Updated PHE advice on PPE backs eye protection for GPs

GPs should wear eye protection in addition to a mask, gloves and apron when providing direct care for a patient with confirmed or suspected COVID-19 infection, updated government advice confirms.

Guidance published on 2 April confirms that 'any clinician working in a hospital, primary care or community care setting within two metres of a suspected or confirmed coronavirus COVID-19 patient should wear an apron, gloves, surgical mask and eye protection, based on the risk'.

It makes clear that masks and eye protection can in some cases be worn for an entire clinical session rather than being changed between patients, and provides updated guidance on required standards of PPE for home visits as well as for use in higher-risk aerosol generating procedures (AGPs).

For non-AGPs, the advice backs the use of aprons rather than gowns and provides advice on 'thoroughly washing forearms if there is a risk of exposure to droplets'.

PPE shortage

The guidance has been welcomed by GP leaders - although senior GPs have warned that practices and frontline staff in other settings continue to experience problems with access to adequate supplies of PPE.

GPonline reported earlier today on calls from a major healthcare union for industrial capacity to be immediately repurposed to support an expansion of PPE production in the UK.

BMA chair Dr Chaand Nagpaul said: 'Although PHE has produced updated guidance, what fundamentally matters is that doctors and healthcare workers get the adequate and appropriate supplies of PPE on the frontline. Without these supplies there is continued unacceptable danger to the health and lives of healthcare workers and their patients.

'It is four days since the government minister Robert Jenrick gave the assurance that no frontline staff should be working without the right protective equipment. Yet this week the BMA has received concerns from doctors in over 30 hospital trusts about inadequate PPE supplies and GPs across England who are yet to receive eye protection.

COVID-19 pandemic

'Doctors are being put in a harrowing position. Faced with a national emergency, they stand committed to meet the immense challenges that lay ahead and to save lives. However, the lack of PPE provision is not only risking the health of doctors but also of them becoming vectors of infection and potentially turning them into super-spreaders, carrying the virus to non-COVID-19 patient after patient. This is putting the lives of the most vulnerable at risk – the very people we are all striving most to protect.

'Lives are at stake. The government must stop at nothing to protect doctors and patients and act urgently to provide proper and adequate supplies of PPE on the helpline. Given global shortages we call upon government to repurpose UK manufacturing to a massive scale to provide the protective equipment healthcare workers and carers so desperately need.'

RCGP chair Professor Martin Marshall said: 'It is crucial that healthcare professionals on the frontline of tackling the COVID-19 pandemic are confident that they are able to work as safely as possible.

'This new guidance provides much of the clarity the college has called for and it is appreciated that Public Health England and NHS England have been receptive to our concerns. It should provide GPs and their teams with much-needed reassurance around how and when to use protective equipment when they are seeing patients face to face in the best interests of their patients, their teams and themselves.

NHS workforce

'We understand that initial stocks of PPE have been getting to GP practices, we now need to ensure that this supply is sustained throughout the pandemic, that practices start receiving new equipment recommended in the guidance such as eye protection soon, and that effective mechanisms are in place for practices to request emergency supplies, should they need them.'

CMO Professor Chris Whitty said: 'It is absolutely right that frontline staff have the appropriate PPE so they are safe and can have the confidence they need to do their jobs.

'Public Health England has updated their advice to provide additional clarity for staff. This was done with the support of a wide range of professional groups and it has my full support. NHS England and the government are working hard to secure the supply lines in this challenging period so staff have the appropriate equipment.'

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