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.

What is coronavirus or COVID-19?

In late December 2019 a new (novel) coronavirus was identified in China causing severe respiratory disease including pneumonia. The World Health Organization (WHO) has advised that the virus responsible is named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes is COVID-19. For more information visit the NHS website which is continually being updated by the government. 

Is there a vaccine?

Globally, scientists are working to develop a vaccine. As a newly identified virus there is currently no human immunity to it and no vaccine currently available to prevent infection. As a viral infection, antibiotics are not an effective treatment.

What can I do about it?

Nursing staff should familiarise themselves with their local policies on emergency planning, infection prevention and control and other relevant guidance in addition to any national guidance issued by the Department of Health and Social Care and the relevant UK public health agencies.

We are in a fast-moving, evolving situation and as with any new strain of virus, the guidance is being updated frequently so it’s important you look at our latest information online, along with the below. 

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. 

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. 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 healthcare staff can take paid annual leave, as well as being able to take rest periods and breaks during shifts.  

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.

What is the current advice about using NSAIDs?

NHS England have released the following advice (Alert Letter 17 March 2020):

“There has been concern about the use of non-steroidal anti-inflammatory medications (NSAIDs) in relation to Covid-19 following a statement by the French Health Minister (a clinician) advising against the use of ibuprofen. 

This statement was based on provisional information reported from French care settings which UK authorities have not seen and is, to date, unpublished. There is no current literature on the impact of NSAIDs use in Covid-19. 

There appears to be some evidence for SARS 1 that there may be an adverse impact on pneumonia. There is also some literature suggesting NSAIDs may increase complications from simple acute respiratory infections or slow recovery. However the evidence is not conclusive overall. 

There appears to be no evidence that NSAIDs increase the chance of acquiring Covid-19. In view of the current lack of clarity the Commission on Human Medicines (an advisory body of MHRA) and NICE have been asked to review the evidence. 

It is therefore suggested that, in the interim, for patients, who have confirmed Covid-19 or believe they have Covid-19, that they use paracetamol in preference to NSAIDs. 

Those currently on NSAIDs for other medical reasons (e.g. arthritis) should not stop them. 

This position will be kept under constant review.”

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

Do I have to pay to park my car at work?

Car parking fees for health and care staff differ across the UK.

  • During the COVID-19 pandemic, all NHS staff will be able to park for free at NHS hospitals and other medical facilities. All on-street parking and open, council-run car parks (including pay and display) will also be free for health and social care workers and NHS volunteers.
  • In Scotland, for three months from 30 March 2020 car parking charges have been suspended for NHS staff (for the three privately run car parks which still charged). 
  • In Wales, parking at all NHS hospitals continues to be free. 
  • In Northern Ireland, all health and social care staff will be reimbursed for car parking charges during the pandemic – staff will receive a letter laying out the terms of the offer.

For staff who pay for their parking through their salaries an adjustment will be made for the three-month period May to July 2020 and staff who pay at hospital car parking machines can get refunds for the period April to June 2020.

What do I need to do to get free parking?

You will need to check with your employer and/or Local Authority about the requirements for evidence and the process for accessing free parking. Where possible, suitable supporting evidence should be displayed clearly in your car windscreen. 

What should I do if my employer is refusing to offer me free parking in line with the above? 

You should ask for a written explanation from your employer and then contact the RCN for further advice. 

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.

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

You may have concerns about possible exposure to coronavirus 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.

You can sign up to national coronavirus alerts from the Department of Health and Social Care (DHSC) and the Medicines and Healthcare products Regulatory Agency (MHRA). These alerts can include notifications of recalled and defective PPE. Your organisation must act on these alerts.

The UK Governments have made financial provision in the event that eligible healthcare 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 allows 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, plus the associated employer National Insurance contributions and minimum automatic enrolment employer pension contributions on that wage. Employers can use this scheme any point from 1st March 2020 until the government closes the scheme.

How do I apply for the scheme?

Employees and workers do not have an automatic right to be furloughed. It is a decision for employers and agencies to take whether to furlough staff based on the needs of their business. In order to be eligible for the scheme you need to have been officially on your employer’s payroll before 19 March 2020. If your employment began in February or March 2020 you may need to check whether you were added to the payroll system in time to be eligible. If you have been on your employer’s payroll long enough to be eligible, you and your employer need to agree in writing that you will be furloughed and will not undertake any work for your employer during this time (an email exchange may be enough to count as this written agreement).

If you think you would benefit from being furloughed then in the first instance you should speak to your manager about the scheme, details of which can be found on the government website.

Can I ask to be furloughed if I need to shield?

