Covid-19 - PPE and Infection Control
Guidance From June 2022
June 2022 - NHSE have issued a letter updating the IPC Guidance.
UKHSA has updated its UK IPC guidance for COVID-19: information and advice for health and care professionals with new COVID-19 pathogen-specific advice for health and care professionals. This advice should be read alongside the National Infection Prevention and Control Manual (NIPCM) for England and applies to all NHS settings or settings where NHS services are delivered.
Management of COVID-19 patients in health and care settings
In health and care settings, non-pharmaceutical interventions (such as mask wearing and enhanced ventilation) may be used, depending on local prevalence and risk assessment, with the aim to reduce the spread of SARS-CoV-2.
Transmission-based precautions should only be discontinued in consultation with clinicians, and should take into consideration the individual’s test results as well as resolution of clinical symptoms.
In addition the letter advises:-
For health and care staff:
Health and care staff should continue to wear facemasks as part of personal protective equipment required for transmission-based precautions when working in COVID-19/respiratory care pathways, and when clinically caring for suspected/confirmed COVID-19 patients. This is likely to include settings where untriaged patients may present such as emergency departments or primary care, depending on local risk assessment. In all other clinical care areas, universal masking should be applied when there is known or suspected cluster transmission of SARS-CoV-2, eg during an outbreak, and/or if new SARS-CoV-2 VOC emerge.
• Universal masking should also be considered in settings where patients are at high risk of infection due to immunosuppression eg oncology/haematology. This should be guided by local risk assessment.
• Health and care staff are in general not required to wear facemasks in non-clinical areas eg offices, social settings, unless this is their personal preference or there are specific issues raised by a risk assessment. This should also be considered in community settings.
The guidance also details, for Primary Care in particular
Patients with respiratory symptoms who are required to attend for emergency treatment should wear a facemask/covering, if tolerated, or offered one on arrival.
• All other patients are not required to wear a facemask unless this is a personal preference.
The BMA note that the Government’s COVID-19 Response: Living with COVID-19 is inconsistent with IPC guidance, as it states that “the health and safety requirement for every employer to explicitly consider COVID-19 in their risk assessments” was removed on 1 April 2022. As such the BMA have published a GP Practice Risk Assessment guide that we would recommend looking at.
Occupational health, vaccination and IPC considerations for staff
Systems should remain in place to ensure that vaccination and testing policies are implemented.
Employers must ensure that COVID-19 is included in risk assessments for any health and care staff who come into contact with COVID-19 due to their work activity.
All staff should be vigilant for any signs of respiratory infection and should not come to work if they have respiratory symptoms. They should seek advice from their IPC teams, occupational health department, GP or employer as per the local policy.
Symptomatic staff should follow the guidance for people with symptoms of a respiratory infection
Additional guidance for the management of staff with a respiratory infection or a positive COVID-19 result is available.
NHSE have also published A rapid review of aerosol generating procedures (AGPs)
FFP3 Face Masks for General Practice
The Department of Health and Social Care (DHSC) have confirmed FFP3 face masks are now available for general practices to order via the PPE portal. The full IPC guidance is set out here, and an updated risk assessment tool has been published.
Practices must have undertaken the necessary risk assessments and arranged for staff to have been fit tested before ordering the equipment. It is a legal requirement on employers that all tight fitting RPE, such as, FFP3 masks must be fit tested on all health and care staff who may be required to wear one to ensure an adequate seal/fit according to the manufacturer’s guidance. Fit testing is specific to the brand of FFP3 mask being deployed.
DHSC have published additional updates for PPE portal users, including a series of FAQs on FFP3 use and fit testing.
The weblink includes a number of useful contacts for PPE related queries: NonAcutePPECustomerDemand@dhsc.gov.uk, firstname.lastname@example.org and email@example.com. For fit test queries please contact the helpline on 07376 304545 or 07376 304546.
One of the most important things about PPE is how we put this on and take it off - if done incorrectly you might as well not wear it.
Click here for a helpful video produced by a Leeds GP.
PHE have also produced a video for PPE
PHE have a page for Infection Prevention Control that includes details on PPE
The Infection Prevention Society (IPS) also have a wealth of Covid-19 resources that include awareness training, patient leaflets and guidance in particular settings.
PPE & Infection Control Resources
NHSE - Supporting excellence in infection prevention and control behaviours: Implementation Toolkit
Read more on infection control in General Practice on our dedicated webpage: www.wessexlmcs.com/infectioncontrolingeneralpractice
PPE Covid-19 Guidance for Home visits
PHE have updated their PPE detail for non aerosol gas procedures and have produced posters to demonstrate the donning and doffing. Please click on the images below to download and print as required.
The Supply Chain & PPE Portal
This remains one of the highest priorities in terms of ensuring practices have an adequate supply and also the ongoing question about the level of PPE you require in general practice.
DHSC, in partnership with NHS Supply Chain, have implemented a new PPE portal: how to order COVID-19 personal protective equipment to ensure continued access to free PPE and related items for eligible users until March 2023.
All eligible users will receive an invite to ensure migration across to the new platform.
Local Resilience Forums (LRFs) can respond to local spikes in need, including those in social care and primary care, where there are current blockages in the supply chain. The PPE stock provided to LRFs is to support urgent need in vital services which are not linked to the NHS Supply Chain. This PPE is intended to support service providers which have exhausted their usual routes for PPE and there remains an urgent need for additional stock.
PPE Portal for accessing covid-19 supplies
The PPE Portal can be used by social care and primary care providers to get critical coronavirus (COVID-19) personal protective equipment (PPE) – not to be used to order PPE for non-COVID-19 requirements.
Delivery times and cost
PPE ordered from the portal is free of charge.
Orders will be delivered by Royal Mail within 5 days
Some orders will require more than one box and may be received as multiple deliveries.
All PPE offered on the portal meets UK government quality standards.
You can find more information on PPE standards at Public Health England’s COVID-19 PPE hub and NHS guidance on supply and use of Personal Protective Equipment (PPE) and other supplies.
When to use local resilience forums
You can now get all the COVID-19 PPE you need from the PPE portal.
However, PPE from local resilience forums (LRFs) can be made available on the basis of clinical need, for example a demonstrable spike in local COVID-19 cases or temporary difficulties in accessing other distribution channels.
All other adult social care services not supplied by the PPE portal will be able to access PPE through their LRFs or local authorities, depending on local arrangements.
Other providers who are not invited to use the portal should continue using their LRFs if they cannot get the PPE they need through wholesaler routes.
For business-as-usual and non-clinical grade PPE needs all providers should continue accessing their normal supply routes.
Call the customer service team on 0800 876 6802 if you have any questions about using the PPE portal.
The team is available from 7am to 7pm, 7 days a week, to help resolve your queries.
The BMA has launched a 24/7 emergency support helpline for doctors who find their PPE is inadequate and need urgent advice. Call the PPE hotline on 0300 123 1233.
The Government also announced on 9th Feb 2021 that is also offering free PPE to unpaid Carers.