request adjustments to be made for you to work from home if you are well and it is possible/appropriate. Advise your employer that your will return to your workplace after your period of self-isolation, depending on the circumstances, in accordance with government guidance.  

My employer is asking me to sign a waiver. Should I? 

No. Some RCN members have been asked by their employers to sign documents which exempt them, or their employer, from adhering to government advice in order to fulfil their role. 

The RCN does not support the use of these documents in any situation and urges all health and care staff to follow the government’s advice. We expect all employers to undertake individual risk assessments for any staff within vulnerable groups and to act upon the risk assessments. Based on the risk assessment employers should make appropriate arrangements, including the option of redeployment, to reduce risk and support individuals to abide by the government advice. 

If you continue to be asked to sign these types of documents, please call RCN Direct on 0345 772 6100. 

Guidance for staff where patients are not self-isolating 

The government stay at home guidance on COVID-19 requires the public to self-isolate if they have symptoms or live with someone who does, and the police now have powers to enforce compliance.  

During their work, some health and care staff have become aware of individuals stating that they do not intend to follow these rules. This situation can result in a conflict between a health professionals’ duty to maintain patient confidentiality and their wider duty to protect the public.  

The Nursing and Midwifery Council’s Code of conduct requires registrants to act without delay if they believe that there is a risk to patient safety or public protection. This duty may override a professional’s duty to maintain patient confidentiality in sufficiently serious situations. 

Nevertheless, maintaining confidentiality is critical for maintaining trust in the delivery of clinical services. The RCN are clear that breaching confidentiality without the consent of those being treated or, if relevant, their families should only be undertaken in extreme circumstances.

In the first instance, the RCN advise members to make strenuous efforts to persuade those they treat and their families to not breach the self-isolation rules. 

If the patient or household member states they will now follow the rules, you do not need to do anything further.

Should the patient or household member not follow the rules, nursing staff should escalate this issue to their line managers. Line managers may then feel it necessary to refer the case to authorities, who have new powers to detain individuals who they believe to be infected. 

If you are concerned, please contact your line manager. You can also read the RCN’s guidance for raising concerns here.

Please be aware that this advice does not apply if you are travelling, or returning, to the UK. In this situation, please see the travel issues section below.

Will I be paid when self-isolating? 

If you work in the NHS you should receive full pay inclusive of all enhancements when self-isolating in line with the official stay at home guidance. This means you should be paid what you would have otherwise earned if you were not in isolation, including any pay enhancements, such as unsocial hours. If you’re unsure, speak to your employer to find out what reference period they will be using to calculate your ‘normal’ pay. In the NHS, this should be in line with section 13 of the NHS terms and conditions handbook (annual leave and holiday pay).  

If you work for an outsourced service or an organisation providing commissioned NHS services in England, you will also be entitled to full pay when self-isolating. You will need to check your employers’ local policy for any reference period. 

For more information on pay when self-isolating, see guidance issued by governments from across the UK here.

We expect all other health and care employers to pay their staff full pay during COVID-19 related absences.

If you are self-isolating and have not been paid your normal full pay, you need to raise the issue with your employer and ask the reason for this in writing. This should be done before contacting the RCN for further advice. If you work within the independent sector you can use this template letter to email or write to your manager asking for full pay for your COVID-19 related absence. If you have your employer’s written response (or they haven't responded within a few days) and you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100. 

What if I am an NHS bank worker? 

If you are an NHS bank worker, you will be entitled to full pay when self-isolating in line with the official stay at home guidance.
  
In England and Scotland, you should be paid full pay based on a “look back” approach, using a reference period of work previously worked or on the work you had booked prior to going into self-isolation. Where employers are paying self-isolating bank workers on a “look back” approach, they are encouraged to use the reference period with section 13 of the NHS terms and conditions handbook (annual leave and holiday pay). Check the employers bank’s policy for more information. 

In Wales, if you need to self-isolate you will be paid for any booked shifts which need to be cancelled. The RCN is pressing the government in Northern Ireland to confirm its position. 

What if I work for NHS Professionals? 

NHS Professionals should be following the same approach as NHS banks. NHSP have developed a number of FAQs which are available on their website

What if I work on a zero hours contract? 

If you are working on a zero hours contract through an NHS bank you should be paid full pay when taking special leave when self-isolating.

Staff working on zero hours contracts who are not working in NHS organisations should in the first instance speak directly to their employer about any arrangements to pay zero hours workers during periods of COVID-19 related self-isolation.  

If I usually work through an NHS bank, can I ask for a fixed term contract during the COVID-19 pandemic?  

If you work in England. the NHS Staff Council  has published joint guidance on how NHS employers can support the bank workforce during COVID-19

In Scotland, the government has asked Health Boards to offer bank staff without part-time contracts fixed-term contracts to help manage staffing levels for COVID-19, and to offer them security and stability.
  
