COVID-19 Healthcare: Personal Protective Equipment

As the issue of personal protective equipment (PPE) availability, or lack of, becomes more and more prevalent, we look at the challenges which this presents to employers as well as offering some practical guidance to ensure compliance of the employer's legal duties.

Authors: Tony Cawley, Mary Edis & Scott Taylor

The provision of adequate personal protective equipment (PPE) to health and social care workers in the context of the current COVID-19 pandemic raises numerous challenges including:

The wide range of health and social care contexts in which NHS employees work and which are now hazardous work environments due to the risks of infection. These range from secondary care inpatient settings, primary, outpatient and community care settings, ambulances, paramedics, first responders and pharmacists. Differing PPE requirements for different settings and contexts including taking account of the fact that certain work environments and procedures carry higher risk of transmission, in particular when staff are caring for patients where high risk aerosol generating procedures (AGPs) such as tracheostomy and intubation are being performed. Accounting for the fact that the provision of healthcare is dynamic and a single care episode may take place in more than one context. In contexts where COVID-19 is circulating in the community at high rates, health and social care workers may be subject to repeated risk of contact and droplet transmission during their daily work. In routine work there may be challenges in establishing whether patients and individuals meet the case definition for COVID-19 prior to a face-to-face assessment or care episode. The rapidly evolving situation. The pandemic evolution and the changing level of risk of healthcare exposure to COVID-19 in the UK locally and nationally together with a growing understanding of the infection risk by the virus, incubation time, infectiousness and severity of the infection mean that guidance for health and social care workers from UK government and relevant UK Public Health agencies is being developed and updated frequently. Guidance is changing almost on a daily basis, in particular in relation to PPE. On 1st April 2020 PHE provided enhanced PPE recommendations for a wide range of health and social care contexts which revised previous guidance. Absorbing and implementing each change in guidance will be challenging. The requirement of individual and organisational risk assessment at local level to inform PPE use in addition to taking into account national public health guidance. Considerations as to which PPE items can be used for a whole session of work rather than for a single patient or resident contact; if items can be re-usable for advice on suitable decontamination arrangements to be obtained from the manufacturer...