Our frequently asked questions about COVID-19 and work
The information below has been compiled by RCN advisers in public health, infection control, and employment relations. We'll be updating it as the situation develops - so please do check back often.
We are working hard in these challenging times to keep you updated. If you can't find what you are looking for please see our Get help page or contact us and we will get back to you as soon as we can.
The below list is non-exhaustive. Please speak to your employer about any concerns and keep up to date with any local reporting procedures and policies.
KN95 face masks must not be used as PPE for work as their effectiveness can not be assured. Read the Health and Safety Executive’s health and safety bulletin (June 2020) for more detail.
If you have worn KN95 face masks at work at any point during the pandemic, we recommend you keep a record of this using your workplace’s incident reporting procedure (i.e. datix or equivalent). If your workplace is continuing to use KN95 masks despite this safety alert, please follow our PPE – are you safe? guidance. If you need further support, call us on 0345 7726100.
Flosteril FLO-MED-8130 non-sterile gowns do not meet minimum standards for fluid resistance. Providers are asked to check their stocks and quarantine any unused gowns. Read the full alert.
Read the full alert for action to be taken to avoid potential unexpected shutdown leading to complete loss of ventilation.
Read the full alert for action to take in light of increased demand for remdesivir.
Please see Medicines and Healthcare products Regulatory Agency (MHRA): Don't rely on temperature screening products for detection of coronavirus (COVID-19).
Please see the MHRA alert: Masks: type IIR from Cardinal Health – destroy affected lots.
No. Existing contractual and statutory entitlements to annual leave and holiday pay will continue to apply throughout the COVID-19 pandemic. The only change relates to the carrying over of unused statutory annual leave. The government has amended the Working Time Regulations, which means that workers will be entitled to carry over any unused statutory holiday entitlement for two years.
If you have taken annual leave and have not been paid your normal holiday pay, you need to raise the issue with your employer and ask the reason for this in writing. This should be done before contacting the RCN for further advice. If you have your employer’s written response but you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100
All workers, wherever they work, have a right under the Working Time Regulations to at least 28 days paid annual leave a year (pro rata for part time staff). This is the equivalent of 5.6 weeks of holiday but can include public holidays.
Please see our information about annual leave entitlements.
The RCN expects employers to protect the health, safety and well-being of all health and care staff during the emergency period. This includes ensuring that nursing and other health care staff can take paid annual leave, as well as being able to take rest periods and breaks during shifts. If you work in the NHS, please see their guidance on managing annual leave for the COVID-19 period.
The RCN is calling on all health and care employers to put in place appropriate arrangements which ensure that:
DHSC guidance for England also reminds employers that they should give the appropriate statutory notice to cancel annual leave and consider whether compensation is appropriate for any out of pocket expenses that a staff member may incur as a result of cancelling their holiday plans.
If your line manager is trying to cancel your annual leave you need to raise the issue with your HR Department or a more senior manager and ask the reason for this in writing. You should also raise it with your local RCN representative if you have one. This should be done before contacting the RCN for further advice. If you have your employer’s written response but you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100.
The UK government has not introduced any legislation or guidance which annuls or delays bank holidays. Some NHS services, including acute hospitals and primary care, may decide to respond to the COVID-19 pandemic by deciding to run some or all services at weekday service levels during bank holidays.
In these instances, where possible, we expect organisations to approach their local staff side or trade union representatives to clarify which services this will affect and consult on communications which will go out to staff on this matter. Wherever possible, organisations should maintain staff goodwill be seeking volunteers rather than requiring staff to work on bank holidays.
Staff covered by NHS terms and conditions who are required to work on bank holidays, should be paid the appropriate bank holiday rate as set out in the NHS terms and conditions of service handbook. Their leave should also be credited with the public holiday so it can be taken at a later date.
If staff would normally not have worked the bank holiday (without having needed to book it off) or usually work shifts and had booked it off, the normal notice requirements for cancelling leave would apply.
If you are being asked to work bank holidays and weekends as part of a move to a full seven day service during the pandemic you will be entitled to unsocial hours payments as set out in section 2 of the NHS terms and conditions of service handbook.
For staff working in an NHS organisation, if you are being asked to cover bank holidays or weekends as overtime then section 3 of the handbook will apply.
All NHS staff are entitled to the full allocation of bank holidays, so if you are asked to work a bank holiday then you will be entitled to that day back as set out in the handbook.
For staff working in primary care (including GP practices), entitlement to pay (including enhancements) when working on public holidays will depend on your contract of employment. However, the RCN expects employers not to seek to vary contractual entitlements during the pandemic. If you have concerns regarding bank holidays you need to raise the issue with your HR Department or a more senior manager and ask the reason for this in writing. This should be done before contacting the RCN for further advice. If you have your employer’s written response but you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100.
For staff working for independent employers the re-designation, or changing, of public holidays will depend on your individual contract. Staff not covered by NHS terms and conditions should check their contract of employment for their annual leave and holiday pay entitlements. If your existing contract makes provision for public/bank holidays and conditions related to those days (e.g. pay or additional leave), you are not obliged to accept a change to your existing contract. However, employers can cancel booked leave if they give the appropriate statutory notice. If you have concerns regarding bank holidays you need to raise the issue with your HR Department or a more senior manager and ask the reason for this in writing. This should be done before contacting the RCN for further advice. If you have your employer’s written response but you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100.
Our position on bullying and harassment is clear: staff must be able to do their jobs without fear of bullying or harassment from colleagues, patients or third parties in any form. Everyone should be treated with dignity and respect at work. Any form of bullying and harassment of health and care staff in the workplace, be that from managers, co-workers, patients or members of the public, is completely unacceptable.
Throughout this pandemic, health and care staff may be experiencing and feeling high levels of anxiety and stress. It is crucial for all employers to ensure that all health and care staff providing patient care, whether they are a registered health professional, student, volunteer, or agency worker, can do so in safety.
Comprehensive advice on practical steps you can take is available in our bullying and harassment advice guide.
We expect all health and social care staff to comply with the government’s stay at home guidance if they feel unwell, or meet the requirements for self-isolation. This will reduce the risk of transmission in shared vehicles.
Every employer has a legal responsibility under health and safety legislation to carry out risk assessments during this pandemic. This includes risk assessing and advising staff in relation to:
When preparing a risk assessment, employers should balance risks and benefits of sharing vehicles with the need to support and protect lone workers.
If you have concerns about cardiopulmonary resuscitation (CPR), please see our guidance on CPR and PPE.
To help control the spread of COVID-19, additional cleaning and disinfection will be needed. For larger spaces a number of cleaning options are available, such as fogging and the use of vapour.
It is important to note:
If you have any concerns, please see our guidance on raising concerns.
If you experience any adverse effects and need support, contact us on 0345 772 6100.
For more information please see the HSE guidance on disinfecting premises during coronavirus outbreak and the UK Infection prevention and control guidance,
See our clinical guidance pages for information and advice on issues including:
If you are a student nurse, please see our COVID-19 advice for students.
The UK governments have made financial provision in the event that eligible health care workers sadly die as a result of exposure to COVID-19 at work. These are known as Coronavirus Life Assurance schemes and are detailed in rules set out by health ministers under their delegated powers.
A one-off lump sum 'coronavirus life assurance' payment of £60,000 will be payable in the event of the death of a health and social care sector worker (who worked in a publicly funded service) who dies and it is likely that they contracted COVID-19 in the course of their work. Payment is made into the estate of the deceased. This is a new benefit that will apply for the duration of the pandemic. It will be paid in addition to any other life assurance staff may have e.g. through an occupational pension scheme like the NHS Pension or Local Government Pension Scheme.
If you are a member of the NHS Pension Scheme your survivors will also receive the life assurance benefits you are entitled to under scheme rules. These are usually a lump sum plus an ongoing payment for a surviving partner and any dependent children.
