Guidance

Principles for managing cases of suspected high consequence infectious diseases in adult social care

Published 28 May 2025

Applies to England

Introduction

These principles are aimed at supporting adult social care providers, managers and staff in England to take initial steps in the unlikely situation where an individual is suspected to have a high consequence infectious disease (HCID) by a registered healthcare professional while in their setting, or under their care, if at home.

It is unlikely that a person who draws on care would be exposed to an HCID as these are very rare events in the UK.

People who are suspected or confirmed as having an HCID will be managed via established pathways in the NHS. This pathway broadly involves transfer to an NHS hospital by ambulance for testing and assessment by an infectious disease or infection specialist, as well as isolation and treatment in suitable NHS facilities.

Anyone receiving personal care, whether in a care home, at home or other care facility cannot be safely isolated if diagnosed with an HCID.

The healthcare professional who has identified the suspected case of an HCID needs to call for an ambulance to transfer the person to a hospital setting for further assessment as a suspected HCID. The healthcare professional must include all information regarding the suspected or confirmed HCID when requesting an ambulance.  They should also alert the local health protection team (HPT).

Any confirmed case of HCID linked to an ASC setting will be dealt with by UK Health Security Agency (UKHSA) health protection team (HPT) and local partners who will provide support to identify contacts of confirmed cases and to manage them appropriately. This may include self-isolation of close contacts and monitoring for symptoms.

The following principles set out what ASC providers and staff should do during the time between a healthcare professional suspecting an HCID, and the person who draws on care being transferred to the NHS by ambulance for further assessment.

Steps for the provider or ASC staff to take 

Contact the local HPT who can support with a risk assessment and advise on any additional precautions and control measures required.

Ensure that standard infection control precautions including personal protection equipment (PPE) (gloves, aprons, masks and eye protection) are being used and that the affected person is being supported to stay away from others as advised in the Infection prevention and control: resource for adult social care.

Support the person to stay in their room and explain to the individual what is happening, considering their capacity and mental state. It may be appropriate to reduce or postpone specific visits when a HCID is suspected. The HPT can provide further advice to support risk assessment. Inform the person’s next of kin and facilitate remote means of contact or communication between the person and their loved ones, as appropriate, before the transfer takes place.

If possible, the person should only be cared for by staff who have already been providing care for them that day to avoid exposing others. If staff have to enter the person’s room then they should wear full PPE as described above. Home or domiciliary care staff should follow the advice from the HPT about visiting their other clients on that day.

The person’s basic care needs must continue to be met so that they are safeguarded from risk, distress, discomfort and lack of dignity. For example, the person needs to have access to toilet facilities (that are not being used by others), somewhere comfortable to sit or lay, access to food and water, medications and so on. Only if it is safe to do so should personal care be postponed until the person has been transferred to the NHS.

Providers should keep a record of who has been in contact with or in the same room of the person since they developed symptoms to support any potential contact tracing and follow-up by the HPT. Record the time, duration and the type of the contact (for example, washing, supporting with eating and drinking, visiting), any PPE used, or failures in PPE.

Unless specific advice has been given, providers should be vigilant for any emerging symptoms or illness in staff and other care users. In the event of any new illness, advice and care may be sought by calling 999 or 111 depending on severity of illness. It may be appropriate to share information about the nature of the suspected or confirmed HCID in the setting (without including identifying personal details) to assist with clinical assessment and care.

The provider should also assess whether they are required to notify the Care Quality Commission as per Regulation 18  of the Care Quality Commission (Registration) Regulations 2009.

What happens once the person has been taken to the hospital

Close the room which the person suspected of having a HCID was occupying. Do not use or clean the room until further information and advice on environmental decontamination and management of waste and linen is available. This will ensure that no one is unnecessarily exposed, and that safe decontamination can be undertaken. The local HPT can advise on the decontamination processes.

If an HCID, or any other infection which requires public health measures, is confirmed, the local HPT will be informed. They will get in touch with those working in any potentially exposed settings to follow up contacts and to advise further.

If the person is confirmed as having an HCID they will remain in hospital until they are no longer infectious and are well enough to return to the care setting or home.