Lateral flow testing in early years settings: what you need to know
Lateral flow testing is available to anyone who works in an occupation related to a childcare provider, school, nursery or college, as well as adults in their household, childcare and support bubbles. This testing is used to identify cases of Covid-19 where no symptoms have been displayed (i.e. asymptomatic testing). NB: If a member of staff is displaying Covid symptoms, then lateral flow testing should not be used. Instead, they should book and take a PCR test (i.e. a test for those with Covid symptoms) and self-isolate until they have received their results.
The below FAQ aims to provide a concise summary of Department for Education guidance on accessing lateral flow tests, taking tests and reporting results.
Guidance for PVI settings and nurseries receiving deliveries of test kits can be found here. Information on lateral flow testing for childminders, and the households and bubbles of early years providers is available here.
- What are LFDs?
LFD stands for Lateral Flow Device. These tests check whether or not someone may have Covid-19 without the need for laboratory processing, and offer a result within 30 minutes. They are different to the PCR (Polymerase chain reaction) tests, which are used for people who have Covid-19 symptoms and must be sent to a lab.
- Are LFD tests accurate?
The Department for Education has advised that LFD tests have been evaluated by Public Health England and the University of Oxford and are said to be accurate and sensitive enough for community screening. They added that “while no test is perfect, these devices have been successfully used to detect Covid-19 in people without symptoms”.
However, those who receive a negative result from an LFD test should continue to follow social distancing and other protective measures.
Ordering and receiving tests
- Who is eligible to receive LFD tests?
All PVI nurseries and pre-schools should start receiving test kits at some point after 11 March, ready to start using on 22 March. You do not need to sign-up to receive the first delivery of test kits.
School-based nurseries and maintained nursery schools should already be receiving these kits.
Registered childminders in England and their household, support and childcare bubbles can access lateral flow testing twice per week by getting tested at a local test site, collecting home test kits, or ordering them online.
- Are wraparound childcare providers included?
Yes. The guidance states that wraparound childcare providers should continue to get tested by either their employer or use test sites. Alternatively, they can order tests online for home delivery here.
- How long is each supply of test kits supposed to last?
The DfE guidance states: "The test kits are expected to last up to three and a half weeks based on staff testing twice a week."
- How do we report missing or damaged supplies?
The DfE has published an online form where PVI settings and nurseries can report any missing or damaged items in their deliveries.
- How do we order more tests after we use up our initial supply?
The DfE has advised that providers can place ongoing re-orders for test via an online order system available here.
To place an order, providers will need to enter their Unique Organisation Number (UON). This will be sent to all provider by email but can also be found on the UON lookup website here by entering your setting's Unique Reference Number and postcode. If your URN is not prefixed with EY (for example EY123456), you should add YE as a prefix to your URN (for example YE123456).
If you operate more than one nursery, you will receive a UON for each nursery. This will allow you to order test kits for each individual nursery.
Where an individual nursery is registered with Ofsted with more than one URN, you may also receive more than one UON. In this scenario, nurseries are advised to use the UON associated with their most recently registered URN.
Guidance on how to place a new order is available here.
Staff and testing
- Which staff members should get test kits?
Early years providers should offer testing to all staff in their settings – including contractors or rotating staff members. Those supporting with wraparound care, those working in catering, and any therapists or volunteers should also be included.
Staff that work at more than one early years setting or school should collect their tests from the same setting each week.
Any members of staff working from home who do not ever attend your setting in person do not need to join the testing programme.
- Are all staff required to take the test?
No. Although the DfE says it expects that all eligible settings will want to participate in the scheme, it is not compulsory for staff to take part if any wish to opt out of the scheme, though it is strongly encouraged. Staff who refuse to take tests can still work in your setting.
- Can staff who have previously tested positive for Covid-19 take part?
Staff who have tested positive for Covid-19 are exempt from LFD testing for 90 days after their positive test result.
- Should staff who have been vaccinated take part in the scheme?
Yes – it is not yet known whether or not the vaccines prevent transmission of the virus so staff who have been vaccinated should follow testing guidelines too. The vaccine will not interfere with their test results.
- Are the tests safe for pregnant staff?
Yes, LFDs are safe for use by those who are pregnant.
Storing and distributing tests
- How should we store the tests?
Tests should be kept indoors, between 2-30 degrees. If they are stored somewhere cooler than 15 degrees they will need to be moved in to a warmer room for around 30 minutes before they are used.
- How should we distribute tests to staff?
Settings should arrange to distribute kits to staff at the setting while maintaining social distancing and wearing appropriate face coverings. The DfE recommends allocating time slots for staff to collect tests to avoid queues and crowding.
Full instructions on how to use the tests are provided with the test kits. Each box contains seven tests.
Settings should keep a test kit log, where they record which individual has taken which kits home in case there is an incident requiring investigation or batch recall
- Should staff always take the tests at home or can they be taken at the setting?