If you work in an NHS bank and/or are employed on a zero hours contract in Wales or Northern Ireland you may want to consider requesting a fixed term contract during the COVID-19 pandemic to ensure that you qualify for sick pay and other NHS national terms and conditions. 

What if I am an agency worker?

The RCN is clear that all health and care staff including agency workers should not experience any financial detriment due to COVID-19 related absences. The RCN has raised concerns with governments across the UK that agency workers providing services to the NHS will not have any income protection during periods of self-isolation. We are also calling on employment agencies to ensure that agency workers do not suffer any financial detriment if they are unable to work shifts because they are self-isolating. 

In the first instance please speak directly to the agency about their policy in this situation. You should also ask what, if any, arrangements will be made to pay agency workers during periods of COVID-19 related self-isolation.  Agency workers may also want to consider joining their local NHS bank or taking a fixed term contract during the COVID-19 pandemic to ensure they are entitled to full pay if they need to self-isolate. 

Shielding is a measure to protect extremely vulnerable people by minimising interaction with others. This means that those who are extremely vulnerable should not leave their homes, and within their homes should minimise all non-essential contact with other members of their household.

The situation around shielding is complex as the governments across the UK are easing restrictions at a different pace. Furthermore, as we’ve seen outbreaks becoming localised, the advice is likely to be subject to change at different times and at a local level.

Members who have received a shielding letter are asked to ensure they familiarise themselves with their respective country and (if appropriate) local guidelines. A summary of the current position relating to shielding and pay, with a link to the relevant guidance for each country, is provided below.

England

Recent changes to shielding guidance announced by the government have relaxed certain restrictions for the general public, for example from 6 July, clinically extremely vulnerable people who are shielding will be able to meet outdoors in groups of up to six and create a ‘support bubble’ with one other household. However, at this stage, people who are shielding should still maintain strict social distancing and minimise contact with others, and this includes not going in to work.

Employers should continue to support people who are clinically extremely vulnerable to shield, including supporting them to work from home or, if there is no prospect of them working from home, following guidance on pay during shielding.

Therefore, if you need to shield, then your employer must look at ways to support this and take steps (wherever possible) to enable you to work from home. Occupational health may also need to be involved to facilitate this and support you. If it is not possible to work from home and you work in the NHS, you will not need to attend work and should receive full pay, as if you were at work, including all enhancements.

You may need to contact your medical adviser (GP or Consultant) if you need confirmation of the reasons for shielding. The guidance secured by the RCN and other health unions clearly states that the NHS will support staff who are shielding to stay well and contribute to work, where adjustments can be made to enable staff to work from home. All employers need to follow the guidance on supporting staff to work from home and develop specific local support for those working from home during the pandemic. 

The recent changes in guidance also state that from 1 August, clinically vulnerable people who are shielding will be able to return to work if they cannot work from home if the workplace is COVID-19 secure. However, employers should undertake an individual risk assessment. Risk assessment guidance is available to support individuals who are shielding to return to work and implement adjustments or redeployment for any staff in these groups. If at this point you are concerned about returning to work, we strongly recommend that you speak to your line manager to understand their specific policies around health and safety and workplace attendance, especially in relation to COVID-19. 

Please see the government's guidance on protecting the vulnerable and if you work in the NHS, please see the NHS employers joint guidance on shielding due to COVID-19.  

Wales

The Welsh government guidance states, “If you are employed, please show the shielding letter from the Chief Medical Officer for Wales (or your GP) to your employer. You should not go to your normal place of work – you will need to work at home until the 16 August 2020, if you can do so. You do not need to get a fit note from your GP."

Scotland

The Scottish government have advised that people who are shielding will no longer need to do so from 1 August 2020. 

Northern Ireland

The government in Northern Ireland announced that from 8 June 2020, people advised to shield are permitted to go outdoors while maintaining strict social distancing: with members of their household or if they live alone they can meet one person from another household (preferably the same person each time).

From 6 July 2020, and if the risk continues to be low, people who are following the shielding advice are able to meet up to six people outside of their home, as long as social distancing is strictly observed. People who are shielding remain vulnerable and should continue to take precautions. It is still best to stay at home as much as possible until shielding is paused.

From 31 July 2020, it is anticipated that shielding for extremely vulnerable people will be ‘paused’.

I have been advised I need to ‘shield’ myself due to a serious health condition. What should I do?

If you need to shield, follow the relevant government or local guidance above.

Your employer must look at ways to support this and take steps – wherever possible – to enable you to work from home. Occupational health may also need to be involved to facilitate this and support you.

If it is not possible to work from home and you work in the NHS you will not need to attend work and should receive full pay, as if you were at work, including all enhancements.

If you do not work in the NHS, you should check your employer’s policy. The RCN is clear in its expectation that all health and care providers should be following government advice and offering full pay or furlough to vulnerable staff and those who have to care for vulnerable people.