The survivors of NHS staff who die as a result of COVID-19 exposure at work will receive coronavirus life assurance benefits including a lump sum of twice the workers annual salary plus an ongoing pension payment for a surviving partner and any dependent children. If the worker is in the NHS Pension scheme, their coronavirus life assurance benefit will be reduced by the amount of life assurance they receive from the NHS Pension scheme.
If a publicly funded social care worker dies without death in service cover in their contracted pension arrangements, the Scottish Government will provide a one-off payment of £60,000 to a named survivor.
We are still awaiting an announcement and continue to press for a benefit to be put into place.
In England, your survivors/estate will be eligible for the £60,000 payment if you:
The payment is made at a flat rate regardless of your length of service, working hours, pension scheme membership or immigration status.
If you do not meet the all of the above criteria, your family may still be awarded a payment at the discretion of the Secretary of State / Minister for Health and Social Care - for example if you are a student on a non-paid placement or a volunteer. This may be especially relevant where COVID-19 is not listed on the death certificate but was a compounding factor.
In Scotland, your survivors will be eligible for the life assurance payments if you:
If you are an existing member of the NHS Pension scheme in Scotland you will be eligible under this scheme but your benefits will be reduced by the amount you receive from the NHS Pension scheme life assurance.
Details on the payment for social care workers have not yet been published.
Your family should make contact with your employer who will initiate the application, discuss claim forms and any necessary documentation checks. The coronavirus life assurance schemes are being administered by the relevant NHS Pension scheme administrators.
No, but it may be counted as part of your estate for inheritance tax purposes. It will also be treated as capital for means tested welfare benefit payments from the Department for Work and Pensions (DWP) (e.g. Universal Credit and tax credits).
NHS and Social Care Coronavirus Life Assurance Scheme (England)
NHS Scotland Coronavirus Life Assurance Scheme
Northern Ireland: arrangements to be confirmed
NHS and Social Care Coronavirus Life Assurance Scheme 2020 (Wales)
The RCN will provide support and assistance to the families of members who die due to COVID-19 to ensure that they receive the payments they are entitled to. Should they encounter any problems with the applications they should contact RCN Direct on 0345 722 6100.
The RCN guidance on DNACPR and verification of death includes the need to wear PPE as an element of standard infection control precautions. Find out more at COVID-19 guidance on DNACPR and verification of death.
Nurses involved in verification of death or ‘laying out’ of patients must comply with standard infection control precautions and the appropriate use of PPE.
As the practices for caring for the deceased vary according to local, cultural and religious context, communication with key stakeholders is imperative, particularly with religious representatives and to also ensure that changes to standard practice are adhered. Transparent conversations with societal leaders led by local health and care providers is essential to maintain trust between organisations and the community.
Viewing, hygienic preparations, post-mortem and embalming are all permitted by professionals experienced in handling bodies of deceased persons, if appropriate precautions are followed, as detailed in the HSE, AAPT (Association of Anatomical Pathology Technology) and RCPath (Royal College of Pathologists) guidance.
Mourners should not take part in any rituals or practices that bring them into close contact with the body of an individual who has died from, or with symptoms of COVID-19.
Some members are reporting a shortages of body bags and are unsure how to care for deceased patients who may or have COVID-19. There is differing guidance across the 4 countries on this issue.
In Scotland, Wales and England, where the deceased was known or suspected to have been infected with COVID-19, there is no requirement for a body bag, and viewing, hygienic preparations, post-mortem and embalming are all permitted when undertaken by professionals trained in handling bodies of the deceased.
Read the full guidance
In Northern Ireland, guidance states those in direct contact with deceased bodies should use or observe the following:
a. A cloth or mask placed over the mouth of the deceased when moving them to help to prevent release of aerosols.
b. A zipped, leak-proof body bag which has had their exterior surface decontaminated using an appropriate detergent/disinfectant. The use of a body bag brings practical advantages of reducing prolonged exposure (including possible bodily fluids) from the transportation and moving of the deceased throughout their journey.
During the COVID-19 pandemic, care after death (last offices) including personal care, may be carried out by nursing staff who are not normally requested to complete this within their scope of practice. In some circumstances nursing staff may be redeployed into a role where this procedure is expected. Their line manager ultimately has responsibility to ensure the relevant support and competencies are in place and that staff members feel confident in carrying out last offices.
When undertaking care after death, the following considerations must be made:
Registered Nurses who wish to undertake this extension of their role are required to understand the Special Edition of Care After Death: Registered Nurse Verification of Expected Adult Death (RNVoEAD) guidance (Hospice UK 2020) and undertake appropriate training in order to be deemed competent to verify an expected adult death. This session is designed to support this training by presenting a case study highlighting the process and responsibilities of an RN when verifying an expected adult death. The session is available via the e-lfh hub.
The Registered Nurse Verification of Expected Adult Death session will also be added to the eELCA learning path, Resources to support staff with difficult conversations and end of life care which was created to support staff during the COVID-19 pandemic and has now been accessed by more than 20 000 users. This learning is available on the e-lfh hub.
Employers should ensure that all nursing staff are provided with factual information on COVID-19, the steps being taken to identify and manage suspected cases and what nursing staff can do to protect themselves, including reinforcing hand hygiene.
Please refer to your relevant national public health / NHS guidance. Information can also be found on our COVID-19 page.
Staff who may be required to deliver clinical care to affected patients should have the necessary skills and experience, and be provided with training and information on any additional infection prevention and control measures needed to work in such environments, including putting on and taking off personal protective equipment (PPE) safely. Employers should make sure staff have access to the appropriate PPE. Please see our guidance personal protective equipment (PPE) and COVID-19 for more information.
Employers are responsible for complying with all health and safety standards, contractual and statutory employment rights as well as equality rights.
Your employer should be carrying out risk assessments and putting measures in place to minimise the risk of exposure by following current public health guidelines on the provision and use of PPE, as well as supplies of alcohol hand gel where appropriate.
You should also be given information and training on the risks of exposure and how to minimise your risk. If you’re required to use PPE, you should be given training on how to properly use this.
The situation is changing daily and the number of cases in the UK is increasing rapidly. Make sure you follow workplace guidelines and safety procedures and practice good hand hygiene.
Please refer to your relevant national public health/NHS guidance and visit the UK government website for the most up-to-date guidance for health care professionals on the assessment and management of suspected UK cases.
Information can also be found on our COVID-19 page. If you feel your organisation is not providing the right support, see the section below on raising concerns.
Rest breaks are very important, even more so at times like this, as fatigue can lead to mistakes and increase the risk of infection. The duty is on your employer to ensure staff can take regular breaks and monitor working hours to prevent the onset of mental and physical fatigue. Wearing protective clothing for long periods can be uncomfortable and hot so, as well as rest breaks, it is also important for staff to keep hydrated. Please see our guidance personal protective equipment (PPE) and COVID-19 for more information.
Staff employed under NHS terms and conditions can find more information on our page COVID-19 employment guidance for NHS staff.
Other RCN members, including those working in general practice, through employment agencies and in the independent sector, should check their contract of employment and local policies in the first instance, or contact their employer or local occupational health service, for information and advice.
If you are struggling financially as a result of COVID-19, the RCN Welfare Service has guidance on entitlements or benefits that may be available to you, advice on what to do if you're struggling with your rent, mortgage, or creditors, and how to access further support.
See COVID-19 and your finances for more details.
If you're a student, see our advice here.
The Coronavirus Job Retention Scheme is a temporary government scheme to support employers whose operations have been severely affected by coronavirus (COVID-19). This scheme has now been extended until the end of March 2021 and may be used by employees anywhere in the UK, including those who have not previously been furloughed.
The government expects that the scheme will not be used by many public sector organisations, as most should continue to provide essential public services. This means the scheme may not be relevant to members working in the NHS, but some members working for independent employers or those working via an employment agency may benefit from the scheme.
The scheme allows employers to ‘furlough’ employees (place them on a leave of absence) and then claim for 80% of the employees’ usual monthly wage costs, up to £2,500 a month.
Employees and workers do not have an automatic right to be furloughed - it remains a decision for employers and agencies to take whether to furlough staff based on the needs of their business. Employees can be furloughed more than once under the scheme, and as of November 2020 there is no requirement to have been furloughed previously in order to make use of the scheme. Each time you are furloughed you and your employer need to agree it in writing (an email exchange may be enough to count as this written agreement). If you think you would benefit from being furloughed then in the first instance you should speak to your manager about the scheme, details of which can be found on the government website.
The Coronavirus Job Retention Scheme was extended to coincide with the latest lockdown in England, however the scheme applies across the whole of the UK. This means that if you live outside of England and believe that the scheme may be of benefit to you in your workplace you can still ask your employer whether they would consider furloughing you.
Before reading this section, please ensure you have also read the 'Furlough: the Coronavirus Job Retention Scheme' information above.
The scheme is currently scheduled to run until the end of March 2021. There is currently no maximum or minimum time you can be furloughed within this period.
If you are currently on furlough and are concerned about being unable to return to work, for example because you do not yet have childcare available, then you should make your employer aware of these issues and discuss them with your manager in the first instance.
If you are furloughed then your employer will only receive 80% of your normal pay from this scheme. This will be calculated based on your pay when the scheme was introduced in March 2020. It will then be for your employer to decide whether to only pay you this 80% or whether to top up your pay to the full amount. The RCN encourages all employers to consider paying our members their full salary not just the 80% they receive from the government whenever they can afford to do so. If you are furloughed then you should speak to your manager about how much you are going to be paid.
Employees who are furloughed for part of their working time and are working their remaining hours as usual should receive full pay for the hours they work, even if they only receive 80% for the hours they are on furlough. Please note that while at work you should be paid based on your current salary, but for any hours for which you are on furlough your pay is calculated based on the average amount you were being paid before scheme was introduced.
If an employer or agency furloughs you then you cannot undertake any work for that organisation for the duration of the time you are furloughed. If you are on part time furlough then you should only undertake work for your employer for the hours you are expected to be at work, and not any of the hours for which you are furloughed.
If you work for more than one employer/agency then it may be possible to be furloughed by more than one organisation at the same time, since each one would only be claiming based on the amount that they usually pay you.
If you have been placed on furlough leave and want to start a new job (e.g. in the NHS, on the staff bank), you need to check this with your main employer. HMRC have confirmed that employees are permitted to work for another employer while furloughed provided their contract allows that. Therefore, please check with your main employer before agreeing to undertake additional work elsewhere.
See below for answers to your questions about self-isolating, shielding and underlying health conditions.
Our redeployment page also offers advice for staff with underlying health conditions.
For more information and resources for staff with ill health or disability issues - including to speak to other members with lived experience of disability at this time - visit our Peer Support Services pages.
Employers should have policies to support employees working at home, whether permanently or because they are being asked to due to the current pandemic. These policies should cover a range of issues - from health and safety to patient confidentiality and GDPR issues. Employers should support staff to ensure compliance with these policies i.e. by providing resources for secure storage if confidential documents are being held at home.
If you are an NMC registrant, you will also need to be aware of your professional responsibilities and accountability in line with the NMC Code. You should raise any areas of concern with your employer.
See our Immigration Advice Service pages.
You should follow your existing organisational policy and guidelines on reporting patient safety and clinical incidents.
The RCN is encouraging members to report incidents relating to potential breaches in health and safety requirements which have led to exposures to COVID-19. Examples include a lack of personal protective equipment (PPE), defective PPE or not being fit tested for FFP3 masks.
Where possible provide as much evidence as you can, including witnesses and where able to do so upload photographs. If this is not possible, you should keep your own records e.g. photographs.
The Health and Safety Executive (HSE) describes an incident as a:
The RCN believes that lack of appropriate or sufficient PPE (including where shortages lead to re-use of PPE designated for single use) and issues around lack of training or fit testing for PPE are examples of undesired circumstances which should be reported. See our PPE guidance for more information.
Being deployed to an area and not receiving appropriate training to carry out your role safely would also justify an incident report, as it is an undesired circumstance - as would not being trained in how to don and doff PPE safely.
The RCN would also encourage members to report any work-related harm to their psychological health including work related stress and cases of violence, bullying and harassment or abuse.
If you don’t feel able to complete an incident form or are worried about confidentially, log your concern in writing with your occupational health provider who can support you to make your manager aware of the problem.
You should never be discouraged or victimised from completing an incident form. If you are please see our bullying and harassment guide for more information.
If you have an RCN representative in your workplace let them know about any incidents or injuries at work, so that they can follow up with your employer and offer you any necessary support, especially if you are off work as a result of an incident or injury.
An incident form also provides a useful record should you go on to develop any health conditions as a result of any workplace incidents.
Find out more in our accidents and work and personal injury guide.
You might be concerned about what protections are in place if something goes wrong in the course of your work during the COVID-19 pandemic. This is where your professional indemnity becomes relevant.
The term ‘professional indemnity’ is sometimes used to describe two different types of cover: clinical negligence cover, and representation for workplace issues.
When we talk about indemnity, we’re referring to clinical negligence cover, i.e. the cover that pays out if a patient is harmed and makes a claim for compensation against a practitioner or health care provider.
If you are providing any NHS-funded care (regardless of your employer) you are covered by a government-backed indemnity scheme in England and Wales. Entry onto these schemes is automatic. In Scotland and Northern Ireland there are slightly different arrangements for GP services.
To provide further reassurance, legislation confirms that indemnity will be provided for those who are responding to the COVID-19 emergency across the four countries, and will include those who backfill posts as well as front line staff.
NHS Resolution has published details of the Clinical Negligence Scheme for Coronavirus (CNSC), including a list of frequently asked questions.
If you’re employed outside the NHS, your indemnity cover is provided by your employer. If your employer is refusing to provide cover for you, please contact us on 0345 772 6100.
If you’re self-employed and involved in non-NHS work, you’ll need to make other arrangements. Find out if the RCN indemnity scheme covers you.
Aside from indemnity cover for clinical negligence claims, you may also be concerned about support with workplace issues such as disciplinary action, inquests or NMC referrals. Unions like the RCN provide this to their members as a benefit of membership. Some Medical Defence Organisation cover includes this service as well.
Waste is generated as a result of health and care practice/processes. There are clear responsibilities for both the ‘producer of the waste’ (the member) and the organisation responsible for the management of waste produced.
UK guidance, Health technical Memorandum (HTM) 07-01 is the overarching guidance for health care organisations to manage waste. This document provides a framework for best practice waste management to enable healthcare organisations/other waste producers meet their legislative requirements and minimise waste production.
The term clinical waste is commonplace in all health care environments including community settings, and is defined within the Controlled Waste (England and Wales) Regulations 2012 as waste from a health care activity that:
Waste generated as a result of providing care to suspected or confirmed patients with COVID-19 falls into the category of clinical waste (Category B waste) as defined by the COVID-19 waste management standard operating procedure. It is the responsibility of the person generating the waste (e.g. a nurse, HCSW, midwife) to categorise the waste correctly and place it in the correct waste receptacle (bin).
It is the responsibility of managers to ensure that health care waste is stored securely so as to prevent the escape of waste, harm to the environment and harm to human health. Failure to do so is a breach of the statutory duty of care. This applies to storage at the point of production and bulk storage areas whilst awaiting transport for onward disposal.
Where waste accumulates and is deemed excessive members should:
Capacity for the management of clinical waste across the health and care system is limited at times due to the amount of waste generated as a result of the pandemic. The communication/feedback of issues relating to waste management/co-ordination can be found in the NHS COVID-19 waste management standard operating procedure (England).
During these challenging times, you may be finding it difficult to maintain your mental health and wellbeing when coping with so much uncertainty and turmoil at home and at work.
For tips and resources on self care and looking after your mental health during the COVID-19 outbreak, see COVID-19 and your mental wellbeing for more details.
If you need further emotional support, you can access the RCN Counselling service, who are operating as normal to support members during this time.
You may also find these resources helpful:
Health Education England (HEE) has developed a module specially for returning midwives.
The RCN has also created a new Return to Practice (RTP) network to support nurses working in health and social care who are returning to work during the COVID-19 pandemic. Further information is also available from the NMC on temporary registrants and returning to practice.
If you have more than one job and are being told that you cannot continue to work in all of your roles due to potential infection control risks, you need to first establish whether your employment contract or any local policy, related to second employment, allows you to hold more than one job. If you are permitted or the information is not clear, please contact us for further advice.
If you have been asked to witness a patient's will, please see the 'signing legal documents during the course of your employment' section of our advice for witnesses.
The RCN recognises that these are unprecedented times and nursing support workers may be required to make adjustments to their normal day to day duties.
The principles of accountability and delegation can be applied to the nursing support workforce and this includes health care assistants, assistant practitioners, trainee nursing associates and nursing apprentices.
Health service providers have a duty to ensure that they meet their legal requirements to provide a safe working environment for nursing support workers to fulfil their delegated responsibilities.
Yes, providing you have agreed to accept it, verbally or by deed. The RN may be in overall charge of the nursing care, however, may need to appropriately delegate to others, according to delegation frameworks/guidance in the four nations.
If you are unable to carry out the delegated task inform the RN in order to protect yourself, your patients, the organisation and even the delegator. If you are still unsure, always seek further advice or clarification. It is advised that you may want to observe a task before asking to do it under supervision, to give you the necessary skills and knowledge you need.
It is important that you have an understanding of local policies and for you to keep your skills and competencies under constant review through regular meetings, debriefing sessions with your line manager and through clinical supervision.
Further resources to support practice are available here:
NIPEC Delegation Decision Framework
You are accountable if you accept the responsibility to perform a task. As a nursing support worker you need to be sure that you have the ability to competently perform tasks allocated to you and you are working within your scope of competency, which includes your job description and terms and conditions. You must inform a senior member of staff if you are unsure.
Nursing support workers in all settings must be supported - which includes relevant and adequate training, guidance and support - in order to provide the best possible end of life care. Due to COVID-19 there will be an increase in numbers of people with palliative and end of life care needs. This will include those who have also become palliative during the pandemic and those who have been impacted by changes to the health and care services. The RCN has developed palliative and end of life care information to support all of its members.
Dignity, respect and compassion must remain at the core of the delivery of end of life care. As far as reasonably possible, people’s cultural, religious and spiritual beliefs should be explored and respected. However, as the pandemic increases this may not always be possible. You must inform your team leader or line manager if you do not have the relevant skills, education, competencies and resources to support end of life care.
Further resources to support practice are available here:
Please see our guidance on redeployment for more information.
Department of Health
Overtime and TOIL arrangements should be detailed in your contract of employment and/or employer's policy. Please check with your employer for more information about how additional working hours will be allocated, recorded and recouped.
Any change to your working patterns should be agreed with you, in accordance with your employer's policies and your contract of employment.
Overtime entitlements are set out in section 3 of the NHS terms and conditions of service handbook.
Systems should also be put in place to ensure that you can take TOIL as soon as possible after you accrue it. Where TOIL cannot be taken within 3 months, managers are responsible for ensuring payments are made, as set out in section 3.5 of the NHS terms and conditions of service handbook.
Please check your employer’s policy for more information about how additional working hours will be allocated, recorded and recouped.
It is expected that managers will need to work additional hours to support their teams respond to the pandemic.
NHS staff at bands 8 and 9 are not usually eligible for overtime when they work beyond their contracted hours. However, the RCN is calling on all UK governments to ensure that all NHS staff receive overtime payments for hours worked beyond full-time contracted hours.
The Scottish Government issued a variation order confirming that the bar on entitlement to overtime payments for staff employed on bands 8 and 9 (section 3.6 of the National Handbook) and for Executive and Senior Managers (ESMs) should be waived in Scotland for the course of the pandemic.
The Health Department for Northern Ireland has made a temporary amendment to Agenda for Change terms and conditions to allow overtime to be paid to bands 8 and above, where required for additional duties relating to COVID-19.
In England, the NHS Trade Unions and NHS Employers have issued guidance to NHS employers outlining the issues that should be included in local policies on overtime during this period – including payment for additional hours for bands 8-9.
The Welsh Government have confirmed that Welsh NHS organisations have discretion to pay overtime at time and a half to these bands where the additional activity relates specifically to the management of COVID-19.
The RCN believes that where local policies are agreed, overtime payments for band 8-9 staff should be calculated on the same basis as for staff on bands 2 to 7.
Please see our guidance on PPE.
The Royal College of Obstetricians and Gynaecologists (RCOG) has issued updated information for pregnant women and their families. Please see in particular the RCOG, RCM and FOM joint statement on Occupational health advice for employers and pregnant women.
The RCN expects employers and occupational health departments to carry out (or review) pregnancy risk assessments for all pregnant workers. The assessment will look at your role, your work environment and the context of your health (including any underlying conditions). It must highlight any potential risks and steps to be taken to remove the risk of harm to you and your unborn child.
The clinical advice from the RCOG’s joint statement on Occupational health advice for employers and pregnant women states that ‘social distancing is particularly important for all pregnant women who are 28 weeks and beyond, in order to lessen their risk of contracting the virus’. Employers should take this into account when carrying out the risk assessment.
Where the risk can't be removed, your employer should look at suitable alternative work, including home working, the use of a single office or redeployment in line with health and safety standards.
If suitable alternative work is not available then you should be suspended on full paid leave for as long as necessary to protect your health and safety, or that of your unborn child. Employers who do not undertake risk assessments or organise suitable alternatives may be breaching the Management of Health and Safety at Work Regulations 1999 (MHSW).
If you have any concerns, discuss these with your line manager in the first instance. You may also wish to discuss the matter with your GP, midwife and Occupational Health department. It is important to contact RCN Direct on 0345 772 6100 if you feel at risk.
If you’re being asked to take early maternity leave you should inform your employer that pregnant staff cannot be required to start maternity leave early. The only requirement to start maternity leave early is if a worker has a pregnancy-related illness in the 4 weeks before their baby is due.
If your employer cannot offer you suitable alternative work, including moving to a different work area or working from home you should be medically suspended on full pay. The statutory right to medical suspension pay applies to employees across the UK who have been in their job for one month and the right lasts for 26 weeks.
If you’re being forced to take early maternity leave notwithstanding the above, you should contact RCN Direct on 0345 7726100.
Please see our guidance on redeployment.
Retired nurses are being encouraged by the UK and devolved governments to return to clinical practice to support the COVID-19 response. However, this is a matter of personal choice and they need only return to work if they choose and feel able to.
In short – no. Following representations from the RCN, the UK government has included helpful measures in the emergency Coronavirus Bill that relate to the NHS Pension (in all UK countries). This means that the three NHS Pension schemes (England and Wales, Scotland and Northern Ireland) are amended during this period so that any restrictions on returning to work are suspended. These restrictions are usually on the number of hours worked or salary earned. The requirement for members of the 2008 and 2015 schemes to reduce their earnings in order to draw down from their pension has also been suspended.
*NB - NHS earnings and NHS pension payments will still be subject to income tax at the usual rates.
Find out more at the NHS Business Services Authority website.
Your employer should make any necessary notifications.
All NHS Pension administrators (England & Wales, Scotland and Northern Ireland) are operating under their business continuity arrangements in order to provide a full service to scheme members and pensioners during this time. However, some non-critical processes may take more time as their workforce is reduced as staff have to work from home, are self-isolating or unwell. They are also supporting employers who may need to change some of their administrative processes due to other pressures.