If you are shielding in line with public health guidance or required to stay home due to an individual in your household shielding, and you cannot work from home, then your employer should risk assess you and may choose to medically suspend you on full pay where necessary. If your employer is not willing to pay you in full while you are shielding, for example because you work via an employment agency, then you may wish to ask them to consider furloughing you instead so you can still receive 80% of your usual pay. It remains your employer’s decision whether to furlough you through this scheme.

If you need to shield and your employer is not willing to medically suspend you or to furlough you then 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. 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.

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 is available for workers and employees furloughed for 3 weeks or more. The scheme will last for at least 8 months from 1 March 2020 and may last longer if the government feels it is still necessary; there is currently no maximum on how long you can be furloughed within this period. From August 2020 employers may be asked to meet part of the costs of the scheme, and some employees may be given the option of being furloughed on a part time basis from that point.

It is possible to be furloughed more than once through this scheme, so you could be furloughed while your employer has no work for you, then be asked to return to work when you are needed before being furloughed again.

Anyone who needs to self-isolate for 7 or 14 days will not be off work long enough to be eligible for this scheme. Read more about self isolation in our section below or if you are off sick, see our guidance on sickness pay.

Will I be paid my full salary or only 80% of what I normally earn while on furlough?

If you are furloughed then your employer will only receive 80% of your normal pay from this scheme. 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 told you are going to be furloughed then you should speak to your manager about how much you are going to be paid.

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 will not be 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 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 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 a 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 NHS 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:

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

The RCN recognises that these are unprecedented times and nursing support workers (NSWs) 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 NSWs 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.

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 NSW 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? 

Your employer can make a reasonable request for you to work somewhere other than your contracted role as a temporary measure, 

If you are asked to move, you should consider the following as a local induction:

  • Your environment - do you know where to find important equipment, the location of fire exits and emergency equipment, etc.? If moving to another organisation, check the appropriate indemnity arrangements are in place (see our FAQ on indemnity, above).
  • Your residents, clients - what level of care will you be expected to give? Do you have any experience with this type of patient? If not, you should only be required to deliver the fundamentals of care.
  • Your role - what will you be doing? Who will be your point of contact for any queries? Who else will you be working with? Times or shifts that you will be required to carry out.

As stated previously, you must be aware of your own competencies to carry out delegated duties and responsibilities. 

If you do not feel competent to work in this area you should speak to your line manager. If this does not resolve the situation, please document your concerns and contact RCN Direct on 0345 772 6100.

You must speak up if you feel you do not have the competence to do what you are being asked. Our guidance on accountability and delegation and duty of care provides more information. 

You are within your rights to refuse to do something if you are not competent to do so or you feel is out your scope. However, you cannot refuse to learn how to do something if it is a requirement for patient care or safety. For further information see our advice on refusal to treat

Further information can also be found on our guidance on redeployment.

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 in the NHS. What are my entitlements? 

Any change to your working patterns should be agreed with you, in accordance with your employers 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’m working extra hours outside the NHS. What are my entitlements? 

Overtime and TOIL arrangements should be detailed in your contract or 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 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 staff receive overtime payments for hours worked beyond full-time contracted hours. We also expect employers to make arrangements for nursing staff on bands 8 and 9 to be paid overtime where they work hours in excess of contracted full-time hours. Overtime payments for senior nurses and managers should be calculated on the same basis as for staff on Bands 2 to 7. Governments in Scotland and Northern Ireland have issued guidance confirming that all staff on bands 8 & 9 will eligible for overtime pay. 
 
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 guidance on pregnancy and COVID-19, including occupational health advice for employers and pregnant women. There is different advice depending on your stage of pregnancy (i.e. before or after 28 weeks of pregnancy).

The RCN expects employers and occupational health to carry out or review a pregnancy risk assessment and put systems in place to protect the health care worker and find suitable alternative work, including home working or redeployment in line with health and safety standards.

Where the risk can't be removed and 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.

You should escalate concerns to your line manager in the first instance. You may also wish to liaise with your GP or midwife, if you are concerned.  

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 about confidentiality?

Organisations should have systems in place for keeping the details of staff involved in caring for patients with suspected or confirmed COVID-19 confidential. Employees should also respect each other’s confidentially and take care not to inadvertently share information when using social media, for example.

Where staff are suspected or confirmed to have COVID-19, their personal details should be treated as confidential, as they would be for any other patient.

Ramadan is a holy month and therefore very important in relation to the Muslim calendar. The dates for Ramadan 2020 are 23 April – 23rd May 2020, which will be followed by Eid al-Fitr.

