A quick guide to…lateral flow testing in England

NHS England is rolling out lateral flow testing for asymptomatic patient-facing staff working in primary care.

The test is self-administered and produces results within 30 minutes.

Optometrist and OT multimedia clinical editor, Ceri Smith-Jaynes, provides tips on how she is using the test in practice.

How do you use lateral flow tests in your practice? And who uses them?

All of our staff use lateral flow tests as they are all customer-facing at times. We ordered one box of 25 tests for each staff member, at no charge, through the Primary Care Services England portal. We contacted our locums to see if they needed any tests, but they were already provided by their other employers. We self-test at home twice a week or every three to four days, either the night before work or early that morning – you don’t want anyone turning up at work only to find they test positive.

Optometrist Ceri Smith-Jaynes

Why did you introduce lateral flow tests?

With vaccines, cleanliness, ventilation, distancing, and personal protective equipment, the tests are another weapon in our arsenal against the pandemic. Although there are limitations to the lateral flow test, there is a benefit in testing asymptomatic staff who have to come to work anyway. We can’t use a negative test result as an invitation to drop our guard, but we might just catch a staff member with a high viral load before they leave the house. The frequency of testing helps balance out the high false negative rate.

What are your top pointers for using the tests effectively?

The instructions provided by the manufacturer have been superseded by instructions from the NHS. You can view a video online and read the NHS instructions for use.

You could train a staff member, who shows the others how to do it the first time. A key point is to blow your nose and wash your hands before you start, then lay out all the parts you’ll need. I use a bottle cap to stand the vial up and drop just six drops of the extraction buffer solution into it. Roll the swab slowly around each nostril 10 times, inserting most of the fuzzy bit. Have a tissue to hand as this may make you sneeze.

When you dip the sample into the vial, give the sides of the vial a good squeeze to extract your nose contents into the solution. After dropping two drops of this onto the cassette, I set a timer for 30 minutes. Reading the test much after 30 minutes can result in a false positive. I also take a picture of the bar code on the cassette as I might not have time to log the result in the leaving-for-work-on-time flap.

Although taking the test is voluntary, reporting the result is mandatory and should be done within a day, whether it is positive, negative or invalid. This can be done online.

NHS England has released answers to a series of frequently asked questions about lateral flow testing. The standard operating procedure for England is also available online.