Rapid scale-up of the testing regime for COVID-19 is a key element of the UK Government’s response to the global pandemic. This project took a consultative approach to developing recommendations for an ethical framework for testing of NHS workers. It aimed to provide a practical guide to decision-making, serve the interests of transparency and trust, assure people that their concerns have been heard, and offer the basis of an agreed, nationwide approach.
THIS Institute collaborated with an independent 15-person diverse multi-disciplinary expert group to guide the development of an ethical framework and practical recommendations. An online consultation exercise with 93 stakeholders, many of them NHS staff and senior leaders, was held between 27 May and 8 June 2020 to characterise the range and diversity of views.
The project report emphasises that getting the COVID-19 swab testing programme for NHS workers right is crucial to support staff and patient safety and broader public health. It offers an ethical framework and practical recommendations to help guide good practice nationally and locally. The framework covers:
The report recognises that COVID-19 does not affect all population groups equally. People who are socio-economically disadvantaged or members of Black, Asian and Minority Ethnic (BAME) groups (while recognising the problematic nature of that term) may face distinctive issues in relation to testing. The possible unintended consequences and implications of testing, including frequent testing, for particular groups should be considered.
The report emphasises that building trust and confidence in the COVID-19 swab testing programme for NHS workers requires clear, transparent, and accessible communication from system leaders over all aspects of testing.
Offering a set of practical and actionable recommendations, the analysis illustrates the value of explicit, systematic and consultative consideration and ethical issues. The framework can allow progress that has already been made to be tracked, as well as providing direction and means of monitoring future improvement. It is likely to have relevance to many other areas of practice and policy in response to the pandemic.
This study is funded by the Health Foundation’s grant to THIS Institute. It is also sponsored by the Department of Health and Social Care and supported by the Wellcome Trust and the Academy of Medical Sciences.