Fasting plays a vital role during the holy month of Ramadan and adult Muslims who are able to are required to fast (abstain from food and drink). Fasting takes place between dawn and dusk and is broken at sunset with the meal of iftar. This meal would generally be followed by eves prayers called taraweeh prayers which would usually take place in mosques. 

As Mosques are closed, during this period employers should make sure that facilities for staff to pray are available and accessible, and support staff members to continue following social distancing guidance. 

Employers and managers should have discussions with their staff about any workplace adjustments needed during this period as well as ensuring that prayer facilities are available for staff. This may also include that breaks for those staff observing Ramadan are prioritised at the point where they would usually be breaking their fast with iftar.

Health and care staff who are unwell or pregnant should use the concession which does not require them to fast during Ramadan.

The wearing of PPE is recognised as a factor which could lead to dehydration and subsequent risk to staff and patients, this advice may be useful for staff who wear PPE to consider

Health and care staff should also be encouraged to speak to their line managers about their specific needs during Ramadan too.  

Guidance from NHS England is also available

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 childcare during the COVID-19 outbreak, which includes who is identified as key workers for the purposes of on-going educational provision. The RCN expects that students who are working during this period will also be counted as key workers. 
 
Here is the guidance for each of the four UK countries:

England

Guidance for schools, childcare providers, colleges and local authorities in England on maintaining educational provision 

Closure of educational settings: information for parents and carers 

Scotland 

Guidance for Scotland Coronavirus (COVID-19): school and ELC closures - guidance for key workers 

Northern Ireland 

Coronavirus (COVID-19): advice for educational settings 

Wales  

Closure of educational settings: information for parents and carers

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

If you are a critical worker your local authority will find a setting for you but this may not be your usual school. 

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. 

I am a single parent expected to work shifts that exceed the times local schools are open. I can no longer ask my elderly parents to help with child care as they are self isolating. What can I do? 

You will need to speak to your employer about the situation and whether it is possible to alter your shifts to something more suitable or whether there are any special leave arrangements that will help. 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. 

I’m a nurse but my partner is working from home. Can I send my children to school so they can work uninterrupted? 

Government guidelines state that this provision of childcare in schools is available where one parent is a critical worker. However, they do also state that every child who can be safely cared for at home should be, to limit the chance of the virus spreading. 

I am worried about the spread of the virus if I send my children to school? 

It is not compulsory to send your children to a school if you are a critical worker. If you are concerned about the risk of the child contracting the virus, talk this through with the school and ensure they are following the advice set out by Public Health departments. 

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 England, Scotland and Wales will be entitled to full pay when self-isolating during the COVID-19 pandemic. The RCN is also calling for the right to full pay to apply to staff in Northern Ireland. 

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 healthcare 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 for 7 or 14 days, you should follow your employer’s emergency preparedness procedures or other local procedure for notifying your employer of your absence. 

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 managers 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 7 or 14 days, depending on the circumstances, in accordance with government guidance. 

We expect all governments in the UK and employers to ensure that where health and care staff are self-isolating, they will be paid in full. No health and care staff should experience any financial detriment when taking credible steps to protect their safety, and that of their colleagues and patients.  If you are unable to resolve the situation with your employer contact the RCN for further advice by contacting RCN Direct on 0345 772 6100.

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.


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. 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 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 a 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?  

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 England, Wales and 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. 

I have been advised I need to ‘shield’ myself for 12 weeks due to a serious health condition. What should I do?  

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. Read the government guidelines on shielding.  
 
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 in England, Northern Ireland or Scotland (confirmation is being sought for Wales) 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. 

If you have concerns you should raise the issue with your employers and ask for a written response. 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 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 in England, Northern Ireland or Scotland agreement has been reached that guarantees your normal pay if you are unable to work due to shielding requirements. Confirmation is being sought for staff in Wales.

If you are shielding and are 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.  

I fall into the ‘extremely vulnerable’ group but have not received a letter yet. What should I do?  

You must contact NHS111 or your GP to ask for a letter to confirm you should be shielding. You may need this as evidence that you must stay at home/not attend work as normal. Even before you receive this letter, if you believe you may be in the ‘extremely vulnerable’ group you should make your employer aware of this so that they can begin a risk assessment.  

If you do not meet the set criteria for highly vulnerable groups but you have an underlying health condition and have concerns about attending work, you should talk to your employer and ask them or occupational health to carry out a risk assessment. Where possible they may seek to redeploy you to another work area or arrange for you to work at home. If the risk assessment confirms you are unable to work, and you work in the NHS, your employer should agree to medical suspension on full pay. 
 
The RCN expects this from all health and care providers in the UK.  

If you have concerns you should raise the issue with your employers and ask for a written response.  If you are unable to resolve the issue, contact your local RCN representative if you have one, or contact RCN Direct on 0345 7726100. 

My employer has told me that they will put me on furlough while I’m shielding.  Can they do this?  

Possibly, especially if you do not work in the NHS. Your employer may be able to place you on 'furlough' and receive support from the government to continue to pay 80% of your normal pay up to £2,500 per month. Your employer should refer to the government guidance for employers and businesses on COVID-19 (see the section Claim for your employee’s wages through the Coronavirus Job Retention Scheme). This scheme applies to all employers, including publicly funded ones, however the government expects that most public sector employers will not need to furlough employees - either because they are working on essential services, or because the employer's public funding covers its staff costs.   

The government guidance says that where employers receive public funding for staff costs, and that funding is continuing, they would expect employers to use that money to continue to pay staff in the usual fashion – and correspondingly not furlough them. This also applies to non-public sector employers who receive public funding for staff costs. 

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 your employer is refusing to do this you should ask for written reasons and, if you are not able to resolve the matter, you should contact your local RCN representative if you have one or 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

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 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 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, find out about SSP at gov.uk. Further information about sick pay and sick leave can also be found in our advice guide

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. 

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. 

In March 2020 the NMC introduced emergency standards for nursing and midwifery education. In response to the pandemic, students were offered the option of choosing to work in a paid clinical placement. In addition, the NMC considered introducing a temporary register for students in the last six months of their nursing degree. However, in May 2020 the NMC announced that this would not be necessary and so students will not be invited to join the temporary register. 

You can find out more in our information on nursing workforce expansion, along with the NMC’s information for students and educators.

What payment and employment rights will I have?

The RCN is clear that students deployed to support the COVID-19 emergency response should receive fair pay for the work that they do – respecting the principles of the NHS Job Evaluation Scheme – and be given contracts with full employment status and employment protection, including contractual entitlements contained in the NHS Terms and Conditions of Service. Deployed students must also have access to all the measures and protections put in place to support NHS staff during this exceptional time.

The RCN has worked/is working in partnership with health departments, employers and relevant educational establishments to agree the following for pre-registration students:

Mid programme students (2nd years and 3rd years in first 6 months)

  • England – should be deployed to a suitable role defined by an existing job description that matches to the Band 3 Clinical Support Worker Higher Level national profile.
  • Scotland – will be employed at band 3 on a national contract with an agreed job description (employed by NES and deployed to relevant health boards)
  • Wales – work is ongoing to produce a standardised job description at band 3
  • Northern Ireland – such students should be deployed at band 3 as agreed by the Department of Health

End programme students (3rd years in their final 6 months)

  • England – will be employed on a band 4 contract (a template job description is provided for local use in the agreed guidance) until such time as the student moves to the temporary NMC register – at this point they will move to a Band 5 contract (a template job description for local use is provided in the agreed guidance)
  • Scotland – will be employed at band 4 on a national contract with an agreed job description (employed by NES and deployed to relevant health boards)
  • Wales - work is ongoing to produce a standardised job description at band 4
  • Northern Ireland – such students should be deployed at band 4 as agreed by Department of Health

There are slightly different arrangements for Honours Students on 4 year programmes in Scotland depending on their institution which takes into account that students on some courses will have more to achieve to complete the requirements for registration. Please see the FAQs on student deployment in Scotland

If you are in England, please see the guidance on the deployment of students. Information from Wales and Northern Ireland will be posted when available.

Student midwives in England should also see Health Education England (HEE) guidance on deployment.

What support will I get in practice?

Students should work to the NMC Code of conduct, preserving safety at all times. Support will be provided for students on extended paid clinical placements to provide safeguarding for the student, existing workforce and patients.

The practice area will need to take into account your knowledge and experience around the environment you are asked to work in. Further support can be accessed in the RCN redeployment guidance.  

You must discuss your assessment of competence and confidence with the nurse in charge.

What support will I get from the RCN?

Existing RCN members who are in the Student category on extended paid clinical placements will receive full support and representation as student members whilst they are on these placements.

Any non members who are students (in their final year of study) who join as a Student member (£10 per year or 84p per month), will receive full support and representation as student members whilst they are on extended paid clinical placements.

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. 

I’ve been given a zero hours contract and am worried that I won’t get regular hours or sufficient hours to go towards my future registration?

The RCN expects employers to offer substantive roles to students taking on paid roles to support the pandemic response and does not generally consider that ZHCs are appropriate.  If your contract is with an NHS employer (not a bank or agency contract) then you will be covered by the full NHS terms and conditions of service including those amended during this pandemic response. 