If you work in the independent sector and have concerns, you should raise the issue with your employers and ask for a written response.

What will I be paid?

The RCN believes that it is vital that health and care staff do not suffer any detriment or loss of pay for being away from work in order to protect public safety. Therefore, the RCN expects all health and care employers in the UK to ensure that when staff are shielding in accordance with national public health guidelines, they must be paid their normal pay and not suffer any detriment. This includes all health and care staff - regardless of who their employer is, or what type of health or care service they work in.

If you work in the NHS, within all four UK countries agreements have been reached that guarantees your normal pay if you are unable to work due to shielding requirements.
 
If you work in the independent sector and you are shielding but not being paid your normal full pay, you need to raise the issue with your employer and ask for their reason for this in writing. This should be done before contacting the RCN for further advice. Use this template letter to email or write to your manager asking for full pay for your COVID-19 related absence. If you have your employer's written response (or if you have written and not received a response) and you haven't been able to resolve the issue, contact your local RCN representative if you have one, or contact RCN Direct on 0345 7726100.

What if I care for someone who is shielding and have concerns about exposure?

If you are a carer and cannot continue in your role whilst also caring for a vulnerable individual who has been instructed to shield, you should discuss this with your line manager. They may be able to offer redeployment to a role which has a manageable level of risk for you, in line with government social distancing guidance. Otherwise, you may want to consider applying for time off, such as carers leave. You can read about different types of leave in our time off work guide.   

An employee who lives in the same household as someone who is shielding may also be eligible to be furloughed under the government scheme so their employer can receive support from the government to continue to pay 80% of their normal pay up to £2,500 per month.

Staff should escalate concerns to their line manager in the first instance. The RCN has advice on how staff can approach raising concerns. Further government guidance for employees, employers and businesses is also available.

I am due to return to work after a period of time shielding. What should my employer do to keep me safe?

Shielded workers are at increased risk of severe illness from COVID-19. They cannot return to workplaces before at least 31 July Northern Ireland, from 1 August in England and Scotland, and from 16 August in Wales. See the country specific sections above for detailed guidance.  

Employers must take measures to make workplaces COVID-19 secure including taking all reasonable steps to maintain a two metre social distance in the workplace and having robust cleaning and hygiene measures in place.

Even after these dates, vulnerable staff working in health and care environments may still need to work from home in order to keep them safe.

However, in advance of any potential return to work, your employer must carry out both an individual and workplace risk assessment to look at your role, your individual risk factors and the environment you may be working in. 

Your employer should not be calling you into work to do a risk assessment, a discussion should take place over the phone/online. As part of the risk assessment, your employer may want to look at redeployment to areas where the risk of exposure is very low or continue with home working. It is natural to feel anxious when being asked to return to work after a long period off, so the RCN would expect your employer to be empathetic and listen to your concerns, offer support for your mental health and look at issues such as risks from travel to work and a phased return as part of the risk assessment.

If you have a disability, your employer will also need to follow the requirements of the Equality Act and make reasonable adjustments. If you are pregnant and have been shielding, your employer must take this into account when reviewing your pregnancy risk assessment. If the employer cannot put the necessary safety measures in place such as adjustments to the job or working from home, you must be suspended on full pay.

If you are concerned about the results of the risk assessment then please speak to you RCN workplace representative or call RCN Direct on 0345 7726100. You may also want to speak to your GP or consultant.  

Please also see the information from NHS People, NHS Employers and the Health and Safety Executive

I applied for a job but the offer was withdrawn when I told the employer I had to shield. I’d disclosed that I have a disability during the recruitment process so this doesn’t seem fair. What can I do?

If you have a health issue or disability that has a substantial and long term impact on your ability to undertake day to day activities it is likely that you would be classed as a disabled person in law. The Equality Act 2010 (and in Northern Ireland the Disability Discrimination Act 1995) states that employers must not treat someone less well or put them at a disadvantage due to a disability. Those who meet the definition of disabled are also entitled to reasonable adjustments during recruitment and upon employment. See our guidance on disability discrimination and the Equality Act 2010.

If you had already accepted an unconditional job offer it is unlawful for an employer to withdraw it as you are deemed to be a legally binding employment contract from the time of acceptance. The RCN expects employers to comply with relevant legislation and to be supportive and flexible in their approach to recruitment and selection at this time.

Our publications Removing Disabling Barriers at Work and Disability Passports cover the benefits of a diverse workforce including those with impairments and the reasonable adjustments process.

If you feel that you have been disadvantaged, unsupported or that your concerns are not being heard, you can contact RCN Direct on 0345 772 6100 for further advice. You can also contact the RCN's Peer Support Service, which is our network for ill and disabled members.

For further information see the Health and Safety Executive.

If I am off sick with COVID-19 will this affect my sick leave entitlement? 

