Public Health England | May 2020 | COVID-19: guidance for stepdown of infection control precautions within hospitals and discharging COVID-19 patients from hospital to home settings
Latest updates to this information
20 May: updates to sections 2, 3 and 4; inclusion of detail on requirements for discharge to a single occupancy room in care facility, including nursing homes and residential homes (section 5); updated with addition of ‘a loss of, or change in, normal sense of taste or smell (anosmia)’ as a symptom (section 5)
This guidance provides advice on appropriate infection prevention and control (IPC) precautions for COVID-19 patients recovering or recovered from COVID-19 and remaining in hospital, or being discharged to their own home or residential care. The NHS Hospital Service Discharge requirements issued in response to the COVID-19 emergency concerns all hospital discharges.
It is important to note that patients can and should be discharged before resolution of symptoms provided they are deemed clinically fit for discharge in a rapid, but safe, manner. People who are discharged from the NHS within the 14-day period from the onset of COVID-19 symptoms may need ongoing social care. They will have been COVID-19 tested and have confirmed COVID-positive status.
All patients being discharged to a care home will be tested prior to discharge to ascertain their COVID-19 status. Refer to the ‘safe discharge from the NHS to social care settings’ section in the Department of Health and Social Care (DHSC) adult social care plan.
In general, people with COVID-19 who are admitted to hospital will have more severe disease than those COVID-19 patients who can remain in the community, especially if they require critical care. In addition, they are more likely to have pre-existing conditions such as severe immunosuppression. In healthcare settings, there also are considerable numbers of immunocompromised and vulnerable patients.
Therefore, a precautionary approach with more stringent rules for ending isolation and infection control precautions is recommended for hospitalised patients, notably at least 14 days for those in critical care and/or immunosuppressed, compared to the at least 7-day since symptom onset rule applied to those managed in the community.
The main measures are detailed in the guidance