The RCN was a co-signatory with the NMC, other Royal Colleges and Trade unions of a joint statement on the deployment of nursing students which committed the Chief Nursing Officers across the UK to develop guidance covering terms, conditions and pay for students working in clinical practice.  Each country’s guidance states that your working hours and pattern are a matter for agreement between you and the organisation you are to work in, and that those hours will be included in any future assessment of your progress to registration.  The expectation from CNOs, the bodies responsible for nursing education (e.g. HEE in England and HEIW in Wales) and Universities is that you will be given enough hours so that you can enter the full register as expected.

If this isn’t the case you should raise your concerns with your university tutor in the first instance and the employer where you are placed but if you are still concerned and haven’t been able to resolve the issue do speak to your local RCN representative if there is one or contact RCN Direct on 0345 772 6100 for advice.

The RCN is pressing the NMC to ensure that all hours completed in extended clinical placements count towards students’ required 2300 hours of clinical practice. We have asked that they explicitly consider and describe the learning environment under COVID-19 and issue appropriate guidance accordingly.

I’ve not seen the job description for the role I’ve been taken on in and neither have I been given any kind of contract to sign. Is this right? I’m worried I won’t get paid.

This is poor employment practice and hopefully you will receive a written contract soon.  All employees wherever they work are entitled to receive a written statement of the terms and conditions of your employment.  This should be provided by your employer within 2 months of starting work.

The statement should include the following:

  • the names of you and your employer
  • the date you started work
  • the title of the job
  • the amount of pay and how often you will be paid, for example, weekly or monthly
  • the hours of work
  • where the job is based, for example, whether you will have to work in more than one location
  • your holiday entitlement, including how many days off you are entitled to and what your holiday pay will be, if any
  • how much warning (notice) you are entitled to if you are dismissed and how much warning you must give the employer if you want to leave the job
  • what the disciplinary, dismissal and grievance procedures are in the workplace
  • what sick pay you are entitled to
  • the pension arrangements.

Some of these issues may be contained in your contract of employment, a staff handbook – or be available on the internal website.

If you have not received a written statement of employment particulars, you should in the first instance raise the issue with your line manager.  If that doesn’t resolve the matter, then you should put a request for such a statement in writing (reference any formal guidance on student deployment and confirm your understanding of the nature and salary for your role). You then have a written record for the employer to respond to or challenge.

If you still don’t receive a statement and/or you don’t receive payment as expected, you should speak to your manager again but if you can’t resolve the situation with them speak to your local RCN representative if there is one or call 0345 772 6100 for advice. 

I wasn’t paid last month even though I had already started my paid placement.  Will I get back pay?

There are two probable reasons why you may not have been paid when you expected to be:

1. You didn’t start work before the payroll deadline.
2. You have been given the wrong contract or a contract with incorrect details.

In both cases the first thing you should do is raise the matter with your manager who may refer you directly to payroll.  If you are unable to resolve the matter this way contact your local RCN representative if there is one or call  0345 772 6100 for further advice.

Any backdated pay should be paid to you as soon as possible but you should keep your own records (e.g. how many hours you worked on what days) just in case this does not happen and you need to take the matter further. 

I normally have reasonable adjustments on placement. Am I still entitled to these on paid placements? Who is responsible for them? 

Reasonable adjustments are an entitlement under law and should not be affected by changes to your placements in response to COVID-19. Ensure that your needs are known by your university, and take a proactive approach in sharing your inclusion plan with your Placement Education Facilitator or other placement contact as early as you’re able to. If you are having issues in establishing or sustaining the adjustments you need, in the first instance consult your university's disability support team and RCN members can call RCN Direct on 0345 7726100 for further advice. 

Where can I find out more?

Please see our information on nursing workforce expansion.

Error regarding student loan repayments

Some students undertaking paid placements have had student loan repayments deducted from their first payslips in error. Please speak to your payroll department and seek written confirmation of the error for your records. We’ve been assured that the sums deducted are expected to be returned to you in the next pay round.

If you are experiencing financial difficulty, please see our advice.
 

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.

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

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.  

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

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.

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.

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 for at least 12 weeks.

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 further please see the sections on shielding and alternative accommodation. 

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.

Will I be paid when self-isolating?

If you are working for an NHS organisation or an organisation commissioned to provide NHS services, you will be entitled to special leave on full pay 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 overtime.

We expect independent employers to also pay their staff normal pay.

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. Read further information and FAQs for nurses and midwives wishing to return to work in the NHS.

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 - 04/06/2020