If you work in the NHS, the answer is no. If you are covered by NHS terms and conditions of service, any COVID-19 sickness would fall under a new full pay temporary entitlement. The length of any COVID-19 sickness absence will not impact on your existing sickness entitlements and you will be paid full pay during any the COVID-19 sickness absence.  
 
Any sickness absence related to COVID-19 for NHS staff should be recorded separately by your organisation. 
 
If you do not work for the NHS, check your employer’s policy for more information about sick leave and COVID-19.

Will COVID-19 absence affect sickness absence triggers?

COVID-19 sickness absence should not trigger any local sickness absence management procedures in the NHS.  If you are not employed by the NHS, you should check your employer's policy. 

What do I need to do before returning to work after COVID-19 sickness absence? 

You should follow any local sickness management procedures and any local and national infection control requirements before returning to work after COVID-19 sickness absence. You should also check the government guidance on recovery and self-isolation.

Should employees provide a fit note (sick note) for any COVID-19 sickness absence that lasts longer than seven days? 

The latest process regarding fit notes can be found at NHS 111 Online

What will I be paid?

See below for more on sick pay.

The RCN called on UK governments to ensure that health and care staff do not suffer any financial detriment or loss of pay when absent from work for COVID-19 related reasons. In response, the governments have issued guidance on terms and conditions for NHS staff during the pandemic.

Staff working in the NHS will be entitled to full pay when on COVID-19 sick leave. This includes enhancements such as unsocial hours and overtime. In England, the guidance on sick pay also applies to staff working for an NHS organisation, an outsourced service or an organisation providing commissioned NHS services. 

The RCN is calling for these entitlements to also be applied to staff working in all health and care settings, including primary care. 

What will I be paid if I am off sick with COVID-19? 

If you work in the NHS you should receive full pay inclusive of all enhancements for any COVID-19 related sickness absence, regardless of your length of service and sick leave entitlement. This means you should be paid what you would have otherwise earned if you were not on sick leave, including any enhancements such as overtime. Your sick pay will be calculated in line with section 14 of the NHS terms and conditions handbook – based on your pay during the previous three months at work including enhancements (known as the reference period).

Your NHS employer may use a different reference period that has been agreed locally. If you’re unsure, speak to your employer to find out what reference period they will be using.

If you work for an outsourced service or an organisation providing commissioned NHS services, you will also be entitled to full pay on COVID-19 sick leave. You will need to check your employer's policy for any reference period.

If you work in the independent sector and you have taken COVID-19 related sick leave and have not been paid your normal pay, you need to raise the issue with your employer and ask the reason for this in writing. This should be done before contacting the RCN for further advice. Use this template letter to email or write to your manager asking for full pay for your COVID-19 related absence. If you have your employer’s written response (or if you have written and have not received a response) and you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100. 

What will I be paid if I am off sick with Long COVID?

Where staff experience relapses and repeated periods of leave due to COVID-19, the RCN expects employers to continue to pay staff COVID sick pay, including enhancements. Any absences which are COVID-related should also not count towards any triggers for the management of sickness absence.

The RCN also expects employers to pay full COVID-19 sick pay to staff regardless of their length of service, including new starters, returners and student nurses on paid placements who responded to the requests to help manage the pandemic.

The RCN is calling for more research to be carried out to understand the impact of Long COVID on the workforce and its wider public health implications. Read more about the impact of long COVID here.
Please call RCN Direct on 0345 772 6100 if you need further advice or assistance.

What should I be paid if I am off sick with a non-COVID-19 illness? 

Your rights to sick pay during any sickness absence for a non-COVID-19 illness will not change during the pandemic. If you are covered by NHS terms and conditions, the entitlements to sick pay are set out in the country-specific section 14 of the NHS handbook. If you are not covered by NHS terms and conditions, you should check your contract and/or your employer’s sick pay policy.  

What if I am an NHS staff bank worker? 

If you are an NHS bank worker, you should in the first instance speak directly to your bank about any arrangements for sick pay during the pandemic. The RCN is calling on governments across the UK to ensure that all health and care staff including bank staff receive full pay, as if they are at work, during any COVID-19 related sickness absence.

In Scotland, the government has asked Health Boards to offer bank workers without part-time contracts fixed-term contracts to help manage staffing levels for COVID-19, and to offer them security and stability. This would mean they would be entitled to full pay during any COVID-19 related sickness absence. Find out more here.   
 
NHS bank workers and those on zero hours contracts in England, Wales and Northern Ireland may also want to consider requesting a fixed term contract during the COVID-19 pandemic to ensure that they to qualify for sick pay and other NHS national terms and conditions. 

What if I am an agency worker? 

The RCN are clear that all health and care staff, including agency workers, should not experience any financial detriment due to COVID-19 related absences. The RCN has raised concerns with the government that agency workers providing services to the NHS will not have any income protection during periods of sick leave, beyond statutory sick pay (SSP) in most cases. We are also calling on employment agencies to ensure that agency workers do not suffer any financial detriment if they are unable to work shifts because they are self-isolating. 
 