If you were covered by NHS terms and conditions before retiring, you should be paid at the top of the appropriate pay band for the role you are doing, providing you previously worked in that pay band or higher.
If you return to the same pay band, you should not be paid at a pay point any lower than this.
If you choose to return to a lower pay band, you should be paid at the top of that band.
If you want to return to a more junior role than the role you retired from, you should be paid the top of the pay scale for that junior role.
Existing RCN members who are in the Retired category who join the temporary register will receive full support and representation as retired members whilst they are on the temporary register.
Any non members who are retired (and don’t have an active NMC PIN) who join as a retired member (£10 per year or 84p per month), will receive full support and representation as retired members whilst they are on the temporary register.
Governments from across the UK have issued guidance on the provision of education and childcare during the COVID-19 outbreak, which includes who is identified as key workers for the purposes of on-going educational provision (where relevant). The RCN expects that students who are working during this period will also be counted as key workers. Despite these measures many members may still be experiencing childcare issues that impact on their ability to work their normal contracted hours.
Here is the current guidance for each of the four UK countries:
Coronavirus (COVID-19): education and childcare
NHS Employers guidance for staff whose children need to self isolate or are affected by school closures (please see the section on caring commitments)
If you are a critical worker your local authority should find a setting for you but this may not be your usual school. If you are having trouble demonstrating that you are a key worker, you should ask your employer for a letter to this effect so that you can show to this to your children’s school/local authority.
If you need to take time away from work to care for your child, your employer should be as supportive and as flexible as possible. You could explore working flexibly or from home, or you could seek to agree a temporary change to your working hours. It is essential that any changes like this are agreed and evidenced in writing, along with how this impacts on your pay.
You should also check your employer’s policy around carer’s leave, so that you’re clear on what you’re entitled to and how you are to be paid if you take this type of leave. Find out more in our time off work guide.
The RCN believes that you should not lose pay as a result of needing to look after your children when school provision is not available.
Please be aware that this advice does not apply if you are travelling, or returning, to the UK. In this situation, please see the travel issues section below.
The RCN has called on UK governments to ensure that health and care staff do not suffer any financial detriment or loss of pay for being away from work in order to protect public safety.
In response, governments from across the UK have issued guidance on terms and conditions for staff during the COVID-19 pandemic. This guidance confirms that staff working in the NHS in every country of the UK will be entitled to full pay when self-isolating during the COVID-19 pandemic.
In England, the guidance on pay during self-isolating also applies to staff working for an NHS organisation, an outsourced service or an organisation providing commissioned NHS services.
The RCN is also calling for the following principles to be applied to staff working for any health and care employer, including primary care.
Employment guidance for NHS staff links to all four UK governments’ guidance for more information.
The governments across the UK have issued stay at home guidance for households with possible COVID-19 in England, Northern Ireland, Scotland and Wales. It applies to health care workers as well as the general public and it is clear that you must self-isolate if you have symptoms or live with someone who does. The risk of spreading the virus to patients, other health care staff or members of the public is high and it is the individual`s responsibility to ensure that every possible step is taken to avoid the spread of the virus both for the sake of health care teams and for the wider population. The Coronavirus Act 2020 came into force on 25 March 2020 and consequences of non-compliance are severe - with individuals risking a criminal record and substantial fines and, if registered with the NMC, the possibility of sanctions including being prevented from continuing to work as registered nurse.
You must continue to follow government advice on isolation and treatment and should seek advice from your employer, your GP or NHS 111 if you are unsure.
If you are told to self-isolate or fall into a category where self-isolation is recommended, you should follow your employer’s emergency preparedness procedures or other local procedure for notifying your employer of your absence.
The UK government guidance provides advice on the management of staff, and patients or residents in health and social care settings according to exposures, symptoms and test results. There may be further information specific to each country in the United Kingdom, as this guidance was written by Public Health England (PHE) primarily for an English health professionals. The information states that this guidance “should be considered alongside local risk assessment and local polices – these are guiding principles and there may need to be an individual risk assessment based on staff circumstances, for example for those working with individuals who are immunocompromised.”
Managers should remain the first point of contact for a health or social care worker who is unsure whether they are fit to work.
As contact tracing arrangements are variable across the four nations of the UK, further information is available from Health Protection Scotland, Public Health Wales, or Public Health Agency in Northern Ireland. This guidance should also be followed regardless of the results of any COVID-19 antibody testing.
If you are self-isolating, but are otherwise well enough to work, you should agree with your line manager whether working from home is possible. Your line manager should consider the work that can be done remotely, and organisations should consider developing/updating their local homeworking policies.
No. If you work in the NHS, or for organisations providing commissioned services for the NHS, UK governments have agreed that if staff need to self-isolate in line with the official stay at home guidance, they will be entitled to special leave on full pay. This special leave should be recorded separately by your employer and it will not affect your entitlements to annual leave, or to your entitlements to carers’ leave or special leave set out in your employers’ local policies.
It is possible that staff will require more than one period of self-isolation. Government guidance makes clear that self-isolation will not be discouraged, and the arrangements above will apply to each period of self-isolation.
The stay at home guidance applies to health and care staff the same as the general public. In accordance with this guidance, people must self-isolate if they have symptoms or live with someone who does.
If you are not supported by your employer to remain at home as per the guidance, inform your manager in writing that you are following UK government guidance and need to stay away from work. You should request adjustments to be made for you to work from home if you are well and it is possible/appropriate. Advise your employer that your will return to your workplace after your period of self-isolation, depending on the circumstances, in accordance with government guidance.
No. Some RCN members have been asked by their employers to sign documents which exempt them, or their employer, from adhering to government advice in order to fulfil their role.
The RCN does not support the use of these documents in any situation and urges all health and care staff to follow the government’s advice. We expect all employers to undertake individual risk assessments for any staff within vulnerable groups and to act upon the risk assessments. Based on the risk assessment employers should make appropriate arrangements, including the option of redeployment, to reduce risk and support individuals to abide by the government advice.
If you continue to be asked to sign these types of documents, please call RCN Direct on 0345 772 6100.
The government stay at home guidance on COVID-19 requires the public to self-isolate if they have symptoms or live with someone who does, and the police now have powers to enforce compliance.
During their work, some health and care staff have become aware of individuals stating that they do not intend to follow these rules. This situation can result in a conflict between a health professionals’ duty to maintain patient confidentiality and their wider duty to protect the public.
The Nursing and Midwifery Council’s Code of conduct requires registrants to act without delay if they believe that there is a risk to patient safety or public protection. This duty may override a professional’s duty to maintain patient confidentiality in sufficiently serious situations.
Nevertheless, maintaining confidentiality is critical for maintaining trust in the delivery of clinical services. The RCN are clear that breaching confidentiality without the consent of those being treated or, if relevant, their families should only be undertaken in extreme circumstances.
In the first instance, the RCN advise members to make strenuous efforts to persuade those they treat and their families to not breach the self-isolation rules.
If the patient or household member states they will now follow the rules, you do not need to do anything further.
Should the patient or household member not follow the rules, nursing staff should escalate this issue to their line managers. Line managers may then feel it necessary to refer the case to authorities, who have new powers to detain individuals who they believe to be infected.
If you are concerned, please contact your line manager. You can also read the RCN’s guidance for raising concerns here.
Please be aware that this advice does not apply if you are travelling, or returning, to the UK. In this situation, please see the travel issues section below.
If you work in the NHS you should receive full pay inclusive of all enhancements when self-isolating in line with the official stay at home guidance. This means you should be paid what you would have otherwise earned if you were not in isolation, including any pay enhancements, such as unsocial hours. If you’re unsure, speak to your employer to find out what reference period they will be using to calculate your ‘normal’ pay. In the NHS, this should be in line with section 13 of the NHS terms and conditions handbook (annual leave and holiday pay).
