Covid-19 restrictions

A national lockdown is now in place to control the spread of Covid-19 as rates rapidly increase across London and the country.

Everyone must now stay at home, and only leave home for specific reasons. Full details of what you can and cannot do are available on the government’s website.

Remember, advice around Covid-19 can change quickly, so keep up to date with the latest information.

 

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COVID-19 testing

Background

As part of the government’s five pillar strategy for coronavirus testing, the government has introduced a number of options for testing:

Regional Testing Centre (RTC)

There are five regional test centres in London - O2 and Lee Valley are the closest ones to Tower Hamlets.

This testing is for those in vehicles only (drive-through) and is by appointment only.

Public access these via the NHS website or by calling the Coronavirus Testing Centre if they have no internet access.

Please see appendix one for further information on RTCs.

Home testing

Home test kits can be delivered to someone’s door so they can test themselves and their family without leaving the house.

Home test kits can be ordered vai the NHS website or by calling the Coronavirus Testing Centre if they have no internet access.

A tutorial video supports the written instructions in the home testing pack, from Dr Amir Khan

Mobile Testing Units (MTU)

Mobile testing units travel around the UK to increase access to coronavirus testing. They respond to need, travelling to test essential workers at sites including care homes, police stations and prisons.

There are a number of MTUs in the borough that can be access via the NHS website.

More information can be found on the Mobile Testing Units page.

This service is for those in vehicles and pedestrians and by appointment only.

Please see appendix one for further information on MTUs.

Walk-in centres

There are currently several Walk-In Testing Centres in Tower Hamlets.

Testing for these can be accessed via the NHS website.

Asymptomatic testing

One in three people who test positive for coronavirus show no symptoms at all.

We are now offering rapid Covid tests (Lateral Flow Tests) to people who don’t have symptoms of Covid-19 but would still like to get tested.

The tests are quick and convenient and provide results in under 30 minutes. If you test positive, you will be referred to get a confirmatory test (a test through the national system).

Currently there is a rapid testing site at the Ecology Pavillion, Mile End Park, E3 5TW. The site is open 10am to 7pm. You do not need to book - it is currently a walk-up test site.

How to get tested

Tests must be done in the first five days of having symptoms. More information on when to apply for a test is available on the Test for Coronavirus website

  • Essential workers can apply online for a test via the UK government website. Tests can also be ordered here if you live with an essential worker.
  • Testing is currently available for anyone of any age in Tower Hamlets. You can apply for a test via the NHS website. If you do not have internet access, a test can also be ordered via phone by calling the Coronavirus Testing Call Centre on 119. For people with hearing or speech difficulties, please call 18001 119.  Alternatively, Tower Hamlets residents can also arrange a test via their GP.
  • Care Homes in England can register for delivery of tests for all their staff and residents via the UK government website, whether or not they have symptoms
  • Employers of essential workers can access a portal which allows them to refer essential workers who are self-isolating either because they or member(s) of their household have coronavirus symptoms, for testing. Find out more about employer referral.

Up-to-date guidance on getting tested is available from the UK government website.

Local Testing in Tower Hamlets

London Coronavirus Response Cell (LCRC) support for testing

The Director of Public Health will work together with the LCRC to help direct the mobile testing units in response to outbreaks.

For further details please see appendix two.

Identifying sites for mobile testing units

The council is working with partners to agree sites to host the government’s mobile testing units which include health facility car parks and council-owned sites.

Local data to inform testing

Regular reporting of a number of key indicators will take place to inform when additional testing may be required, including number of positive tests, with geographical mapping (once numbers are above five).  This will help to identify where to deploy mobile testing, or implement other rapid local testing pathways, if required.

Clusters will be automatically reported by Public Health England to the local authority. 

Further local testing approaches

The council have established the ability to rapidly deploy additional testing capacity using either regionally commissioned services or local services. The local services have already been thoroughly tested through operating an enhanced fortnightly COVID-19 testing system for the last four weeks in care homes, provided by the GP Care Group.

This not only provides additional swabs but also the ability to deploy experienced testers to high risk settings with fully tested results management system interfacing with the national NHS Test and Trace service.