In the first instance please speak directly to the agency about their policy. You should also ask what, if any arrangements will be made to pay agency workers during periods of self-isolation or sickness absence. 
 
If you do not have a contractual right to sick pay, please see the government guidance on SSP. You may also wish to look at our advice on sick pay and sick leave.

NHS Employers suggest agency workers may also wish to consider joining their local NHS bank during the COVID-19 pandemic to ensure they are entitled to full pay for cancelled shifts if they need to self-isolate. 

Should I be going on to reduced sick pay if my treatment was postponed by the hospital to enable its COVID-19 response?

If you are covered by NHS terms and conditions, your entitlements to sick pay are set out in section 14 of the NHS handbook. If you are not covered by NHS terms and conditions, you should check your contract and/or your employer’s sick pay policy. However, the RCN believes that you should not experience financial detriment due to the impact of COVID-19 on your scheduled treatment or surgery. We are therefore lobbying for all health and social care employers to be sympathetic to the hardship reduced sick pay may cause to staff, to use their discretion and recognise that the length of absence has been increased through the unique circumstances of COVID-19, and to consider paying full pay as part of a COVID-19 related absence. Where possible, they should also prioritise or fast track staff treatment.

The RCN offers support to all members on long term sick leave and can provide representation at formal meetings. Please call RCN Direct on 0345 772 6100 if you need further information or assistance.

During the COVID-19 crisis nursing staff will turn, like everyone else, to online communication to keep in touch and to connect with their communities.

Quite rightly, there is unprecedented interest in the experiences of nursing staff on the front line of the pandemic and concern for their welfare. Importantly, nursing staff have raised issues like lack of PPE and testing that influence government policy. They must continue to speak up.

Some members have reported pressure from their employer not to mention difficulties. Whilst sympathising with the challenges faced by employers, they must continue to draw attention to their own concerns. Nursing staff are in a unique position to provide the evidence that will lead to improvement.

The purpose of this guidance is to encourage you to keep pressing for safety improvements, but to do so in ways that will not risk damage to your career. Some disputes with employers and referrals to the NMC have arisen from the use of social media during the emergency. We want to alert you to potential problems, so that they can be avoided.

Using social media safely

The NMC Code has a section specifically devoted to the use of social media, as follows:

“Use all forms of spoken, written and digital communication (including social media and networking sites) responsibly.” (The Code, paragraph 20.10)

The NMC has also produced a useful guide that sets out uses of social media that might breach sections of the Code.

Recently, the NMC has received some referrals to their Fitness to Practise Directorate involving the use of social media. These include posting misinformation about the virus, promoting sales of dubious products, inappropriate information about an employer or inappropriate comments about individuals. Hopefully, these cases will be resolved without long term difficulty, but registered nurses must remain aware that they are exposed to more scrutiny than the general public. Anything posted can end up in a public place, even if originally covered by privacy settings.

Those working in unregistered positions can be disciplined by an employer for unprofessional social media use.

How to raise concerns safely

The RCN guidance on raising concerns will lead you step by step through the process.

Social media attacks

A few members have become the victims of trolling online. If this happens to you, you can escalate the matter to your manager and your HR department may become involved. They could even involve the police. The RCN advises members to not engage with trolls and to seek RCN support.

And remember, the RCN is here to support you. We are actively challenging local and UK-wide issues on your behalf. Come to us first by speaking to your RCN advisers or your local rep. Please visit our Get help pages or telephone 0345 772 6100.

Please see our position statement on staff living in care homes for more information. 

Read our guidance to support you and your team as you welcome those returning to practice at this time.

Health and care workers - including students - are being exposed to COVID-19 in their workplaces and in their communities. The RCN is clear that the UK government and devolved governments must prioritise testing of all health and care staff urgently. This must be universally available to all staff, including agency and bank staff, irrespective of whether they present with symptoms or have been caring for patients with COVID-19. Without this, frontline health and care staff cannot be deployed safely or effectively.

It is essential that employers have the ability to exclude or confirm COVID-19 cases, so that not every person with potential symptoms has to self-isolate, removing themselves from the active workforce.

There is specific guidance for those who are symptomatic and for those who are asymptomatic

Looking for information about getting tested? See the UK government guidance for more. This guidance is the part of the COVID-19: management of exposed staff and patients in health and social care settings, which clarifies the position for staff testing positive and when to return to work. 

The Scottish Government has also issued guidance for health boards to prioritise testing to ensure health and care workers can get back to work, with a focus on prioritising areas under greatest pressure locally.

When it is available, antibody testing must be undertaken to determine those who may be immune from the virus. Widespread testing will also protect the families of health and care workers, helping to allay many of the fears experienced by these staff.

Is testing for COVID-19 mandatory? 

Mandatory testing should be unusual, as most nursing staff will undertake testing on a voluntary basis.  

