Information

Coronavirus (COVID-19): extended use of face masks and face coverings in hospitals, primary care and wider community healthcare

Guidance for staff within acute hospitals, community hospitals, primary care and wider community healthcare, together with advice for visitors, including those attending for an appointment.

This document is part of a collection


Additional guidance - hospital staff

In addition, all staff in non-clinical areas of hospitals are strongly recommended to wear a face covering when not seated, whilst at work, except in a limited number of circumstances, such as when working alone in a closed office. Control measures continue to be essential, i.e. good ventilation, easy access to hand washing and/or hand sanitising facilities and regular cleaning of the area.

Boards may choose to maintain physical distancing in these areas to prevent large numbers of staff being identified as contacts or subsequent cases and resulting in service impact when high numbers have to self-isolate.

Staff who work solely in non-clinical buildings- such as NHS Board headquarters or other standalone offices – and who do not enter buildings where patient care is provided, would not be expected to wear FRSMs, but instead may wear their own face covering. Staff members who work in non-clinical buildings but as part of their job role will enter buildings where clinical care is provided, would be expected to change to a FRSM if they do enter a building where care is provided.

Table 1

The table below sets out when FRSMs should be worn in hospitals:

Situation

FRSM

Exceptions

Direct patient care

It is strongly recommended that you wear a FRSM all times when providing direct patient care unless an FFP3 respirator is required in line with national guidance

If the person they are supporting/caring for is a person who lip-reads to communicate then a transparent face mask may be worn.

or

After a risk assessment when the person they are supporting / caring for is showing signs of distress.

Wherever possible, maintain two metre distancing if FRSM removed.

Present within and moving around clinical areas

It is strongly recommended that you wear a FRSM at all times throughout shift

If the person they are supporting/caring for is a person who lip-reads to communicate then a transparent face mask may be worn.

or

After a risk assessment when the person they are supporting / caring for is showing signs of distress.

Wherever possible, maintain two metre distancing if FRSM removed.

Non-clinical areas

It is strongly recommended that you wear a FRSM (or your own face covering) when moving around (i.e. not seated at your desk.

Boards may choose to maintain physical distancing in these areas to prevent large numbers of staff being identified as contacts or subsequent cases and resulting in service impact when high numbers have to self-isolate

When working alone in an office or when seated in a well-ventilated office and after appropriate hand hygiene.

If going into a clinical area, FRSM should be worn.

Break times

It is strongly recommended that you wear a FRSM at all times when not seated and/or eating.

Boards may choose to maintain physical distancing in these areas to prevent large numbers of staff being identified as contacts or subsequent cases and resulting in service impact when high numbers have to self-isolate

When seated and after appropriate hand hygiene

It is important to note that overcrowding in any area of a healthcare facility, including inpatient areas, waiting areas, outpatient departments, canteens and rest areas, increases transmission risk for respiratory viruses including COVID-19 and it is important to remain mindful of the volume of people in a space at any one time taking account of healthcare workers, patients and visitors. Settings must not return to pre-pandemic practices which facilitated overcrowding and steps should be taken to prevent this. 

Some services may decide that it is necessary to maintain physical distancing in where FRSMs are removed to prevent critical loss of staff should there be a COVID-19 exposure .

Current guidance - primary care (GP practices, dentists, opticians and pharmacies) and wider community healthcare settings (excluding care homes)

It is strongly recommended that staff providing direct care to individuals in primary care (GP practices, dentists, opticians and pharmacies) and wider community healthcare settings (including health professionals visiting an individual within their own home) continue to wear a FRSM at all times throughout their shift. “Extended” in this regard means that an FRSM will be worn throughout the shift, but should be removed and replaced as necessary (observing hand hygiene before the mask is removed and before putting another mask on), and as recommended during the shift, including e.g. if it becomes contaminated, damaged or moist.

Health and community healthcare staff should use their professional judgement, and undertake a risk assessment, in instances where it is necessary to remove the FRSM for a short period, and ensure it is safe to do so - for example, when the person they are supporting / caring for is showing signs of distress, or to communicate with a person who lip-reads. Transparent face masks may be worn as an alternative to this.