If you work for an outsourced service or an organisation providing commissioned NHS services in England, you will also be entitled to full pay when self-isolating. You will need to check your employers’ local policy for any reference period.
For more information on pay when self-isolating, see guidance issued by governments from across the UK here.
We expect all other health and care employers to pay their staff full pay during COVID-19 related absences.
If you are self-isolating and have not been paid your normal full pay, you need to raise the issue with your employer and ask the reason for this in writing. This should be done before contacting the RCN for further advice. If you work within the independent sector you can use this template letter to email or write to your manager asking for full pay for your COVID-19 related absence. If you have your employer’s written response (or they haven't responded within a few days) and you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100.
If you are an NHS bank worker, you will be entitled to full pay when self-isolating in line with the official stay at home guidance.
In England and Scotland, you should be paid full pay based on a “look back” approach, using a reference period of work previously worked or on the work you had booked prior to going into self-isolation. Where employers are paying self-isolating bank workers on a “look back” approach, they are encouraged to use the reference period with section 13 of the NHS terms and conditions handbook (annual leave and holiday pay). Check the employers bank’s policy for more information.
In Wales, if you need to self-isolate you will be paid for any booked shifts which need to be cancelled. The RCN is pressing the government in Northern Ireland to confirm its position.
NHS Professionals should be following the same approach as NHS banks. NHSP have developed a number of FAQs which are available on their website.
If you are working on a zero hours contract through an NHS bank you should be paid full pay when taking special leave when self-isolating.
Staff working on zero hours contracts who are not working in NHS organisations should in the first instance speak directly to their employer about any arrangements to pay zero hours workers during periods of COVID-19 related self-isolation.
If you work in England. the NHS Staff Council has published joint guidance on how NHS employers can support the bank workforce during COVID-19
In Scotland, the government has asked Health Boards to offer bank staff without part-time contracts fixed-term contracts to help manage staffing levels for COVID-19, and to offer them security and stability.
If you work in an NHS bank and/or are employed on a zero hours contract in Wales or Northern Ireland you may want to consider requesting a fixed term contract during the COVID-19 pandemic to ensure that you qualify for sick pay and other NHS national terms and conditions.
The RCN is clear that all health and care staff including agency workers should not experience any financial detriment due to COVID-19 related absences. The RCN has raised concerns with governments across the UK that agency workers providing services to the NHS will not have any income protection during periods of self-isolation. We are also calling on employment agencies to ensure that agency workers do not suffer any financial detriment if they are unable to work shifts because they are self-isolating.
In the first instance please speak directly to the agency about their policy in this situation. You should also ask what, if any, arrangements will be made to pay agency workers during periods of COVID-19 related self-isolation. Agency workers may also want to consider joining their local NHS bank or taking a fixed term contract during the COVID-19 pandemic to ensure they are entitled to full pay if they need to self-isolate.
Shielding is a measure to protect extremely vulnerable people by minimising interaction with others.
The situation around shielding is complex as the governments across the UK are easing or imposing restrictions at a different pace. Find the latest guidance below:
The RCN believes that it is vital that health and care staff do not suffer any detriment or loss of pay for being away from work in order to protect public safety. Therefore, the RCN expects all health and care employers in the UK to ensure that when staff are shielding in accordance with national public health guidelines, they must be paid their normal pay and not suffer any detriment. This includes all health and care staff - regardless of who their employer is, or what type of health or care service they work in.
If you work within the NHS, please see the NHS employers guidance Supporting our most vulnerable people.
Speak to your employer about any concerns you have. If you feel that you are being disadvantaged or you are being placed at risk, please contact RCN Direct on 0345 772 6100 for further advice.
Please see our guidance on skin health.
If you work in the NHS, the answer is no. If you are covered by NHS terms and conditions of service, any COVID-19 sickness would fall under a new full pay temporary entitlement. The length of any COVID-19 sickness absence will not impact on your existing sickness entitlements and you will be paid full pay during any the COVID-19 sickness absence.
Any sickness absence related to COVID-19 for NHS staff should be recorded separately by your organisation.
If you do not work for the NHS, check your employer’s policy for more information about sick leave and COVID-19.
COVID-19 sickness absence should not trigger any local sickness absence management procedures in the NHS. If you are not employed by the NHS, you should check your employer's policy.
You should follow any local sickness management procedures and any local and national infection control requirements before returning to work after COVID-19 sickness absence. You should also check the government guidance on recovery and self-isolation.
The latest process regarding fit notes can be found at NHS 111 Online.
See below for more on sick pay.
The RCN called on UK governments to ensure that health and care staff do not suffer any financial detriment or loss of pay when absent from work for COVID-19 related reasons. In response, the governments have issued guidance on terms and conditions for NHS staff during the pandemic.
Staff working in the NHS will be entitled to full pay when on COVID-19 sick leave. This includes enhancements such as unsocial hours and overtime. In England, the guidance on sick pay also applies to staff working for an NHS organisation, an outsourced service or an organisation providing commissioned NHS services.
The RCN is calling for these entitlements to also be applied to staff working in all health and care settings, including primary care.
If you work in the NHS you should receive full pay inclusive of all enhancements for any COVID-19 related sickness absence, regardless of your length of service and sick leave entitlement. This means you should be paid what you would have otherwise earned if you were not on sick leave, including any enhancements such as overtime. Your sick pay will be calculated in line with section 14 of the NHS terms and conditions handbook – based on your pay during the previous three months at work including enhancements (known as the reference period).
Your NHS employer may use a different reference period that has been agreed locally. If you’re unsure, speak to your employer to find out what reference period they will be using.
If you work for an outsourced service or an organisation providing commissioned NHS services, you will also be entitled to full pay on COVID-19 sick leave. You will need to check your employer's policy for any reference period.
If you work in the independent sector and you have taken COVID-19 related sick leave and have not been paid your normal pay, you need to raise the issue with your employer and ask the reason for this in writing. This should be done before contacting the RCN for further advice. Use this template letter to email or write to your manager asking for full pay for your COVID-19 related absence. If you have your employer’s written response (or if you have written and have not received a response) and you haven’t been able to resolve the issue, you should raise your concerns with your local RCN representative directly or by contacting RCN Direct on 0345 772 6100.
Where staff experience relapses and repeated periods of leave due to COVID-19, the RCN expects employers to continue to pay staff COVID sick pay, including enhancements. Any absences which are COVID-related should also not count towards any triggers for the management of sickness absence.
The RCN also expects employers to pay full COVID-19 sick pay to staff regardless of their length of service, including new starters, returners and student nurses on paid placements who responded to the requests to help manage the pandemic.
The RCN is calling for more research to be carried out to understand the impact of Long COVID on the workforce and its wider public health implications. Read more about the impact of long COVID here. Please call RCN Direct on 0345 772 6100 if you need further advice or assistance.
Don't be alone when you are facing the uncertainty of this new health condition. Speak to other members in a similar situation to give and receive non-professional support. In the first instance, you can join our closed Facebook group for members affected by COVID-19. You must provide your membership number when prompted in order to join the group and reference that you are joining for support with Long COVID.
Your rights to sick pay during any sickness absence for a non-COVID-19 illness will not change during the pandemic. If you are covered by NHS terms and conditions, the entitlements to sick pay are set out in the country-specific section 14 of the NHS handbook. If you are not covered by NHS terms and conditions, you should check your contract and/or your employer’s sick pay policy.
If you are an NHS bank worker, you should in the first instance speak directly to your bank about any arrangements for sick pay during the pandemic. The RCN is calling on governments across the UK to ensure that all health and care staff including bank staff receive full pay, as if they are at work, during any COVID-19 related sickness absence.
In Scotland, the government has asked Health Boards to offer bank workers without part-time contracts fixed-term contracts to help manage staffing levels for COVID-19, and to offer them security and stability. This would mean they would be entitled to full pay during any COVID-19 related sickness absence. Find out more here.