We are aware that some staff may refuse to be swabbed in certain circumstance e.g. where they fear they may suffer a detriment in their employment situation such as significant loss of earnings due to some employers not providing full pay for COVID-19 related absences.  

The RCN’s view has always been that vaccination should not be mandatory as this could contravene Human Rights legislation. However, this is different due to the public health implications and the fact that testing is a diagnostic procedure, rather than a preventative ‘treatment’ which may carry a personal risk.

Currently, the common law right for a person with capacity to refuse medical interventions would apply, unless superseded by statute in the individual case. There is nothing in the Coronavirus Act 2020 which authorises testing without consent.

Can my employer force me to be tested for COVID-19? 

If testing is entirely voluntary, then an employer cannot force someone to take the test against their will unless there is a contractual right to compel the employee which is unlikely. However, some employers have introduced a new contractual clause which compels new employees to have annual flu jabs, it is always worth checking the contractual position in these cases.  

If there is no contractual right to require the employee to take the test it may amount to a breach of the implied term of mutual trust and confidence and/or a failure to comply with a reasonable management instruction for an employee to refuse the test. This could amount to an act of misconduct or give rise to some other substantial reason that may give an employer grounds to dismiss depending on the context in which the employee works. For example, someone who works in ITU as opposed to a non-clinical setting would be more likely to be required to take the test. 

If an employee refuses to take the test thus causing doubt as to whether they are safe within the workplace setting, there may pay consequences for example, suspension with or without pay. This would depend on the contract and the circumstances of each case.  

Increased testing may uncover positive cases where people are asymptomatic carriers but who feel well and fit for work. If this is the case the same principles apply as with other infectious disease i.e. staff should be asked to isolate and remain on full pay for the advised period. The RCN position on pay is clear, staff should not suffer a detriment when isolating and they should be paid in full, not SSP, when off work due to COVID-19, whether sick or self isolating. 

If I am a registrant, what professional considerations do I need to take into account? 

The four principles of the NMC code are very clear: Prioritise People, Practice Effectively, Preserve Safety and Promote Professionalism and Trust. 

Many aspects of the code refer to protecting patients from harm. This is also specifically addressed under ‘Preserving Safety’ which states that a registered nurse must “… make sure that patient and public safety is not affected” by their actions or inactions. Furthermore, the NMC clearly states in the code under section 19.4, that registrants must: “Take all reasonable personal precautions necessary to avoid any potential health risks to colleagues, people receiving care and the public “.

In the context of a serious infectious disease such as COVID-19, it is reasonably foreseeable that a refusal to be tested which results in harm to others, could be challenged as a breach of the code. 

The RCN holds a position that based on their professional responsibilities, all nursing staff should avail of testing and not refuse. If a member refuses, they must be aware that they could potentially risk a challenge from either an employment or regulatory perspective. 

I am concerned that I may suffer a detriment at work if I test positive for COVID-19, what should I do?

 In situations where staff fear that they may suffer a financial detriment as a result of a positive test, they should seek further advice, support and/or representation relating to their individual circumstance. It is the RCN’s position that all health and care employers in the UK must ensure that when health and care staff self-isolate, in accordance with national public health guidelines, they must be paid in full. This includes all health and care staff regardless of who their employer is or what type of health or care service they work in. 

If you are coming into the UK for the first time, or returning to the UK after any overseas travel you must follow the government guidance Coronavirus (COVID-19): how to self-isolate when you travel to the UK. Please note, this guidance is constantly under review and may change at short notice.

Planning overseas travel

If you already work in the UK and wish to travel overseas, please discuss your travel plans with your employer and agree how any self-isolation period may be managed. Check your local written policy on quarantine. The RCN believes it is vital that health and care staff do not suffer any detriment or loss of pay for being away from work in order to protect public safety.

If you work in the NHS in England, please also see the NHS employers information quarantine and self-isolation on entering or returning to the UK. There is separate guidance for NHS staff in Scotland.

If rules change when you are already overseas

Government guidance is under constant review and may change at short notice. As a result, you may face quarantine requirements on your return to the UK that weren’t in place previously. 

Speak to your manager as soon as possible to agree the arrangements for your quarantine period, including whether you will be able to work from home, can take leave (paid/unpaid) or use TOIL.

If you work in the NHS in England, please also see the NHS employers information quarantine and self-isolation on entering or returning to the UK. There is separate guidance for NHS staff in Scotland.

I am trapped overseas. What should I do?

If you are currently abroad and are struggling to return to the UK, please see further advice on what to do next. You should also contact your employer at the earliest opportunity to discuss the situation and note any quarantining measures that may be required on your return.

Your employer may require you to obtain written confirmation from the relevant airline/ferry/train company that services have been cancelled.

If you require evidence that you are an essential health or social care worker in order to be prioritised for travel or be allowed to travel on an otherwise ‘freight only’ service, your employer should provide this evidence in writing as soon as possible. It would only be your employer that could provide such confirmation. The Royal College of Nursing cannot provide this letter.