Staff are not required to wear an FRSM during mealtimes in staff restaurants but are recommended to continue do so when not seated at a table, such as when queueing, entering or leaving the canteen (in line with other hospitality venues). During breaks, and where possible, consideration should be given to facilitating the use of outdoor spaces, which provide a safer alternative than enclosed indoor spaces. Additionally, consideration should be made to the staggering of staff breaks.

Boards may choose to maintain physical distancing in these areas to prevent large numbers of staff being identified as contacts or subsequent cases and resulting in service impact when high numbers have to self-isolate.

There will also be instances of staff who may suffer from breathing difficulties, or suffer from genuine discomfort or distress when wearing a FRSM. We expect staff to be fully supported and appropriate steps taken locally to implement the guidance in a way that has regard to staff well-being. A workforce risk assessment should be undertaken.

Table 2

Table 2 below sets out when FRSMs should be worn in primary care (GP practices, dentists, opticians and pharmacies) and wider community healthcare settings (including health professionals visiting individuals within their own homes) :

Situation

FRSM

Exceptions

Direct patient care

It is strongly recommended that you wear a FRSM at all times when providing direct patient care unless an FFP3 respirator is required in line with national guidance

If the person they are supporting/caring for is a person who lip-reads to communicate then a transparent face mask may be worn

or

After a risk assessment when the person they are supporting / caring for is showing signs of distress.

Wherever possible, maintain 2m distancing if FRSM removed.

Present within and moving around clinical areas/ communal areas in hospital and primary settings/ communal and resident areas in healthcare settings (excluding care homes) homes of individuals in receipt of healthcare within their own home It is strongly recommended that you wear a FRSM at all times throughout your shift

If the person they are supporting/caring for is a person who lip-reads to communicate then a transparent face mask may be worn.

or

After a risk assessment when the person they are supporting / caring for is showing signs of distress.

Wherever possible, maintain 2m distancing if FRSM removed.
Non-clinical areas/ community non- resident areas (excluding care homes)

It is strongly recommended that you wear a FRSM (or your own face covering) when moving around (i.e. not seated at your desk.

Boards may choose to maintain physical distancing in these areas to prevent large numbers of staff being identified as contacts or subsequent cases and resulting in service impact when high numbers have to self-isolate.

When working alone in an office or when seated in a well-ventilated office and after appropriate hand hygiene.

If going into a clinical area, FRSM should be worn.

 

Break times

It is strongly recommended that you wear a FRSM /face covering at all times when not seated and eating.

It is recommended that you wear a FRSM (or your own face covering) when moving around (i.e. not seated at your desk.

Boards may choose to maintain physical distancing in these areas to prevent large numbers of staff being identified as contacts or subsequent cases and resulting in service impact when high numbers have to self-isolate.
When seated and after appropriate hand hygiene.

It is important to note that overcrowding in any area of a healthcare facility, including waiting areas, increases transmission risk for respiratory viruses including COVID-19 and it is important to remain mindful of the volume of people in a space at any one time taking account of staff, patients and visitors. Settings must not return to pre-pandemic practices which facilitated overcrowding and steps should be taken to prevent this. Some services may decide that it is necessary to maintain physical distancing in where FRSMs are removed to prevent critical loss of staff should there be a COVID-19 exposure.

Guidance for staff on how to support individuals (including children aged 5 and over) receiving care

All outpatients should be strongly encouraged to continue to wear a face covering upon entering health and community healthcare settings. Face masks are provided at the entrance to hospitals for any individual who requires one.

Staff working in health and community healthcare should ensure that anyone who is not able to wear a face covering due to an existing medical condition is not forced to do so or refused treatment – this includes women in labour and children aged under 5. Clinical teams may wish to include a pre-admission/pre-appointment triage question regarding the individual’s ability to wear a face covering before they attend for their appointment and take this opportunity to encourage the use of face coverings by individuals on attendance at a health and care setting. It may be helpful to advise the individual that the reason for continuing to ask patient to use face coverings and FRSMs in health and care settings is to help protect the many vulnerable individuals using the services.

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