NHS bank workers and those on zero hours contracts in England, Wales and Northern Ireland may also want to consider requesting a fixed term contract during the COVID-19 pandemic to ensure that they to qualify for sick pay and other NHS national terms and conditions.
The RCN are clear that all health and care staff, including agency workers, should not experience any financial detriment due to COVID-19 related absences. The RCN has raised concerns with the government that agency workers providing services to the NHS will not have any income protection during periods of sick leave, beyond statutory sick pay (SSP) in most cases. We are also calling on employment agencies to ensure that agency workers do not suffer any financial detriment if they are unable to work shifts because they are self-isolating.
In the first instance please speak directly to the agency about their policy. You should also ask what, if any arrangements will be made to pay agency workers during periods of self-isolation or sickness absence.
If you do not have a contractual right to sick pay, please see the government guidance on SSP. You may also wish to look at our advice on sick pay and sick leave.
NHS Employers suggest agency workers may also wish to consider joining their local NHS bank during the COVID-19 pandemic to ensure they are entitled to full pay for cancelled shifts if they need to self-isolate.
If you are covered by NHS terms and conditions, your entitlements to sick pay are set out in section 14 of the NHS handbook. If you are not covered by NHS terms and conditions, you should check your contract and/or your employer’s sick pay policy. However, the RCN believes that you should not experience financial detriment due to the impact of COVID-19 on your scheduled treatment or surgery. We are therefore lobbying for all health and social care employers to be sympathetic to the hardship reduced sick pay may cause to staff, to use their discretion and recognise that the length of absence has been increased through the unique circumstances of COVID-19, and to consider paying full pay as part of a COVID-19 related absence. Where possible, they should also prioritise or fast track staff treatment.
The RCN offers support to all members on long term sick leave and can provide representation at formal meetings. Please call RCN Direct on 0345 772 6100 if you need further information or assistance.
During the COVID-19 crisis nursing staff will turn, like everyone else, to online communication to keep in touch and to connect with their communities.
Quite rightly, there is unprecedented interest in the experiences of nursing staff on the front line of the pandemic and concern for their welfare. Importantly, nursing staff have raised issues like lack of PPE and testing that influence government policy. They must continue to speak up.
Some members have reported pressure from their employer not to mention difficulties. Whilst sympathising with the challenges faced by employers, they must continue to draw attention to their own concerns. Nursing staff are in a unique position to provide the evidence that will lead to improvement.
The purpose of this guidance is to encourage you to keep pressing for safety improvements, but to do so in ways that will not risk damage to your career. Some disputes with employers and referrals to the NMC have arisen from the use of social media during the emergency. We want to alert you to potential problems, so that they can be avoided.
The NMC Code has a section specifically devoted to the use of social media, as follows:
“Use all forms of spoken, written and digital communication (including social media and networking sites) responsibly.” (The Code, paragraph 20.10)
The NMC has also produced a useful guide that sets out uses of social media that might breach sections of the Code.
Recently, the NMC has received some referrals to their Fitness to Practise Directorate involving the use of social media. These include posting misinformation about the virus, promoting sales of dubious products, inappropriate information about an employer or inappropriate comments about individuals. Hopefully, these cases will be resolved without long term difficulty, but registered nurses must remain aware that they are exposed to more scrutiny than the general public. Anything posted can end up in a public place, even if originally covered by privacy settings.
Those working in unregistered positions can be disciplined by an employer for unprofessional social media use.
The RCN guidance on raising concerns will lead you step by step through the process.
A few members have become the victims of trolling online. If this happens to you, you can escalate the matter to your manager and your HR department may become involved. They could even involve the police. The RCN advises members to not engage with trolls and to seek RCN support.
And remember, the RCN is here to support you. We are actively challenging local and UK-wide issues on your behalf. Come to us first by speaking to your RCN advisers or your local rep. Please visit our Get help pages or telephone 0345 772 6100.
Please see our position statement on staff living in care homes for more information.
Read our guidance to support you and your team as you welcome those returning to practice at this time.
The RCN supports testing of asymptomatic healthcare workers for COVID-19 where the risk assessment indicates that it is merited and proportionate.
The RCN is urging employers to ensure that testing is carried out in working hours at a convenient location and that there is no detriment suffered by its staff in the event of a positive test.
Members have queried whether they must agree to be tested and we set out below some of the issues they should consider when making a decision. Please contact us if you have concerns.
Yes. Under the common law, any person with capacity to make decisions about their own treatment can refuse medical intervention. However, this right does not prevent an employer or regulator from then taking action.
If your employment contract contains a clause requiring you to have testing, then refusing to comply could result in your employer taking disciplinary action against you (or even dismissing you). However, it is unlikely that many employment contracts will contain such a clause.
Even if there is no express contractual requirement to be tested, refusing the test may well amount to a breach of the implied term of mutual trust and confidence and/or a failure to comply with a reasonable management instruction. This could be deemed an act of misconduct or give rise to ‘some other substantial reason’ that may give an employer grounds to dismiss you, depending on the context in which you work and your individual circumstances. Someone who works in ITU as opposed to a non-clinical setting, for example, would be more likely to be required to take the test. Your reason for refusing would also play a part (for example, you may have a medical reason), as would the ability of your employer to deploy you safely without testing.
If you do not want to be tested, or if you want to be tested in a different way, then you should raise your concerns with your employer. Your employer must consider the health and safety requirements of the service being provided alongside your own concerns.
The RCN advocates that testing is carried out in working hours, does not require unreasonable travel and is a proportionate response to the health and safety needs of the organisation. Testing should also be undertaken consistently.
If you are unable to resolve the issues by agreement with your employer, you should contact us for further support.
The Code requires you to reduce, as far as possible, any potential for harm associated with your practice. This includes keeping to and promoting recommended practice relating to controlling and preventing infection. It also includes taking all reasonable precautions to avoid any potential health risks to colleagues, people receiving care and the public. If you unreasonably refuse testing and as a result there is increased risk to patients or the public, there is a chance that the NMC could commence an investigation, but it would very much depend on all the circumstances at the time.
There is no need for the employer to obtain a written consent in respect of the medical procedure; provided the staff member knows what a throat-swab is and knows that the test is for COVID-19, then permitting the tester to take the swab constitutes implied consent. However, consent should also be obtained in relation to the processing of that test data.
Ordinarily, your employer cannot share personal data about you with anybody else without your consent. However, if you have tested positive, then those with whom you have been in contact will need to be informed in order that they can self-isolate. This should not involve naming you, but you might be identifiable from the circumstances. Otherwise, your employer can describe their testing regime to the public.
If you are coming into the UK for the first time, or returning to the UK after any overseas travel you must follow the government guidance Coronavirus (COVID-19): how to self-isolate when you travel to the UK. Please note, this guidance is constantly under review and may change at short notice.
If you already work in the UK and wish to travel overseas, please discuss your travel plans with your employer and agree how any self-isolation period may be managed. Check your local written policy on quarantine. The RCN believes it is vital that health and care staff do not suffer any detriment or loss of pay for being away from work in order to protect public safety.
If you work in the NHS in England, please also see the NHS employers information quarantine and self-isolation on entering or returning to the UK. There is separate guidance for NHS staff in Scotland.
Government guidance is under constant review and may change at short notice. As a result, you may face quarantine requirements on your return to the UK that weren’t in place previously.
Speak to your manager as soon as possible to agree the arrangements for your quarantine period, including whether you will be able to work from home, can take leave (paid/unpaid) or use TOIL.
If you work in the NHS in England, please also see the NHS employers information quarantine and self-isolation on entering or returning to the UK. There is separate guidance for NHS staff in Scotland.
If you are currently abroad and are struggling to return to the UK, please see further advice on what to do next. You should also contact your employer at the earliest opportunity to discuss the situation and note any quarantining measures that may be required on your return.
