COVID-19: testing from 1 April 2024
Explains testing from 1 April 2024 onwards and sets out the purpose of ongoing testing, who will be eligible to access testing and when tests should be used.
The role of testing
Throughout the coronavirus (COVID-19) pandemic, the government has prioritised protecting the most vulnerable and those in high-risk settings. Government-funded testing will continue to focus on these groups. In March 2023, the Government announced further changes towards managing COVID-19 like other respiratory illnesses. New changes from 1 April 2024 are the next stage in delivering this approach.
The ongoing success of the vaccination programme, increased access to treatments and high immunity among the population have allowed the government to scale back testing in England. From April onwards, testing will be provided to individuals at highest risk from COVID-19, continuing to support diagnosis for care and access to treatments.
From 1 April 2024, routine provision of free COVID-19 lateral flow device (LFD) tests for the management of outbreaks in higher risk settings will come to an end in England. However, free polymerase chain reaction (PCR) testing to determine the cause of an acute respiratory infection outbreak in higher risk settings, where deemed appropriate by a local UK Health Security Agency (UKHSA) health protection team (HPT), will remain to test for a wide range of respiratory viruses.
The cohort of people eligible for COVID-19 treatments can still access free COVID-19 LFDs from their local pharmacy. These people, who are at highest risk of getting seriously ill, are encouraged to test to gain timely access to treatments. A full list of those who are eligible, and information on how to access tests, is available on the NHS website: https://www.nhs.uk/COVIDtreatments
Routine asymptomatic COVID-19 LFD testing on discharge from hospital into care or hospice settings will also end to align with the approach for other respiratory illnesses, though NHS Trusts will have local discretion to re-introduce this or other forms of testing as clinically appropriate following risk assessment, involving local authority public health teams, UKHSA HPTs and care providers as necessary in decision making.
Within healthcare settings, limited testing, including symptomatic testing of staff working on inpatient wards focused on treating profoundly immunocompromised individuals, will continue in line with locally derived protocols to protect those most at risk. Symptomatic testing of patient-facing hospice staff who work closely with people who are severely immunocompromised will also continue as outlined in guidance, in line with similar NHS settings.
Where symptomatic testing is recommended, this should be based on the current list of COVID-19 symptoms.
All other residents, service users, patients and staff who are symptomatic should follow guidance for the general population on what to do if they have symptoms of a respiratory infection or a positive COVID-19 test, and the guidance on actions we can all take to help reduce the risk of catching COVID-19 and passing it on to others.
Testing recommended in NHS settings
| Situation | Type of test |
|---|---|
| Symptomatic adults and children admitted for care or developing symptoms within hospitals where having COVID-19 will change clinical management, for example to inform treatment | PCR and LFD at local discretion |
| Symptomatic adults and children eligible for antiviral treatment or in community settings to inform treatment | LFD |
| Discharge of asymptomatic patients to care settings, for example care homes or hospices | Not routinely required, however LFD tests could be introduced at local discretion based on risk (Note 1) |
| Symptomatic NHS staff and staff in NHS-commissioned Independent Healthcare Providers working on wards focused on treating severely immunosuppressed individuals | LFD in line with locally derived protocols |
| Outbreak testing in healthcare settings | LFD or PCR in line with locally directed protocols. PCR where needed for diagnosis |
In addition to the recommended testing identified, local healthcare organisations, with appropriate advice (including from Medical Directors, Nursing Directors or Directors of Infection Prevention and Control), may exercise local discretion to continue testing for specific individuals or cohorts in line with broader infection prevention and control measures. This includes emergency admission, elective pathway and transfer of care admissions, for example to a ward caring for patients who are severely immunosuppressed.
Note 1
Together with the care home or hospice setting, hospitals should assess the risk in the period before planned discharge, seeking advice on proposed changes to testing arrangements from local authority public health teams or UKHSA HPTs, if needed. Following discussion with care home providers and any advice from public health teams or HPTs, hospitals may decide to undertake an LFD test, for example if there is a local outbreak within the hospital setting. This test should be provided and done by the hospital.
Testing recommended in care services (adult social care and hospices)
Guidance on a range of infection prevention and control measures in adult social care has now been combined with acute respiratory infection guidance in the guidance for infection prevention and control in adult social care: acute respiratory infection.
| Setting | Testing | Type of test |
|---|---|---|
| Care homes | Outbreak testing | PCR (based on risk assessment by HPT) |
| Symptomatic testing for those eligible for COVID-19 therapeutics | LFD | |
| Hospices | Outbreak testing | PCR (based on risk assessment by HPT) |
| Symptomatic testing of staff providing direct care to profoundly immunocompromised patients | LFD, where recommended by the hospice | |
| Symptomatic testing for those eligible for COVID-19 therapeutics | LFD | |
| Extra care and supported living | Symptomatic testing for those eligible for COVID-19 therapeutics | LFD |
Testing recommended in other non-healthcare settings
These settings include prisons, immigration retention or removal centres, asylum reception centres, asylum hostel accommodation and reception centres, homelessness settings (including night shelters, hostels, hotels, and other temporary accommodation), domestic abuse refuges and respite rooms.
| Setting | Testing | Type of test |
|---|---|---|
| Non-healthcare settings | Outbreak testing | PCR (based on risk assessment by HPT) |
| Symptomatic testing for those eligible for COVID-19 therapeutics | LFD |
The risk of harm from COVID-19 for children and young people is very low.
Children and young people (CYP) settings do not require continued access to testing in residential special educational needs and disability (SEND) settings or the CYP secure estate (CYPSE).
Settings are encouraged to follow guidance on GOV.UK: