Government indecision means nursing staff facing postcode lottery in PPE protection

Press Release 23/01/2021

Government indecision means nursing staff facing postcode lottery in PPE protection

  • Updated official guidance will deepen current variation between hospitals
  • Some hospitals offering staff higher level respiratory PPE, leaving a postcode lottery
  • Staff absence due to Covid-19 soars by 22% as highly infectious strain spreads

The Government’s failure to address concerns about personal protective equipment in the face of new highly infectious variants of the Covid-19 virus is creating a postcode lottery for nursing staff, the Royal College of Nursing (RCN) warns today.

Updated government guidance on infection prevention and PPE, issued on Thursday night, deepens the PPE lottery by accepting the use of different masks in neighbouring hospitals, despite similarly high risk and pressure.

RCN Chief Executive and General Secretary, Dame Donna Kinnair, has written to the Government and the workplace safety watchdog warning that this inadequate personal protective equipment (PPE) may be putting the lives of nursing staff, their colleagues, families and patients at risk.

Kinnair is responding to concerns among RCN members that the standard face mask may not be effective in protecting many staff against new strains of the virus and possible airborne spread in healthcare settings.

The College is calling for a review of the infection control guidance and for all NHS staff to be given the higher grade of PPE as a precaution pending the outcome. Higher grade PPE is used routinely in intensive care units (known as FFP2/3).

The newly-identified UK strain of the virus is said to be up to 70% more infectious and there are concerns that the standard face mask does not offer effective protection against very small airborne viral particles.

Kinnair said: “The Government’s silence on this issue is creating a postcode lottery for nursing staff whereby some working on wards have access to the higher-grade face masks and others do not.

“It must stop dragging its feet on this issue. Nursing staff need to have full confidence that they are protected.

“Staff picking up this virus at work are angered at any suggestion they have stopped following the rules – this is down to the new variant and the dangerous shortage of adequate protection.”

In the letter to health minister Jo Churchill, Kinnair demands the Government:

  • assure professional organisations supporting and advocating for health and care staff that the current UK Infection Prevention and Control guidance is sufficiently robust in light of the new variants of concern in order to protect health and care staff and patients in all settings.
  • ensure that nursing staff are supported to use respiratory personal protective equipment (PPE) such as FFP2 or FFP3 masks based on local risk assessment as a precautionary approach to protecting staff from airborne spread of infection.
  • review the effectiveness of ventilation across the health care estate.

In her letter to the minister she adds: “We are very concerned that our members may now be at greater risk of infection as a result of their occupation.

“They are aware that fluid repellent surgical face masks and face coverings, as currently advised in most general healthcare settings and patients’ homes, are not protective against smaller infective aerosols despite the government video outlining risks of infective aerosols in the air.”

In a further letter to Sarah Albon, chief executive of the Health and Safety Executive, which is responsible for the enforcement of workplace safety laws, Kinnair calls for it to conduct an urgent review of the guidance, adding: “In the absence of clarity on the reasons behind the new variants’ increased infectivity, we are calling for the Health and Safety Executive (HSE) to take a precautionary approach and to use your role as a regulator to ensure employers and those developing national guidance meet and understand their responsibilities.”

She adds: “Adequate supplies of PPE that meet the required specifications are vital to support nursing staff to do their jobs safely. Without support to use suitable PPE, nursing staff are putting their own lives, and the lives of their colleagues, families and patients, at risk.”

In the letter, which is co-signed by doctors’ union the British Medical Association, she calls for the HSE to:

  • review the Infection, Prevention and Control (IPC) guidance for health and care to reduce transmission, particularly in respect to aerosol and airborne transmission as a result of coughing, talking, calling out or shouting, as commonly occurs in health and care settings. This must include an assessment of the use of appropriate PPE across settings.
  • assess ventilation across the health and care estate, ensuring it remains fit for purpose given the emergence of new variants – and the risks in stuffy and enclosed environments.

In both letters, Kinnair describes the more infectious nature of the UK and other variants of the virus as “extremely concerning”, adding that the virus has taken a devastating toll on nursing staff recently.

She cites NHS England data showing a 22 per cent rise in the average number of health care staff off sick due to Covid-19 in the first week of this month compared with the last week in December.


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