Abstract
BackgroundAs COVID-19 death rates have risen and health-care systems have experienced increased demand, national testing strategies have come under scrutiny. Utilising qualitative interview data from a larger COVID-19 study, this paper provides insights into influences on and the enactment of national COVID-19 testing strategies for health care workers (HCWs) in English NHS settings during wave one of the COVID-19 pandemic (March–August 2020). Through the findings we aim to inform learning about COVID-19 testing policies and practices; and to inform future pandemic diagnostic preparedness.MethodsA remote qualitative, semi-structured longitudinal interview method was employed with a purposive snowball sample of senior scientific advisors to the UK Government on COVID-19, and HCWs employed in NHS primary and secondary health care settings in England. Twenty-four interviews from 13 participants were selected from the larger project dataset using a key term search, as not all of the transcripts contained references to testing. Framework analysis was informed by the non-adoption, abandonment, scale-up, spread, and sustainability of patient-facing health and care technologies implementation framework (NASSS) and by normalisation process theory (NPT).ResultsOur account highlights tensions between the communication and implementation of national testing developments; scientific advisor and HCW perceptions about infectiousness; and uncertainties about the responsibility for testing and its implications at the local level.ConclusionsConsideration must be given to the implications of mass NHS staff testing, including the accuracy of information communicated to HCWs; how HCWs interpret, manage, and act on testing guidance; and the influence these have on health care organisations and services.
Highlights
As COVID-19 death rates have risen and health-care systems have experienced increased demand, national testing strategies have come under scrutiny
Drawing on the results of interviews with UK scientific advisors and health care workers (HCWs) this paper provides insights into national COVID-19 testing policies and practices in English NHS health care settings during the first wave of the COVID-19 pandemic (March–August 2020)
This paper draws on a subset of 24 interviews discussing testing from 13 Caucasian participants
Summary
As COVID-19 death rates have risen and health-care systems have experienced increased demand, national testing strategies have come under scrutiny. Utilising qualitative interview data from a larger COVID-19 study, this paper provides insights into influences on and the enactment of national COVID-19 testing strategies for health care workers (HCWs) in English NHS settings during wave one of the COVID-19 pandemic (March–August 2020). The importance of ongoing diagnostic testing as part of an integrated approach to pandemic containment has been well documented, with a range of benefits including understanding infection rates, providing appropriate health care, preserving lives, preventing international spread and minimising response costs [3,4,5]. Challenges noted by the authors included shortages of diagnostic materials, supply chain disruptions and limited national and local surveillance and diagnostic capacity [6]
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