Hospice staff should be tested each week for coronavirus otherwise facilities risk having to close, an end-of-life charity said.
Marie Curie said the lack of access to regular weekly testing, which is available to care home staff, is compromising the care of dying people.
The charity is concerned whether its hospices will be able to operate safely while supporting the increasing number of people who will need palliative care this winter.
It is also calling for weekly testing of a close relative or carer who will be able to provide support to the patient when they visit.
And it is concerned about delays and shortages of flu vaccines for hospice staff, calling this a further “kick in the teeth” for the sector.
Regular weekly testing would help prevent staff without symptoms unknowingly spreading Covid-19 and ensure staff levels are sufficient to keep hospices fully open.
Marie Curie said the different approaches to testing across the UK is leading to confusion and means asymptomatic staff are not always identified early.
In some areas all staff are tested when there is an outbreak but in others only those with symptoms are tested, it said.
The charity fears that concerns about contracting the virus, a lack of testing among staff and visiting restrictions, will mean people needing help will be reluctant to use hospices.
Medical director Dr Sarah Holmes said asymptomatic spread between staff can be a problem “despite the most stringent of infection control measures”.
She said: “While staff who are symptomatic or have a family or household member who is symptomatic will still need to isolate, this still leaves us with a dilemma as we know that staff can remain asymptomatic and we wouldn’t know.
“Every day that passes without a regular weekly testing regime in place for hospice staff puts the most vulnerable people in society at risk. The lack of testing could also end up paralysing not only Marie Curie hospices but other independent providers too.”
She added: “We do not want people who need our help to decide not to come to one of our hospices because of fear of contracting the virus, or not being able to have any visitors.”
Caroline Kennedy, 59, died in July with ovarian cancer.
She went into a hospice for a few days in May but her family brought her home because they were not able to visit her.
Her daughter Charlotte Kennedy, 27, from Enfield, London, said: “When we chatted to hospital and hospice staff, we offered to pay for our own tests so we could come in to see mum. But at that point it was a blanket no to visitors. If there had been anything we could have done, we would have.
“It’s inconceivable that people have to die alone, without their family around them, just so they can get the care they need. Testing is the answer and it would resolve that impossible situation.”
A Department of Health and Social Care spokesman said: “We are hugely grateful for the work hospices have undertaken during this challenging period and we have made up to £200 million available to support them this year.
“Anyone working in healthcare with symptoms can access testing as a priority, but we must target testing capacity at the areas that need it most.
“In March we had capacity for 2,000 tests a day, by the end of this month it will be at 500,000 and we will continue to expand availability where we can.”