Strict new rules over masks for NHS staff

Health and social care workers have been told to wear surgical masks and aprons if they come within two metres of any suspected coronavirus patient.

Medical staff wearing personal protective equipment (PPE) wait to receive coronavirus patients at the door of the Respiratory Assessment Unit at the Morriston Hospital in Swansea. Picture: PA

The new guidance issued on personal protective equipment (PPE) covers NHS workers in hospitals, GP and dental surgeries, and those working in care homes and delivering care to people’s homes. It has been released following controversy over whether people were getting the right kit.

The strengthened guidance says that when staff are providing direct patient care within two metres of somebody with confirmed or suspected Covid-19, they should wear appropriate kit.

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Previously, the kit was only required if staff were working within one metre of a confirmed or suspected case.

The guidance stresses that when “the potential risk to health and social care workers cannot be established” before caring for a patient, then aprons, surgical masks, eye protection and gloves should be worn.

The details were released as another 569 people were yesterday confirmed to have died in the UK after contracting Covid-19. The total number of deaths is 2,921, with 126 of those in Scotland.

In primary care, the guidance stops short of recommending GPs use PPE for all patient contacts, but suggests this may be necessary depending on “local risk assessment”.

GP receptionists talking to people within two metres are urged to wear a disposable mask.

The guidance makes no changes to the actual kit to be worn in hospitals, stressing the World Health Organisation (WHO) has approved the guidance as meeting its standards.

The guidelines were unveiled in Scotland by health secretary Jeane Freeman yesterday after they were agreed by the UK’s four chief medical officers, chief nursing officers and chief dental officers. In some situations, PPE will be able to be worn for “full sessions” and not changed after each patient. Posters and online videos specifying what PPE should be worn and how it is put on will be sent to the relevant workers.

Unpaid carers who look after vulnerable family members will be able to access the appropriate PPE, Ms Freeman said. The health secretary continued: “In terms of shielding the extremely vulnerable in our society, the guidance asks that secondary, primary and community care home workers should wear a surgical mask when providing care to any individuals in this extremely vulnerable group.

“We appreciate that it is an incredibly busy time for all of our health and social care workers, but we also know that those on the frontline need absolute clarity.”

Ms Freeman added: “Protecting staff working on the frontline is an absolute priority and I want to thank each and every one of them for their hard work and commitment in this incredibly challenging situation. I want our staff to feel as safe as possible and this updated guidance provides clarity, so that health and social care staff caring for patients feel confident in which PPE they need to wear in different situations and settings.”

There has been sharp criticism over a lack of PPE in some areas as shortages have led to shortfalls on the NHS frontline. Some staff have reported being “petrified” over a lack of kit while others have been left in tears as they fear for the safety of themselves and their families. Others have said they have even been threatened with reprisals if they speak out about concerns.

The new guidance says that while gloves and aprons should be disposed of after a single use, masks and eye protection can be used for a session of work.

Gowns can also be worn for a session of work in higher risk areas, it says.

The UK-wide guidance says WHO recommends the use of FFP2 masks for aerosol-generating procedures, such as dental drilling, intubating patients and surgery, but “the UK has gone further and recommends the use of FFP3 masks”.

But FFP2 masks can be used if FFP3 masks are unavailable.

Scotland’s chief medical officer Dr Catherine Calderwood said: “The updates to the guidance reflect the fact that Covid-19 is now widespread in the community, so health and social care workers are more likely to see patients with the virus, some of whom will not have symptoms yet.

“We have introduced new measures to improve the distribution of PPE, including a single point of contact for all health boards to manage local PPE supply and distribution, and an email address for NHS staff to contact if they do not have what they need.”

She said an email address had been set up for NHS workers who are concerned about a lack of PPE at [email protected]

Dr Yvonne Doyle, medical director of Public Health England, said: “Protecting our NHS colleagues on the frontline is vitally important. This updated guidance provides a greater degree of clarity so that NHS clinicians caring for patients feel confident in the PPE they need to wear.

“Our standards are amongst the highest in the world and in line with what WHO recommends in circumstances and settings with the highest risk of transmission.”

Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said: “We cannot underestimate the loss of confidence among key frontline staff on this issue – today’s guidance is badly needed and we very much hope this will be an important step towards rebuilding trust.”

But he said “guidance is not the whole answer”.