Coronavirus (COVID-19) face masks and face coverings guidance withdrawal: letter
Letter issued to the social care sector regarding the withdrawal of the ‘Coronavirus (COVID-19): Extended use of face masks and face coverings guidance’ across health and social care.
To:
All social care services
Local Authorities
Nurse Directors
Chief Officers HSPC
NHS Chief Executives
Directors of Public Health
Chief Social Work Officers
Medial Directors
9 May 2023
Dear Colleagues
Withdrawal of the Coronavirus (COVID-19): extended use of face masks and face coverings guidance across health and social care
We are writing to inform you of a change to the extended use of face masks and face coverings guidance in health and social care settings.
Following a review, the Cabinet Secretary for NHS Recovery, Health and Social Care and the Minister for Social Care, Mental Wellbeing and Sport have agreed to withdraw the ‘Coronavirus (COVID-19): use of face coverings in social care settings including adult care homes’ guidance and the ‘Coronavirus (COVID-19): extended use of face masks and face coverings in hospitals, primary care and community healthcare settings’ guidance.
The outcome of this review recognises that Scotland continues to adapt to the COVID-19 pandemic and has entered a calmer phase of the pandemic. Now the right time to withdraw the extended face mask and face covering measures across health and social care settings.
This is due to the high uptake of COVID-19 vaccinations, especially amongst residents of care homes, reduced severity of illness and hospitalisations, and availability of treatments for COVID-19. This follows advice from Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland and Scottish Government Professional Clinical Advisors in Infection, Prevention and Control (IPC).
This guidance will be withdrawn on 16 May 2023.
In the absence of the extended use of face mask/face covering guidance; health and social care services are advised to follow the infection prevention and control (IPC) guidance on the appropriate use of personal protective equipment (PPE) for standard infection control precautions and transmission based precautions as detailed in the National Infection Prevention and Control Manual (NIPCM) and the Care Home National Infection Prevention and Control Manual (CHIPCM). For further advice please engage with local health protection and IPC teams.
In practice, for social care settings, this will mean that the element of choice to wear a mask outwith when it is recommended in the NIPCM/CH NIPCM will no longer apply. Personal Protective Equipment (PPE) including face mask use should be based on clinical need and risk assessment as per the NIPCM and CHIPCM.
If staff have concerns around the withdrawal of the extended guidance, then they should speak with their employer. Individual occupational health assessments and risk assessments, which should take place as appropriate. Public Health Scotland has guidance on how to carry out risk assessments. Further information about the withdrawal of the guidance and what you should do can be found in Annex A.
Please note that the Scottish Government webpages currently hosting each set of guidance (relevant to either healthcare or social care settings) will remain online for an interim period and contain a position statement, advising that the face masks/face coverings guidance has been withdrawn. Links to the webpages are below:
- Coronavirus (COVID-19): extended use of face masks and face coverings in hospitals, primary care and wider community healthcare
- Coronavirus (COVID-19): use of face coverings in social care settings including adult care homes
It is important to be vigilant in our response to COVID-19: vaccination is the best protection. It is worth noting that the level of protection may have reduced since a person’s last vaccination, therefore booster doses are recommended to help protect the most vulnerable. The spring booster is being offered to people at greatest risk including adults aged 75 or over, residents in care homes for older adults, and people aged 5 and over with a weakened immune system.
While health and social care workers are not being offered a spring booster, they remain eligible for the primary offer (first and second dose) of COVID-19 vaccination. We would encourage all those yet to take up this offer to do so before the primary offer ends on 30 June. Details of the vaccination can be found on Public Health Scotland’s webpage. Vaccination policy in Scotland is based on recommendations from the Joint Committee on Vaccination and Immunisation (JCVI), who continue to consider latest clinical evidence on vaccine effectiveness and waning.
The Scottish Government regularly reviews this guidance as the pandemic situation changes and new emerging evidence is received.
We are grateful for the incredible work you and your teams have done to provide care and support while responding to the pandemic. You have worked tirelessly through challenging times to implement guidance to keep individuals safe, responding as the guidance has changed due to clinical advice.
Yours sincerely,
Professor Gregor Smith
Chief Medical Officer
Professor Alex McMahon
Chief Nursing Officer
Angie Wood
Interim Director, Social Care Resilience and Improvement
Tim McDonnell
Director, Primary Care
Scottish Government
Annex A
Additional Information on the removal of the guidance
The wearing of face masks can impact on the health and wellbeing of staff and users of social care, especially those with dementia or cognitive impairment. They can create communication barriers and impact negatively on relationships. Social care settings are peoples’ homes, and it is important that we continue to move towards more normalised living, with face masks only worn when there is a clinical need to do so as per the National Infection Prevention and Control and Care Home National Infection Prevention and Control Manuals.
Wearing a mask outwith times where there is a clinical need can create a false sense of security. In some services blanket approaches to face mask wearing have been taken which are not recommended. Appropriate IPC practices are also not always being followed.
In addition to the social harms of mask use, there are environmental and financial impacts with increased use.
What you should do
The vaccination is the best protection from COVID-19 and we encourage all who are eligible to take up this offer, including health and social care staff who have not taken the primary offer (first and second dose). Details of the vaccination can be found on Public Health Scotland’s webpage.
Staff should continue to follow the guidance within the National Infection Prevention and Control Manual and Care Home National Infection Prevention and Control Manual. These outline the standard infection control precautions (SICPs) which should be used by all staff, in all care settings, at all times, for all persons whether infection is known to be present or not. This includes guidance on hand hygiene, which is considered an important practice in reducing the transmission of infectious agents. The guidance also details transmission based precautions (TBPs), which are additional precautions required to be used by staff when caring for persons with a known or suspected infection or colonisation.
As part of SICPs and TBPs, face masks should be worn in particular scenarios.
You should have conversations with staff and visitors who have been choosing to retain mask use so your service is ready to revert to the National Infection Prevention and Control and Care Home National Infection Prevention and Control Manuals from 16 May 2023.
Employers should continue to follow health and safety legislation for workplaces. The Health and Safety Executive has guidance on how to keep people safe and healthy at work. The Coronavirus (COVID-19): safer workplaces and public settings guidance remains strongly recommended. Individual occupational health assessments and risk assessments should take place as appropriate. Public Health Scotland has guidance on how to carry out risk assessments.
Staff who have symptoms of a respiratory infection, including COVID-19, should follow Coronavirus (COVID-19): staying at home guidance.
Contact
Email: cno@gov.scot
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