Staff should take the tests at home, not at the setting. This is because the risk of transmission is reduced if a staff member tests positive at home rather than in the setting. The home test kits are also manufactured specifically for use at home and the instructions are specific to this environment.
- When and how often should the tests be taken?
Tests should be taken twice a week with a gap of three or four days between each test.
The tests should ideally be used in the morning, before coming into work, though the DfE advises that staff can also test on a Sunday evening.
Any staff who work part-time should still be tested twice weekly, in the same intervals.
- Do we need to test during the holidays if the setting is closed
The Deparment for Education has advised that "PVIs will need to test when a setting is open, so if the PVI closes for the holidays, it will not need to test over that week. If the PVI remains open throughout the holidays, then staff should continue to be tested."
- Are there any rules or requirements for how to take the tests?
Staff should avoid drinking or eating in the half-hour before taking the test – although drinking a small amount of water should be okay. The DfE says that brushing your teeth is “unlikely” to have an impact on the test but advises waiting a while after doing so before testing.
- How much time is the administration of home testing expected to take?
The DfE estimates that the initial set up and registration of staff and distributing kits will take up to two days and the regular recording of staff test results will take up to one day over the course of a working week.
They recommended that each setting appoints a ‘Covid Coordinator’ and a ‘Registration Assistant’.
Your Covid Coordinator will need to cover the overall management of the programme engage and communicate with staff and parents.
Your Registration Assistant will need to:
- distribute test kits and manage the distribution schedule
- work with the Covid Coordinator to manage kit and stock
- record self-reported results and send reminders to staff to report their results online and to the setting
- respond to staff questions about testing
- ensure that staff follow the right instructions
- report incidents and carry out risk management
- reorder test kits when required (advice on this will follow soon).
- What happens if a member of staff gets a negative test result?
Staff who get a negative test result should log their result via the NHS Test and Trace self-report gov.uk page. They can then continue working, though it is important that they keep following Covid-19 guidelines as normal.
The DfE has advised that there is no requirement for staff to provide proof of a negative test result.
- What happens if a member of staff gets a positive test result?
If staff get a positive result from a LFD test, they should report their results to NHS Test and Trace as soon as the test is complete, via the self-report gov.uk page. They should also let their setting know so that they can identify close contacts and make cover arrangements.
The member of staff and the rest of their household should immediately self-isolate. However, the staff member will also need to book a PCR test to confirm the result. This should be taken within two days of the LFD test.
If the follow-up PCR test is negative, they and their household can stop isolating.
If the PCR test is also positive, then the staff member should continue to isolate (alongside any other members of their household) in line with Stay at Home guidance inform their nursery or pre-school of the positive PCR result.
- If a member of staff gets a positive test result, does their whole bubble have isolate or can we wait for the confirmatory PCR?
The Department for Education has confirmed to the Alliance that if a member of staff gets a positive result from a LFD test, then those who have come into close contact with staff who have a positive LFD result should isolate straight away rather than waiting for the staff member’s confirmatory positive PCR test.
- What happens if a test is void?
This means that the test has not worked correctly and the staff member should take another test as soon as possible – ideally on the same day. This should be with a new test kit. Nothing from the first kit should be reused.
The result should still be reported to NHS Test and Trace, via the self-report gov.uk page.
If more than one test has a void result, you may have a faulty batch of test kits.
- A staff member has been told to self-isolate by NHS Test and Trace, but has taken an LFD test which was negative. Do they still have to self-isolate?
Yes. Staff who are contacted by NHS Test and Trace as a contact of a positive case will need to self-isolate immediately. LFD results cannot be used to allow staff to end self-isolation.
- Does the setting need to keep a record of test results?
Yes – there is no way to access staff test results through the NHS reporting system so you will need to do this in the setting in order to help with contact tracing. You can download a template for doing this here. You’ll need to keep this for 12 months from the date of your setting’s last entries in the log.
Your setting will need to be satisfied that it has a ‘lawful basis’ for processing this information under data protection regulations. You should provide staff with a privacy notice – you can download this template to use.
- I am a childminder. Do I need to report my test results?
Yes, childminders should report all test results via the NHS portal via the steps below:
- Select ‘Start Now’ to begin recording your result.
- In the next section (‘Did you take this test for your job?’), select the ‘Yes’ option.
- On the following page ('Tell us about the work’), select ‘It’s for an education provider’.
- In the next section (‘Which of these best describes you?’), select ‘Employed as a childminder’.
You will then be able to proceed to answer a number of questions to register your result as appropriate.
- Do the tests contain any harmful substances?
No – the manufacturer stats that there are no hazards anticipated if individuals follow instructions for their use.
- Are the tests latex-free?
Yes - the swabs do not contain any latex.
- Do the tests contain any animal products?
The antibody technology present in the LFD kits are made using animal cells – this is common with other tests of this kind, including commercially available pregnancy tests.
No animal products have been used in the production of the swabs, which is the only materials which individuals come into direct contact with and at no time were any of the component parts tested on animals.