In situations where pre-booked transportation has been cancelled, employers can reasonably expect you to find an alternative form of transport if the cost is not prohibitive (for example asking employees to fly home if ferries have been cancelled). Where you can demonstrate that no reasonably affordable travel options are currently available, we would expect employers to treat the absence as COVID-19 related and continue normal pay until such time as travel becomes possible.

For further information on measures taken by non-UK countries, please visit the UK government website.

I am a retired nurse based overseas. Can I return to help?

As COVID-19 escalates, we understand that many British nationals residing and working overseas might want to return to the UK to be with their families and to join our frontline workers. The Foreign and Commonwealth Office (FCO) have advised against all non-essential travel, and for British nationals that permanently reside overseas to not travel back to the UK. In addition, from 8 June 2020, the UK government has imposed a 14-day period of quarantine for all travellers entering the UK.

Travel restrictions are necessary measures for preventing the further spread and escalation of COVID-19. The RCN therefore expect health and care staff living aboard to follow government’s advice and refrain from unnecessary travel. You should also follow the advice of local authorities in the relevant other country.

What if I have an underlying health condition and have concerns about exposure?

Social distancing

Government guidance lists people who may be more vulnerable to or have a higher risk of complications and higher mortality than the general population.  

The guidelines advise that these individuals should practice social distancing. This means that they should avoid contact with someone who is displaying symptoms of coronavirus. Also avoid non-essential use of public transport, varying your travel times to avoid rush hour, when possible and work from home where possible.  

If you meet the definition of vulnerable as set out in government advice, and during the course of your work, you are likely to come into contact with someone who is displaying symptoms of COVID-19, you should inform your line manager immediately.

The RCN would expect employers and occupational health lead to carry out a health and safety risk assessment and put systems in place to minimise the risk of harm and allow the health care worker to work safely. The employer also has a duty to make reasonable adjustments where the staff member has identified themselves as disabled.   

Organisations such as Diabetes UK provide additional advice on working with long term conditions.   

Please also see our guidance on redeployment.

Shielding

Government guidance also lists people who are extremely vulnerable and so at very high risk of severe illness from COVID-19. People in this group need to ‘shield’ themselves. See ‘shielding’ above for more information.

Asthma

Members have raised concerns that there is conflicting advice regarding whether they should be following shielding recommendations for those classified as very vulnerable due to a diagnosis of asthma. This is particular concern relating to differing advice from Asthma UK, the Government and individual GPs. 

The government has provided clear advice on social distancing. If you have not been contacted, you should follow the social distancing rules for everyone. If you later receive a letter asking you to shield, you should do so. Otherwise, you should follow the social distancing rules.

The RCN recognises that members with a diagnosed long-term condition may lead to concerns as to whether it is safe to continue direct patient contact during the COVID-19 crisis. Individuals with asthma and other long-term conditions have a spectrum of severity that will need to be taken into account. 

If you have received a letter from your clinician stating that you have been identified as very vulnerable you should; inform your employer, follow the shielding guidance and stay at home. You should continue to discuss the situation with your GP and Occupational Health services for any ongoing risk assessment.

There may be opportunities to work remotely depending on their role/ employer.

If a family member who lives with a member receives a shielding letter, please see the sections on 'shielding' above. 

Speaking to your employer

You should escalate your concerns to your line manager in the first instance, having checked your employer’s COVID-19 response policy. The RCN has advice on how staff can approach raising concerns should your manager be unsupportive. 

Further guidance for employees and employers is also available.

Please call RCN Direct on 0345 7726100 if you cannot resolve your concerns with your employer.

Read our uniform and workwear guidance for more information.

RCN members who wish to support the delivery of care and treatment to patients and the public during the pandemic can do so in a range of ways, including:

  • redeploying to a different clinical setting
  • returning to clinical practice
  • joining the temporary NMC register, or
  • volunteering. 

Our guidance on redeployment will help you if you're changing or taking on a new role.

If you are registered nurse who has left the register within the last 3 years you can apply to re-join the temporary NMC register and find more information about how to do this on the NMC website.

England 

For nurses who are already on the NMC register wishing to return to clinical practice you will need to apply directly to any local employers who you wish to work for (see below). This is the same for those who wish to work as a nursing support worker.

Many employers are setting up fast track recruitment systems to support this. Check local websites for information. You can also join an employer’s bank or an agency to work flexibly.

Some organisations in England use NHS Professionals who have set up a rapid response process.
 
Most jobs within the NHS across England and Wales are advertised on NHS Jobs website

If you're interested in volunteering (as opposed to working) to support efforts to tackle the COVID-19 pandemic, NHS Volunteer Responders is a new group that will carry out simple, non-medical tasks to support people in England who have been asked to shield themselves from coronavirus because of underlying health conditions. They will be used by healthcare professionals to make sure people who are highly vulnerable are able to stay safe and well at home.

