Guidance for critical health services during an Omicron outbreak

Last updated: 7 April 2022

On this page:

Definition of ‘critical workers’ and ‘critical health services’ in the context of the Omicron response
Access to rapid antigen tests (RATs) for critical health services
Guidance for return to work for healthcare workers
Additional guidance to support implementation of the guidance for managing COVID-19 healthcare staff exposures at work
Templates for exposure event management

Now that New Zealand has transitioned to the COVID-19 Protection Framework, (also known as the ‘traffic light’ system) from the previous Alert Level System, the day-to-day operations of health and disability services have changed when there is COVID-19 in the community.

Under Alert Level 4 in the previous system, there were stay-at-home orders and lockdowns, where all non-essential health and disability services were required to close. The new COVID-19 Protection Framework does not rely on lockdowns, and all health and disability services and their workers can continue to operate under the COVID-19 Protection Framework, critical or not, during green, amber and red. In response to community transmission of the Omicron variant of COVID-19, the Ministry of Health has released a three-phase response.

In phases 2 and 3 of the Omicron response, critical health workers who are close contacts can utilise rapid antigen tests (RATs) to ensure they can return to work during their isolation period, providing they produce a negative test prior to their shift. This reflects the critical nature of their work including the necessity of these services to prevent death or serious harm and that these services can only be conducted in person in the workplace.

All other workers across the health and disability system are still able to operate under the COVID-19 Protection Framework, and close contacts should instead follow the self-isolation guidelines highlighted on the Ministry of Health’s Contact Tracing page in the event of a COVID-19 exposure.

Definition of ‘critical workers’ and ‘critical health services’ in the context of the Omicron response

Within the health and disability settings, a ‘critical worker’ is somebody who works for a critical health service, in a role that:

must be performed in person at the workplace; and
requires a person with particular skills; and
must continue to be performed to:
- prevent an immediate risk of death or serious injury to a person or animal; or
- prevent serious harm (social, economic or physical) to significant numbers in the community.

Any health and disability worker that meets the above definition, works for one of the critical health services listed in our information on critical health services in the health and disability system document below, and is identified as a positive case of COVID-19 or a close contact, should refer to the guidance documents on this page.

Critical health services in the health and disability system have been identified as those that meet one or more of the following five criteria:

A health and disability service that provides direct, hands-on care and support that maintains a person’s necessities of life.
A health and disability service that ensures the safety of the critical workforce.
Disability Support Services (DSS) and Aged Care services, including Home and Community Support Services (HCSS), that support high-risk and vulnerable client groups.
Crisis support for people who feel unwell or are unsafe (e.g., funded helplines, refuges and family violence services, sexual violence crisis services).
A health and disability service that enables the delivery of equitable care to those people most at risk of harm.

Further information about critical workers and critical health services in the context of the Omicron response, including a full list of critical health services are in the documents below:

If the service you provide does not fall under any of the critical health services groups highlighted in the document above, and you believe a new group should be included, please email the Ministry of Health at [email protected] and confirm which of the five criteria your service meets in your email.

Access to rapid antigen tests (RATs) for critical health services

Many health and disability employers have already been front loaded with a supply of RATs. They include:

COVID response organisations – DHBs, GPs, pharmacies, PHOs providing frontline services, and community health providers (and Police, MIQFs and first responders)
High-density vulnerable populations – ARC, hospice and other residential healthcare facilities (and Corrections and Youth Justice facilities).

If you are an organisation, an employee or a contractor delivering a critical health service that has not been front loaded with a supply of RATs from the Ministry of Health, please register for the Close Contact Exemption Scheme through MBIE’s Business Connect Website.

More information about how to order RATs once registered, and guidance RAT testing guidance for critical workers during phases 2 and 3 of the Omicron response is available on the Ministry of Health’s rapid antigen testing page.

Guidance for return to work for healthcare workers

The guidance below can be used where healthcare workers are COVID-19 cases or contacts. Guidance covers both when service provision is not at risk of substantial compromise due to staff absence as well as when there is a risk of substantial compromise.

Information sheets for critical Health Care Workers (HCW) returning to work, if service delivery is at risk by their absence

These information sheets refer to scenarios outlined in the guidance document above Guidance for return to work for healthcare workers. These are intended for the affected worker. Managers should refer to the guidance document above for further information.

See the relevant exemption notice issued by the Director-General of Health pursuant to clause 30 and clause 27A of the COVID-19 Public Health Response (Self isolation Requirements and Permitted Work) Order 2022 for critical workers delivering a critical health service who are confirmed or probable cases of COVID-19: Director-General of Health Notice for critical healthcare workers

Key information for organisations

Where healthcare workers are either cases or contacts the guidance can be applied.
For healthcare workers who are identified as close/higher level contacts in the community or while at work, return to work can be managed using the guidance.
Healthcare workers who are COVID-19 cases or probable cases may return to work using the guidance providing they are asymptomatic or mildly symptomatic (and improving) and taking appropriate precautions.
A COVID-19 Public Response (Self-isolation Requirements and Permitted Work) Order 2022 is now in place as of 4 March 2022, allowing critical healthcare workers who are a confirmed or probable case to return to work.

Key information for individual healthcare workers

Ensure you engage with your employer or occupational health team at work to let them know if you have been identified as a case or a contact of COVID-19.
If you have been identified as a case or close contact, your employer will be able to work with you to support your health and safety. Where you have been identified as a critical part of the health team to keep services going, a safe return to work can be managed through a ‘Test-to-return’ approach.
Outside of your workplace setting, you will need to continue to follow the public health advice for community cases or close contacts.

Additional guidance to support implementation of the guidance for managing COVID-19 healthcare staff exposures at work

For guidance on how to apply the risk assessment matrix and categorisation of healthcare workers exposed to COVID-19 at work in Primary Care or in Home Community Support Services, please read the appendices below as relevant to your setting. Other services may also find this additional guidance useful.

Primary care

This guidance is intended to provide an understanding of expected processes and the implications for clinical practice and service continuity in Primary Care settings.

Home and Community Support Services

This guidance is for use for HCSS providers who hold current certification under their respective service standards and are contracted by the Ministry of Health, Ministry of Social Development, ACC or DHBs.

Templates for exposure event management

To assist you to undertake a risk assessment of a COVID-19 exposure event in a healthcare setting, use Template 1 to have a ‘living’ summary of the relevant information about your service. We recommend reviewing it monthly to keep this document live.

Template 1: Risk Assessment Preparation (Word, 27 KB)

The templates below are designed to help to support the healthcare provider with application and documentation of the risk assessment and contact categorisation matrix. These are not mandatory for use, but are intended to be used as decision-making tools and support provider documentation.

This advice will be updated as the COVID-19 situation continues to evolve. Updates will be made available through this website and the documents attached to it. The Ministry of Health welcomes any feedback to inform future iterations of our workforce COVID-19 case and exposure guidance documents. This can be sent to [email protected].