20 January 2022

Update from the RCSLT in alliance with the Covid Airborne Protection Alliance (CAPA) and British Occupational Hygiene Society (BOHS).

The NHS and the wider healthcare system are still in the grips of dealing with the usual winter pressures along with the significant impact of COVID-19 – this includes staff sickness levels as well as the ongoing delivery of services to meet the needs of the populations we serve.

As a result, the challenges of ensuring the safety and resilience of the NHS and wider workforce, along with patient safety, are greater than ever, notwithstanding the planned reduction in COVID-19 restrictions announced on 19 January.

For the last 16 months, the Covid Airborne Protection Alliance (CAPA) – of which the RCSLT is a member – has been campaigning to influence infection prevention and control guidance to ensure that all healthcare workers can access the right level of respiratory protective equipment (RPE) to protect them from COVID-19.

The alliance has worked with the British Medical Association (BMA), the Royal College of Nursing (RCN) and the British Occupational Hygiene Society (BOHS) to support consistency of messaging to government, other key stakeholders and our healthcare workforce.

This includes alerting system leaders of the need to meet their legal responsibilities (as laid out in the Health and Safety at Work Act 1974) for ensuring the safety of the healthcare workforce through the provision of appropriate RPE.

We have evidence that over 30 NHS Trusts across the UK are now leading the way in how they assess workplace risk and provide staff with appropriate levels of RPE, including FFP3.

We are therefore pleased to see that, this week, the government made important updates to two pieces of guidance which will help to keep healthcare workers, patients and the public safe:

The Cabinet Office guidance is consistent with other government guidance, such as that from the Department for Education (England) on COVID-19 and the use of face coverings in education settings (PDF) which highlights that the Scientific Advisory Group for Emergencies (SAGE) has advised that Omicron might show more airborne transmission.

RCSLT chief executive Kamini Gadhok MBE said: “Having worked closely with CAPA partner organisations for 16 months and led the coordination of our campaign with the RCN, BMA and BOHS to secure enhanced respiratory protective equipment for healthcare workers, I’m delighted that Government guidance now acknowledges that COVID-19 is airborne.

“Healthcare workers should now have access – without restriction – to the FFP3 masks that they need to protect themselves and their patients. I look forward hearing from RCSLT members on how this is being rolled out in their services.”

Dr Barry Jones, Chair of CAPA, said: “I’m delighted that the new IPC guidance makes it clear that healthcare workers can have access to enhanced levels of respiratory protective equipment without being restricted to the current list of aerosol generating procedures (AGPs) which is no longer relevant.

“The IPC guidance however does not specify how COVID-19 is transmitted, placing risk assessment at the mercy of individual employers or managers views or assumptions on this key part of the risk assessment process. We are pleased the Cabinet Office guidance explicitly states that COVID-19 is spread by airborne transmission, close contact via droplets, and via surfaces. Airborne transmission is a very significant way that the virus circulates.”

Professor Kevin Bampton, CEO of BOHS, added: “System leaders now need to mobilise their health and safety and IPC leads to ensure appropriate risk assessments are carried out and the right level of RPE is provided in a safe and effective manner. This includes ensuring that fit-testing for FFP3 is available, and reusable FFP3 equivalent masks can also be accessed.”

Dr Christine Peters, Consultant Microbiologist and FreshAirNHS representative, commented: “As SARsCOV 2 transmits by travelling in aerosols produced when breathing, speaking and talking it is crucial that healthcare workers are provided with the correct RPE to ensure protection for them and their patients. We are delighted to see a change in guidance that advocates for this in line with WHO and urge all employers to ensure rapid roll out of respiratory level protection for this airborne infection”.

Further reading