Additional capacity can be deployed for high risk settings using a combination of regional offer e.g. London Find and Treat team for hostels, LCRC outbreak control, along with the local offer. The local offer includes:

  • The Tower Hamlets GP Care Group and the Primary Care Networks can increase local capacity by raising tests requests via the T quest system for swabs to be locally provided, undertaken and analysed using the existing pathology pathways at the Royal London Hospital.  This additional capacity can be deployed via outreach to high risk settings such as hostels, care homes, schools, children settings or on a locality basis e.g. estate or workplace.
  • Mobile testing units including a clinical mobile unit have been identified and when needed this can provide additional capacity to the GP Care Group testing through the deployment of sexual health nurses to undertake testing. Where mass testing needs to take place in a setting where people being tested are not registered with the local GPs this system has advantages that the tests can be raised, processed and results communicated using the Barts pathology and sexual health pathways. Any positive results will enter the NHS Test and Trace service for partner notification.
  • Community testing can also be implemented using the Blood Borne Virus (BBV) team from Barts, along with trained community testing workers from an existing voluntary sector provider who have previously undertaken BBV testing in the community.

The council is also establishing a COVID-19 testing support function within the school health service. This referral-only provision will help families access testing when they unable to do so through NHS Test and Trace. Test kits can be delivered and collected to pupil’s homes, and virtual or direct support will be provided for families to ensure that tests are undertaken accurately. Further detail on this arrangement is given in Chapter one.

Supporting residents to participate in testing

In Tower Hamlets, the Test and Trace Community Mobilisation group (see Chapter 6) aim to ensure all residents, particularly those most vulnerable to COVID-19, are supported to participate in the NHS Test and Trace programme.

In Tower Hamlets, some people are likely to need extra support to be able to engage with the Test and Trace programme for the following reasons:

  • Access to health services for BAME individuals can be affected by language and cultural barriers, as well as migration status
  • Housing and overcrowding –Overcrowding has implications for the remote access of health services as well as people’s ability to self-isolate
  • Those most at risk may also have the most barriers to engaging with the programme – including precarious employment. This includes those least likely to work from home, zero- hour contracts and attendant worries about job retention and financial stability if needing to self-isolate after a positive test
  • Those with disabilities/impairments
  • Migration status – fears around deportation/disease status being shared with immigration authorities will be a barrier to engagement, as will disease-related stigma in their own communities, lack of GP registration and the Test and Trace programme not being culturally sensitive with regards to language and unconscious bias.

The Community Mobilisation Group will be working with residents to better understand barriers and ways we can support people.

Appendix one:  Regional Testing Centres and Mobile Testing Units (MTU)

Regional Testing Centres (RTC) and Mobile Testing Units (MTU)

MTU and RTC tests are by appointment only: Tests will only be conducted for those people who have an appointment booked via the national booking portal. Anyone without an appointment will be asked to book on-line before returning. This should also include any household members travelling if they expect to be tested. 

Visit GOV.UK for self-referral and employer referral registration. The gov.uk page also includes details of who is eligible for tests.

Opening times for all MTU sites are approximately 10.30am-3.30pm. As of the eight of June some MTUs are now open until 4pm. Please see confirmation of times available when booking a time slot using the booking portal.

Access to tests at RTCs is for those in vehicles only. Tests at MTUs are available for those in vehicles and for pedestrians. Pedestrian access is technically possible but currently discouraged and registrations require vehicle registration details to be added when booking places.

Booking portal timings

Thirty percent of bookings are released two days in advance of the testing day. These are in part reserved for the employer referral booking system. The additional seventy percent are opened to self-referral bookings one day (at 20.00hrs) before the site opens.

The release of bookings onto the portal starts with employer referrals which have priority access from 5pm.

The portal is set to allow self-referral bookings for the wider public from 8pm onwards. At the same time thirty percent of the bookings for the following day (D+1) are opened on the portal.

Capacity fluctuates at sites according to the logistics of teams coming from a variety of hub locations (time constraint) and other resource constraints in the testing programme which are being actively managed.

Employer booking portal

Key worker employer organisations can register to use the employer referral booking portal (link to register on this page). The employer referral portal reserves a percentage of the test booking slots for employers to refer staff before those slots are released to the general eligible public via the self-referral portal. This system is more effective than it was at the start of the MTU testing capability because MTU locations are now available on the system further in advance.

