LBS COVID-19 Self-Isolation Local Risk Assessment support

Request for critical worker exception

 
You will need to complete this form to request critical worker exemption from self-isolation. This process will remain in place until the national guidance changes on 16th August 2021. 

Please be aware that exemptions are agreed on a case by case basis and before completing this form you should have taken all actions to maintain business continuity as detailed in your business continuity plan.

If you have done this and still feel that your service cannot continue safely, this form will allow you to identify specific individuals and specific, face to face tasks that will ensure your  service operates safely. This process is only available to staff who:

• are contacts of a non-household COVID-19 case,
• are fully vaccinated with both doses of an MHRA approved vaccination and more than 14 days had elapsed since the final dose at the time of last contact with the positive case,
• have a negative PCR test result,
• can test with lateral flow tests for at least 7 days (and to a maximum of 10 days/ completion of the identified isolation period) prior to starting work each day,
• can use appropriate PPE.

If you have any problems completing this form, please contact publichealth@sutton.gov.uk for assistance.

PLEASE READ BEFORE CONTINUING

 

Before filling out this form please make sure you have worked through your business continuity plan (BCP) in order to eliminate or mitigate any potential risks arising from absences due to staff having to self-isolate.

Please note that a senior responsible officer or director within your organisation can also provide authorisation of exemption and they should be approached first for discussion.

Only proceed if after consulting your BCP and/or senior members within your organisation you are still concerned that there is a real and serious risk of harm to your resident/clients from continued staff absences.

The staff member should be advised to follow the advice provided to them by NHS Test and Trace and/or the NHS COVID-19 App and self-isolate at home for the required period of time.

Please click Submit.

This is required for being considered for an early return to the workplace. A test should be obtained as soon as possible. If their test is positive, they are not eligible and will need to self-isolate at home for a full 10 days from the date of the test if asymptomatic, and if symptoms develop during this period, then the 10 days restarts from the day after the symptoms started.

Please click Submit.

Daily lateral flow tests are required for people making an early return to the workplace. The results must be entered onto the NHS Test and Trace Portal (www.gov.uk/report-covid19-result). If a LFT is positive, the person will need to self-isolate at home and take a further PCR test.

Please click Submit.

Please obtain the member of staff's permission before providing any details.

Please click Submit.