Your employer may require you to obtain written confirmation from the relevant airline/ferry/train company that services have been cancelled.
If you require evidence that you are an essential health or social care worker in order to be prioritised for travel or be allowed to travel on an otherwise ‘freight only’ service, your employer should provide this evidence in writing as soon as possible. It would only be your employer that could provide such confirmation. The Royal College of Nursing cannot provide this letter.
In situations where pre-booked transportation has been cancelled, employers can reasonably expect you to find an alternative form of transport if the cost is not prohibitive (for example asking employees to fly home if ferries have been cancelled). Where you can demonstrate that no reasonably affordable travel options are currently available, we would expect employers to treat the absence as COVID-19 related and continue normal pay until such time as travel becomes possible.
For further information on measures taken by non-UK countries, please visit the UK government website.
As COVID-19 escalates, we understand that many British nationals residing and working overseas might want to return to the UK to be with their families and to join our frontline workers. The Foreign and Commonwealth Office (FCO) have advised against all non-essential travel, and for British nationals that permanently reside overseas to not travel back to the UK. In addition, from 8 June 2020, the UK government has imposed a 14-day period of quarantine for all travellers entering the UK.
Travel restrictions are necessary measures for preventing the further spread and escalation of COVID-19. The RCN therefore expect health and care staff living aboard to follow government’s advice and refrain from unnecessary travel. You should also follow the advice of local authorities in the relevant other country.
Government guidance lists people who may be more vulnerable to or have a higher risk of complications and higher mortality than the general population.
The guidelines advise that these individuals should practice social distancing. This means that they should avoid contact with someone who is displaying symptoms of coronavirus. Also avoid non-essential use of public transport, varying your travel times to avoid rush hour, when possible and work from home where possible.
If you meet the definition of vulnerable as set out in government advice, and during the course of your work, you are likely to come into contact with someone who is displaying symptoms of COVID-19, you should inform your line manager immediately.
The RCN would expect employers and occupational health lead to carry out a health and safety risk assessment and put systems in place to minimise the risk of harm and allow the health care worker to work safely. The employer also has a duty to make reasonable adjustments where the staff member has identified themselves as disabled.
Organisations such as Diabetes UK and Asthma UK provide additional advice on working with long term conditions.
Please also see our guidance on redeployment.
See ‘shielding’ above for more information.
You should escalate your concerns to your line manager in the first instance, having checked your employer’s COVID-19 response policy. The RCN has advice on how staff can approach raising concerns should your manager be unsupportive.
Further guidance for employees and employers is also available.
Please call RCN Direct on 0345 7726100 if you cannot resolve your concerns with your employer.
Read our uniform and workwear guidance for more information.
Find resources and guidance around COVID-19 vaccination delivery on our public health pages.
The RCN welcome the indication from the Joint Committee for Vaccination and Immunisation (JCVI) that when a safe, effective vaccine is available, health care staff will be in the first priority groups to be offered it (see JCVI Interim statement).
The RCN would expect organisations to make sure this is made available for all health and care staff as soon as possible.
The RCN would encourage members to access the vaccine to help protect themselves as well as their families and friends.
Similar to our position on the influenza vaccine for staff, the RCN do not support staff being made to have the vaccine. We are concerned that mandating staff to have the COVID-19 vaccine would not be effective or increase uptake. Staff vaccination should not be used as part of staff contracts, terms and conditions of employment or linked to pay.
The RCN recommends that all organisations have a proactive approach and make sure their staff have easy access to the vaccine when available - and within the working day.
If you remain anxious about having the vaccine, the RCN would support your decision. It may be appropriate for your employer to consider redeploying you to lower risk areas, for example.
If you are experiencing difficulties in your workplace related to the COVID-19 vaccine, please contact us on 0345 7726100 for further support.
RCN members who wish to support the delivery of care and treatment to patients and the public during the pandemic can do so in a range of ways, including:
Our guidance on redeployment will help you if you're changing or taking on a new role.
If you are registered nurse who has left the register within the last 3 years you can apply to re-join the temporary NMC register and find more information about how to do this on the NMC website.
For nurses who are already on the NMC register wishing to return to clinical practice you will need to apply directly to any local employers who you wish to work for (see below). This is the same for those who wish to work as a nursing support worker.
Many employers are setting up fast track recruitment systems to support this. Check local websites for information. You can also join an employer’s bank or an agency to work flexibly.
Some organisations in England use NHS Professionals who have set up a rapid response process.
Most jobs within the NHS across England and Wales are advertised on NHS Jobs website.
If you're interested in volunteering (as opposed to working) to support efforts to tackle the COVID-19 pandemic, NHS Volunteer Responders is a new group that will carry out simple, non-medical tasks to support people in England who have been asked to shield themselves from coronavirus because of underlying health conditions. They will be used by healthcare professionals to make sure people who are highly vulnerable are able to stay safe and well at home.
Members in Northern Ireland who are interested in volunteering in hospitals should contact their local Health and Social Care Board for more information,
For paid work opportunities, please go to the HCSNI Jobs website for more information.
Members in Scotland who are returning to clinical practice, or are currently practicing but want to be redeployed to work for NHS Scotland can find more information on the Scottish government webpages.
Paid work opportunities can also be located through contacting agencies and through the NHS Scotland jobs site.
For members in Scotland, volunteering opportunities can be found by approaching your local NHS Board directly or through contacting Volunteer Scotland.
In addition to NHS Jobs, links to current vacancies for registered nurses and healthcare support workers can be found on each Health Board’s website:
Volunteering opportunities can be found at Volunteering Wales.
The Working Time Regulations were adopted to ensure the health, safety and wellbeing of workers at the workplace. The 48-hour maximum working week is an average over an agreed reference period, usually 17 weeks. The reference period can be extended to up to 26 weeks without agreement or up to a maximum of 52 weeks with agreement between the employer and local trade unions.
Your employer can ask you to work more than 48 hours in any one week, without the need for an opt out - as long as they reduce your hours within the appropriate reference period, to even out your average weekly hours.
The RCN expects that during the pandemic, all employers across the UK should refrain from approaching staff to sign up to ‘individual opt-outs’ of the 48-hour average working week. According to the regulations, employees can choose to opt out of the average working week. However, the regulations make it very clear that an individual opt out is entirely voluntary.
Contact your local RCN representative or RCN Direct on 0345 7726 100 if your employer is seeking your opt-out on a continual basis or beyond the reference period that applies in your workplace.
Where staff are working long hours, employers should provide an appropriate level of supporting facilities such as rest areas, accommodation, access to food and drink, toiletries etc. as required, to enable the safe and effective provision of services during this period.
There should be no requirement for staff to sleep on site. If there are sleep facilities available for staff who wish to use them, this should be managed via existing or adapted local policies with increased infection control measures.
See the Department of Health and Social Care (England) guidance on the health, safety and well-being of staff for more information.
The 48-hour weekly average is the limit of what you should work, even if you have more than one job. Your employer must make sure you are not working more than an average 48 hours a week in total across both jobs. Employers must maintain accurate records and take measures to protect the health, safety and wellbeing of workers even during the pandemic - so your employer(s) can ask you about your working hours with another employer.
The risks of working 12-hour shifts in a critical care environment during the COVID-19 pandemic should not be ignored. They include:
There is also the significant psychological impact of caring for COVID-19 patients.
The Health and Safety Executive recommend the avoidance of shifts that are longer than 8 hours where the work is safety critical and physically demanding. They recommend that where 12-hour shifts are implemented there should be adequate rest breaks and that 12-hour night shifts should be limited to two or a maximum of three in a row.
The health and safety of health and care staff is of paramount importance. Where 12-hour shifts cannot be avoided, the RCN expect the following safeguards to be put in place:
If your employer isn’t following the above guidance, speak to your manger in the first instance. For further support, call RCN Direct on 0345 7726 100.
Page last updated - 01/12/2020