The employer referral system enables employers to:

  • Submit requests for test centre appointment allocations by uploading an excel file (.xls/.xlsx) each day.
  • Download submitted requests which have had appointments allocated.
  • View the status of your submitted requests each day after 5pm.

Employees will be sent a booking confirmation for their nearest test location with availability directly from the system.

As of 4 June, DHSC has moved the employer referral portal to a “continuous run” state. This means the original 3pm daily submission deadline has been removed. Employers will still upload only one spreadsheet a day, but all uploaded spreadsheets will be processed every 5 minutes between 8am and 6pm.

E.g. if an employer believes they are ready to upload requests at 11am they can upload then and it will be almost instantly processed. But if employers want to hang on past 3pm for any reason until later in the day, they can do so.

DHSC have also simplified the form to avoid errors that prevent employers from uploading successfully. E.g. they no longer ask for the vehicle registration number.  DHSC have also added the user guide to the post-login page. All of this work is aimed at creating a more sustainable system.

Appendix Two: Mobile Testing Units: Guidance for Regional Coordination Groups and the directing of Mobile Testing Units (MTUs)

1 Purpose and objectives

The government has built a national infrastructure for COVID-19 testing, with the aim to expand the reach of testing across the UK.  Mobile testing is one of a suite of testing capabilities which has been developed.

Mobile testing is an agile capability that allows temporary testing sites to be set up quickly to serve communities on a rolling basis. The Mobile Testing Units (MTU) have been designed as a flexible testing capability that can respond to most situations. There are some situations in which MTUs are not the most appropriate testing capability.

The high-level direction and supply of MTUs sits with the DHSC, with decisions around their daily deployment being made at a London wide level by the MTU Deployment Cell. The MTU Cell directs the movement of MTUs, but with greater input from Directors of Public Health (DPH). While DPHs will have the power to direct MTUs in response to outbreaks, the decision to do so will be taken together with London Coronavirus Response Cell (LCRC), building on the existing model and the learned experience and familiarity with the capability held by MTU Cell.

2 What is a Mobile Testing Unit?

An MTU provides a clinically assured, stand-alone testing capability in the community. It is an adapted standard white van that can be used in a variety of different settings and setups to deliver testing where needed.

The MTU comprises a van with pop-up shelters and an integral traffic management system. It can operate at varying scales in order to best serve the community, with a standard capacity of up to 500 tests per day. The number of tests that can be completed in a day depends on the size of the site, the ratio of vehicle to pedestrian subjects, the hours of operation and the distance it has to travel form the host Regional Testing Centre.

A smaller unit, without the need for parking spaces except for the unit, is now being added to the capability.

MTUs use RTS as supply and delivery hubs, moving between the RTS and selected sites in the community.  Tests undertaken by the MTUs are returned to Regional Testing Centres and are managed as Pillar 2 tests.

3 The Mobile Testing Unit National Distribution

Mobile Testing Units will be allocated into three main groups:

  • Regionally Allocated MTUs – MTUs allocated by Region for routine scheduling by the MTU cell under the auspices of the DsPH
  • Regional Reserve MTUs – MTUs kept in Reserve by the MTU Cell to meet Local Outbreaks(“next-day-testing”)  and to provide immediate Resilience in case of MTU failure (break down etc)
  • Strategic Reserve MTUs – c30 MTUs, regionally dispersed but scheduled and operated centrally by the DHSC. The Strategic Reserve will meet Nationally Generated Demand and may be deployed in support of Local Outbreaks when requested to provide surge capacity.

The initial deployment of MTUs is being expanded through June and early July. This will result in sixteen MTUs in London. (approx. one per two councils by 13 July 2020.

