Updated: 06 May 2020
The Welsh Government’s current phase of testing for COVID-19 is focussed on critical workers (including non-healthcare workers), symptomatic patients in hospital and symptomatic care home residents. On 28 April 2020, the Welsh Government announced that an online booking system for coronavirus tests will be available from 30 April 2020 and that lab capacity for tests is over 2000 per day. The policy and arrangements for testing in Wales are different to those in England, Scotland and Northern Ireland. This briefing outlines how the COVID-19 testing policy in Wales has changed over time, the current testing policy and the amount of testing taking place in Wales.
The test that is in regular use in Wales and the UK is an antigen test. This swab test is used to identify whether someone is currently infected by the virus. Guidance on the testing process, including information on booking an antigen test, has been published. An effective, reliable antibody test (blood test) is being sought for use by Governments in the UK, to detect previous exposure to COVID-19 and potential immunity.
How testing policy has changed over time in Wales
Initial response
During the initial ‘contain’ phase of the UK’s response to coronavirus, the focus was on detecting early cases and following up close contacts. Symptomatic individuals were tested for the virus; in Wales this began on 29 January 2020 with those returning from overseas. Wales also began testing frontline NHS staff on 7 March 2020.
Focus on hospital admissions
On the 12 March 2020, the UK entered the ‘delay’ phase, with the aim of slowing the spread of COVID-19. The Chief Medical Officer (CMO) for Wales subsequently issued advice (PDF 168KB) to the NHS on changes to testing criteria. This specified that testing of individuals displaying COVID-19 symptoms was not routinely recommended, and outlined criteria for testing symptomatic individuals who required admission to hospital. It also included interim criteria for testing key frontline healthcare workers, and clusters of disease in residential or other care settings.
At this time, the Welsh Government (and other governments across the UK) were asked why the UK approach to testing apparently differed from the World Health Organization’s (WHO) advice. WHO said that every suspected case of COVID-19 should be tested, as well as those they have been in close contact with.
New testing plan
On 7 April 2020, the Welsh Government published details of its COVID-19 testing plan for Wales. It outlined testing prioritisation and the intention to test more key workers and ultimately members of the public (as testing capacity increases). The Welsh Government described its plan as “complementary and interoperable” with the UK Government’s testing strategy for England, also published in early April.
New policy of testing critical workers
On 18 April 2020, the Welsh Government published an additional policy which sets out its current approach for testing of “critical workers”. The broad categories of critical workers include:
- Health and social care workers;
- Public safety (emergency workers) and national security workers;
- Local and national government workers;
- Education and childcare workers;
- Workers in businesses related to food and other necessary goods;
- Transport workers;
- Utilities, communication and financial services workers; and
- Key public service workers.
On 22 April 2020, the Minister for Health and Social Services (the Minister) said in Plenary “we're now testing all symptomatic care home residents and all care home residents who are returning from hospital. All symptomatic care home workers themselves can now also be referred for testing.” On 2 May testing was extended to all residents and staff in care homes with outbreaks.
On 28 April 2020, the Welsh Government announced that an online booking system for coronavirus tests will be available from 30 April 2020, allowing people to book tests at drive-through centres in Cardiff and Newport. The new system will later be rolled-out to other parts of Wales. On 29 April 2020 guidance on the testing process, including information on booking a test, was published.
The most recent update on testing shows that as of 1pm on 26 April 2020, 33,257 tests have been done (13,406 of healthcare workers).
Testing capacity
The testing plan for Wales highlights that testing capacity is dependent on a number of factors, including the availability of test kits, the ability to safely increase laboratory activity, appropriate staffing, and suitable information management systems.
On 5 April 2020, the Welsh Government set out its aims for an increase in capacity:
We currently have capacity to carry out approximately 1,100 tests a day in Wales. By mid-April, we will have capacity to provide up to 5,000 antigen tests a day to people admitted to hospitals with suspected coronavirus, frontline NHS staff and people who are classed as extremely vulnerable. A further 4,000 antigen tests a day will be available as part of a four-nation deal for the UK – these will be available to people in the community. As soon as an antibody test has been verified for use in the UK, this will be available in Wales, in addition to the antigen tests.
On 18 April 2020 the Welsh Government published a review of its coronavirus testing regime. This described a “range of delays” and “supply chain issues”, and confirmed that the target of 5,000 tests per day by the third week of April would not be reached. During questioning at its press conference on 20 April, the Welsh Government said that it would no longer be setting targets for testing.
The Welsh Government’s review includes recommendations to improve test referral and results processes, and a commitment to provide weekly updates setting out expected and actual increases in testing capacity. The first weekly update (22 April 2020) showed that lab capacity was 1,800 tests, with 1,033 tests having been carried out in the previous 24 hours. It also showed that over 98% of results are being authorised within three days regardless of testing location (whether drive-through centre, hospital or testing unit). However, it does not show how long it takes for an individual to receive their result. It stated that “this information will be provided when the testing referral app is available”.
The second weekly update (28 April 2020) shows that lab capacity remains at 1,800 tests, with 1,250 tests carried out in the previous 24 hours. On 28 April 2020, following a media briefing the BBC reported that the Minister said “daily capacity has now reached 2,000, with 1,191 tests actually carried out yesterday.”
Testing centres
The Welsh Government’s review of its Coronavirus testing regime outlines plans to increase access to testing across Wales. On 22 April 2020, the Minister also said in Plenary that the Welsh Government thinks it is “getting closer to home testing”.
The most recent weekly testing update published on 28 April 2020 states:
The Cardiff City and Newport testing site has started testing non-health key workers, including fire, police, prison officers and care home workers in the South East Wales area. They are linked to the UK wide testing programme operated by Deloitte. Swansea Bay also have a testing unit at a sports field just off the M4 outside Neath Port Talbot. Our aim is to have a network of these sites, where people can travel to be tested within 30 minutes of their homes.
On 28 April 2020, the Welsh Government announced that a testing centre in Llandudno would open on 29 April 2020 and a centre in Carmarthen centre would start testing critical workers on 30 April 2020.
Wales’ recovery framework
On 24 April 2020, the Welsh Government published its “Leading Wales out of the coronavirus pandemic: a framework for recovery”. Whilst the framework does not include specific information on testing, the framework states that the Welsh Government is “focussed on further understanding and measuring the level of infection that is present in Wales” and is “stepping up” testing capacity to do so.
With regards to public health surveillance, it outlines plans to:
…monitor transmission in communities, in vulnerable groups and in NHS care settings. Once a vaccine is available, surveillance will shift to monitoring vaccine impact, uptake, vaccine failures and adverse events, changes in epidemiology and strain variation in the virus, and control of outbreaks.
Further information
- Public Health Wales’ interactive data dashboard includes daily data on numbers of confirmed cases and tests carried out (broken down by local health board and local authority area), and numbers of deaths (by local health board).
- UK Government webpage on the latest number of COVID-19 cases and risk level in the UK.
- Office for National Statistics data and analysis related to the coronavirus (COVID-19) pandemic and its impact on our economy and society.
- House of Commons Library briefing with further information about coronavirus testing in England.
- The Scottish Parliament Information Centre (SPICe) COVID-19 FAQs.
Article by Philippa Watkins and Emily Williams, Senedd Research, National Assembly for Wales
We’ve published a range of material on the coronavirus pandemic, including a post setting out the help and guidance available for people in Wales and a timeline of Welsh and UK governments’ response.
You can see all our coronavirus-related publications by clicking here. All are updated regularly.
