Guidance: Quarantine arrangements for exempt nurses arriving from overseas

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This guidance set out the standards required for NHS trusts to provide managed quarantine accommodation (hospital managed quarantine) for internationally recruited nurses who are taking up immediate employment in the NHS in England, and who are from or travelling through red-list countries. The exemption does not cover nurses already employed by the NHS or nurses returning from abroad for any other reason (for example, holiday or visiting family).

These nurses are exempt from red-list hotel managed quarantine (also known as managed quarantine service or MQS) if compliant NHS trust-arranged accommodation can be used for the duration of their quarantine period (youll find details on the length of quarantine related to testing in the Testing section of this document).

Trusts may choose not to use the exemption and to fund MQS as an alternative. If a trust cannot provide compliant accommodation, MQS must be used. We encourage trusts to work on a regional basis to provide compliant trust-arranged accommodation where possible.

NHS trusts are responsible for the safe and effective quarantine of all nurses in hospital managed quarantine and must ensure adherence to these guidelines.

Assessment that accommodation adheres to these standards needs to be signed off by the trusts Infection Prevention and Control (IPC) lead and Director of Nursing. Ongoing compliance must be reviewed on a monthly basis. If changes to the provision of accommodation or standards required means accommodation becomes non-compliant, the trust must not accept further nurses for hospital managed quarantine until compliance is achieved.

Travel groups

When nurses are recruited as a cohort and travel together from and/or through red-listed countries, they may be considered a travel group. This means they will be able to quarantine together and share facilities. Regardless of cohort sizes for flights, on arrival in the UK, travel group numbers should be minimised and be no larger than 6 individuals, as smaller group sizes reduce the risk of many nurses being delayed from starting work should a member of the travel group test positive for COVID-19. All recommended control measures (including maintaining social distancing, wearing face coverings and handwashing) will be required within a travel group throughout quarantine.


The legal exemption from hotel MQS is set out in regulations.

It only covers nurses coming from or travelling through red-list countries to take up immediate NHS employment in England.

Eligibility does not extend to family or dependents. If nurses are bringing children or family, the family unit as a whole will need to quarantine in an approved hotel (MQS).

The red list of countries is regularly updated check the GOV.UK website regularly to make sure you know which countries are affected.


As well as following the guidance in this document, nurses will need to comply with all other guidance on managing the COVID-19 risk. Government guidance is subject to change always refer to the latest guidance on GOV.UK.

Relevant guidance includes, but is not limited to:

Coronavirus (COVID-19) testing before you travel to England

Fill in your passenger locator form

Entering the UK

(COVID-19) Coronavirus restrictions: what you can and cannot do (post-quarantine)

Before arrival

Before departure the trust will need to provide the nurse with a letter setting out their eligibility for the exemption, for the benefit of Border Force officials on arrival. This letter should include the following details:

  • full name
  • date of birth
  • name of employing trust and trust contact number
  • passport number
  • Certificate of Sponsorship number
  • date of arrival
  • arrival airport

A template letter will be sent to trusts to ensure the information is complete and in the same format. Border Force will ensure that the details on the letter match the passport, visa and Certificate of Sponsorship that the nurses will show on arrival.

It is vital that all details are accurate to ensure the nurse has no problems entering the country. Border Force may contact Trust International Recruitment leads directly to confirm planned employment and check details to mitigate fraudulent use of this exemption. Please ensure up-to-date contact details are provided, including out of hours contact details if possible.


Nurses must be able to travel from the airport to hospital managed quarantine accommodation in COVID-19 secure private (including trust-owned) transport. Coaches or minibuses are to be used as preference to ensure easier social distancing from the driver and, where relevant, other travel groups. Private cars or taxis can be used on an exceptional basis.

Trusts may want to work together on a regional basis to plan transport for travel groups (nurses that are recruited as a cohort and travel together no greater than 6 per group). More than one travel group may travel on the same coach as long as done so in adherence with guidance outlined below.

Nurses must go straight to meet the trust representative/driver on arrival at the airport. They must not use facilities once through immigration control.

Details of the standards required for secure travel can be found in Coronavirus (COVID-19): taxis and PHVs.

Main points are:

  • all travellers and drivers should wear face coverings, regularly clean their hands before and after every contact and maintain social distancing where possible at all times
  • ensure good ventilation within the vehicle through open windows and no recirculated air in the vehicle
  • ensure a three-row barrier between the driver and all separate travel groups in the same vehicle
  • ensure on-board toilet facilities are available for longer journeys
  • ensure that transport does not stop at any services (including at the request of passenger), unless in an emergency such as fire. Drivers must ensure adequate fuel in advance of pick-up. Where the journey is more than 4.5 hours long, the driver must take the legally required break, but nurses must remain in the vehicle
  • ensure cleaning of the vehicle after use and drop-off

Internal flights must not be used by nurses coming from or travelling through red-list countries

Accommodation requirements

Hospital-managed accommodation for quarantining nurses must be private or trust-provided accommodation and the building must be used exclusively for quarantining. Commercial hotels must not be used.

The accommodation must provide individual en-suite bathroom facilities and individual food facilities for nurses quarantining alone. Where accommodation has communal areas (bathrooms, kitchens) and provisions for travel groups (groups of no more than 6 nurses that are recruited as a cohort and travel together), the communal areas (bathrooms, kitchens) must only be used by one self-contained travel group.

Trusts may want to work together on a regional basis for quarantining travel groups of nurses arriving together to maximise use of the accommodation available.

Wherever possible, accommodation buildings should house only nurses quarantining from red-list countries or nurses quarantining from non-red-list countries. If this is not possible, clearly defined floors/areas of buildings should be identified for red-list and non-red-list quarantine.

One-way systems should be put in place to ensure appropriate separation and social distancing while entering and leaving quarantine accommodation.

All quarantining accommodation must have individual ventilation systems (for example, room or window fan coil units that do not recirculate to other parts of the building) or windows that open (safely).

Nurses who have completed quarantine must be in separate accommodation from quarantining nurses.

Nurses in quarantine must have:

  • access to suitable food and drink (taking into account personal, religious or social dietary requirements) either provided by the trust or using facilities provided to access this (for example, refrigerators, kettles, microwaves, hobs, ovens, cutlery and crockery)
  • an on-call provision from the trust to check on the nurses each day (this may be informal, for example via WhatAapp or regular phone calls)
  • a contact number and access to a telephone for a point of contact at the trust for the duration of the quarantine

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