Covid-19 Patients refusing to wear face coverings
We have been asked on a number of occasions if practices can refuse to see patients that will not wear a face covering in a face-to-face consultation.
You cannot refuse to see someone on the basis that they refuse to wear a face covering.
However, there are factors that you can control:
- Everything should be done remotely that can be.
- Patients should be seen at times that minimise exposure and risk for other patients e.g., in waiting rooms.
- Can you see the patient outside?
- Can you socially distance effectively in a room. Is the biggest room available to see these patients?
- Would they accept wearing a scarf if not a mask? Would they accept covering their mouth / nose for the closest part that is needed, with the understanding that the health care professional can step away if the patient needs a break from covering their mouth / nose?
- Can they face in a different direction especially for anything that involves close contact? There is evidence that direct face to face, as in standing opposite each other, is the highest exposure.
- Can you maximise ventilation of the space where they are seen?
- The health care professional wears appropriate PPE for the risk. Do they wear a different level of mask e.g., FFP3 mask correctly fitted?
- Which health care professional they are seen by. Carry out a risk assessment.
Viral exposure seems to depend on ventilation, occupancy, and exposure time - https://www.bmj.com/content/370/bmj.m3223 - this article is an interesting read.
It is reasonable for the practice to alter some of these other factors which may result in an appointment that is less convenient for the patient, but this needs to be balanced against the increased risks to staff and other patients that are associated with not wearing a mask.
The PC Webinar of 28th Jan 2021 also revisited this issue and had this to say: -
Seeing patients who are not wearing face coverings
The safety of both our staff and our patients is of paramount importance and face coverings or face masks should be worn by patients in a practice setting, in line with government guidance.
However, not all patients are able to wear a face covering and a patient should not be refused access to care if they are unable to, or refuse to, wear a covering. For these patients, practices should ensure that they can take all reasonable steps to identify practical working solutions with the least risk to all involved.
For example: offering the patient a mask, if the patient is able to wear one;
- booking the patient into a quieter appointment slot,
- or in a separated area
- or providing care via a remote appointment