4. The Roles and Responsibilities of London MTU Cell

While the ultimate powers to direct an MTU will remain with DHSC, decisions around where to place vehicles and direct their movements will continue to be planned by the London MTU Cell with input from the DsPH. To support the DsPH in the delivering their statutory requirement the MTU Cell will have four primary roles relating to MTU deployment:

The MTU Cell will:

  • Work with regional stakeholders to collate testing demand requests and determine where and when an MTU is needed on a routine basis. The MTU Cell will maintain a forecast out to at least 5 days including associated site permissions and access; ensuring this is delivered when the MTU attends at each site.
  • Maintain a Reserve of at least 2 MTUs at any time from within the London’s allocation of vehicles.
  • Respond to areas of urgent need, informed by LCRC/LA IMTs, under the direction of DsPH. This may draw upon the London Reserve vehicles.
  • Identify and agree local sites for MTU use and establish a broad portfolio of sites that can be accessed routinely or in times of urgent need.

Should a crisis or outbreak arise, the DHSC may deploy additional units from the Strategic Reserve to an area on a temporary basis if the Regional Reserve is not enough.

These may be requested urgently by the MTU Cell and/or DsPH to provide surge capacity when demand exceeds London capacity.

At all times, the MTU Cell will remain accountable to DsPH.

5. Pre-planning

Boroughs need to identify a network of sites that cover all areas of the Borough as possible sites for MTU deployment.  This work could also review sites suitable for alternate day deployment of MTUs using the following criteria:

Accessible for all – fit with existing outreach services/ JSNA priorities

  • Social vulnerability – link to find and treat service
  • Hard to reach groups-Lack of digital access
  • Language barriers
  • HMOs/overcrowding
  • Physical access to testing sites – low car ownership

Meets potential local surge in prevalence

  • High demand in local areas
  • Communities with outbreaks
  • Workplaces
  • Population needs and behaviour/ any groups less likely to comply with social distancing
  • Suitability of site

For the smaller units you do not need on-site parking, except for the van.

6 Mobile Testing Unit deployment for large local outbreaks

London Coronavirus Response Cell (LCRC) (Incident Management Team) or LA Incident Management Team (IMT) or DPH identifies a situation (either through data or notification from DPH) where an enhanced investigation will be required, e.g.

  • School
  • Universities / halls of residence
  • Other educational settings
  • A complex workplace
  • A place of worship, place of mass gathering – once these are allowed

LA/ LCRC identifies a need for testing at scale to manage the situation/outbreak as per Standard Operating Procedures and joint agreement, taking into account the need for rapid testing, difficulties accessing the Regional Testing Site or scheduled MTU deployments in the local area, convenience and accessibility.

If the number of tests required for outbreak management cannot be met through the usual route of LCRC arranging PHE pillar 1 tests AND the scale of the outbreak is such that a local testing site is required, a decision will be taken by the DPH to request a MTU deployment the following day.

Operational process

  • The DPH notifies the mobile testing unit (MTU) cell of the need for an MTU the next day, the number of tests needed, the location for the deployment, and that a list will be provided of the names of those advised to attend.
  • LA, working with the school, workplace, or other setting, contacts all people or parents of children requiring testing in writing ideally by email· These people attending the MTU will be provided with a test kit by the MTU.
  • LA confirms with mobile testing cell that the site meets the requirements (see DHSC guidance) for a full-scale MTU with vehicular accessor if a smaller MTU deployment is required (e.g. pedestrian only), and provides a list of names.
  • LA staff will support on the day to register people who attend but are not on the list of names provided in advance.
  • All testing will be as per national testing protocols and results entered onto SGSS and CTAS systems.

Prioritisation

In London, MTU numbers are increasing which will provide additional capacity to allow for  DPH requested “next-day-testing” (NDT).

In the event that more than one borough requests urgent MTU deployment for the same day, and the number of reserve MTUs available is not sufficient to provide for these requests, a request can be made to access MTUs from the DHSC national reserve.

If required, there is also the ability to redeploy one or more of the MTUs that are operational in London to meet surge requirements.  A decision on which MTUs to redeploy will be taken jointly by the LCRC on-call lead and the MTU DPH on-call lead in consultation with DHSC and military commanders responsible for MTU deployments.

Tasking should be according to the following priorities:

  1. Homeless/hostels as this is a mobile population which it may be difficult to find in 24/48hrs time.
  2. Community clusters
  3. Care homes: residents and staff
  4. Schools/ nurseries
  5. Workplaces
  6. Other

DPH/LCRC/IMT will decide if all those waiting for tests should be asked to self-isolate until tested and the results received.