For more information:
GoodSAM
NHS England

Northern Ireland

Members in Northern Ireland who are interested in volunteering in hospitals should contact their local Health and Social Care Board for more information,

For paid work opportunities, please go to the HCSNI Jobs website for more information.

Scotland

Members in Scotland who are returning to clinical practice, or are currently practicing but want to be redeployed to work for NHS Scotland can find more information on the Scottish government webpages

Paid work opportunities can also be located through contacting agencies and through the NHS Scotland jobs site.

For members in Scotland, volunteering opportunities can be found by approaching your local NHS Board directly or through contacting Volunteer Scotland.

Wales

In addition to NHS Jobs, links to current vacancies for registered nurses and healthcare support workers can be found on each Health Board’s website

Volunteering opportunities can be found at Volunteering Wales.

Can my employer make me opt out of the 48-hour working week? 

The Working Time Regulations were adopted to ensure the health, safety and wellbeing of workers at the workplace. The 48-hour maximum working week is an average over an agreed reference period, usually 17 weeks. The reference period can be extended to up to 26 weeks without agreement or up to a maximum of 52 weeks with agreement between the employer and local trade unions.
 
Your employer can ask you to work more than 48 hours in any one week, without the need for an opt out - as long as they reduce your hours within the appropriate reference period, to even out your average weekly hours. 
 
The RCN expects that during the pandemic, all employers across the UK should refrain from approaching staff to sign up to ‘individual opt-outs’ of the 48-hour average working week. According to the regulations, employees can choose to opt out of the average working week. However, the regulations make it very clear that an individual opt out is entirely voluntary. 
 
Contact your local RCN representative or RCN Direct on 0345 7726 100 if your employer is seeking your opt-out on a continual basis or beyond the reference period that applies in your workplace.  
 
Where staff are working long hours, employers should provide an appropriate level of supporting facilities such as rest areas, accommodation, access to food and drink, toiletries etc. as required, to enable the safe and effective provision of services during this period.  
 
There should be no requirement for staff to sleep on site. If there are sleep facilities available for staff who wish to use them, this should be managed via existing or adapted local policies with increased infection control measures. 

See the Department of Health and Social Care (England) guidance on the health, safety and well-being of staff for more information.  

What if I have more than one job? 

The 48-hour weekly average is the limit of what you should work, even if you have more than one job. Your employer must make sure you are not working more than an average 48 hours a week in total across both jobs. Employers must maintain accurate records and take measures to protect the health, safety and wellbeing of workers even during the pandemic - so your employer(s) can ask you about your working hours with another employer. 

12 hour shifts in critical care

The risks of working 12-hour shifts in a critical care environment during the COVID-19 pandemic should not be ignored. They include:

  • wearing PPE for long periods which is physically demanding, and can result in potential heat stress
  • errors when donning and doffing PPE
  • high levels of moving and handling activity when positioning patients
  • increased time exposed to patients with infection, leading to a potentially increased viral exposure 
  • the potential for errors or safety lapses caused by fatigue.

There is also the significant psychological impact of caring for COVID-19 patients.

What safeguards should my employer put in place?

The Health and Safety Executive recommend the avoidance of shifts that are longer than 8 hours where the work is safety critical and physically demanding. They recommend that where 12-hour shifts are implemented there should be adequate rest breaks and that 12-hour night shifts should be limited to two or a maximum of three in a row.

The health and safety of health and care staff is of paramount importance. Where 12-hour shifts cannot be avoided, the RCN expect the following safeguards to be put in place:

  • regular rest breaks
  • introduction of ‘huddles’ or check-ins during the shift to check that staff have been able to take a break and arrange cover if not
  • assessment of any specific needs of staff who may be going through the menopause, have long term conditions or other protected characteristics which require reasonable adjustments to be put in place
  • avoid scheduling safety critical jobs (for example, drug rounds) towards the end of the shift when staff will be at risk of fatigue related errors
  • provision of adequate time for safely donning and doffing PPE
  • ease of access to rest facilities and quiet zones following the principles in RCN’s guidance: Rest, Rehydrate and Refuel
  • ease of access to food and drink during the shift, including night shifts
  • permission to have power naps during breaks
  • limit to three back to back 12 hour shifts (especially night shifts). The RCN believes that 4x12 hour shifts are unsafe in these situations and could lead to a breach of the working time regulations and the employer’s duty of care.
  • wellbeing check at end of the shift and check in on the safety of staff who need to drive home
  • respect days off and do not call in staff to work on their scheduled days off
  • compliance with the working time regulations 
  • where possible, offering staff flexibility and a choice of shift lengths.

If your employer isn’t following the above guidance, speak to your manger in the first instance. For further support, call RCN Direct on 0345 7726 100.


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Page last updated - 22/10/2020