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BMA calls for more stringent PPE guidance for GP settings

The BMA has called for more stringent PPE guidance in primary care amidst ‘significant and growing concerns’ about aerosol transmission of Covid-19 in healthcare settings.

In a letter to Public Health England, BMA chair Dr Chaand Nagpaul said there needed to be an urgent review of PPE use to better protect those in general practice.

Extra protection, such as FFP3 respirators, should be in use in high-risk settings such as general practice and Covid-19 ‘hot hubs’, the letter warned.

And steps must be taken to provide access to fit testing to staff working in primary care, or access to alternative equipment,’ he said.

Dr Nagpaul said the guidance that has been in place since the first wave was driven by lack of PPE supply but now it should be updated to take a more ‘precautionary approach’.

It follows guidance from the World Health Organization that said where higher-grade respirators are available for healthcare staff they should be considered for wider use, the BMA said.

Ensuring the appropriate level of protection is especially important for staff who have a higher vulnerability to Covid-19, including those from a BAME background, the letter said, ‘with those at greater risk too often feeling less protected’.

‘Now that we have been assured that supply is no longer an issue, we believe guidance should be updated to take a more precautionary approach to better protect those working on the frontline,’ Dr Nagpaul wrote.

‘If healthcare workers fall ill from being infected and are unable to work, it will be devastating for the health service at this time of critical pressures, and it will compound the pressures besieging hospitals and GP practices.’

In a second letter, the BMA has also asked the Department of Health and Social Care to ensure that PPE was not ‘one size fits all’ after female doctors reported struggling to find masks that fit properly.

‘We have raised concerns in the past that PPE is designed to fit men, not women – despite the fact that 75% of the NHS workforce are women.

‘Guidance and provision must take account of differing needs of the individual healthcare worker – no matter who you are, you should have proper-fitting PPE, regardless of gender, ethnicity and religion,’ Dr Nagpaul said.

RCN lead for infection, prevention and control Rose Gallagher said the Government is dragging its heels on this issue’. The RCN has urged nursing staff to be given a higher level of PPE if working with suspected or confirmed Covid-19 cases.

Ms Gallagher continued: ‘All health care professionals need urgent reassurance from government ministers and scientists that they are sufficiently protected from the new variant, by PPE and safety procedures in their place of work.’

Public Health England said the UK Infection Prevention Control (IPC) guidance, written with NHS leaders and agreed by all four chief medical officers, in consultation with medical and nursing royal colleges, recommends appropriate PPE for health and care workers to minimise the risk of infection.

Dr Yvonne Doyle, medical director at PHE said: ‘NHS staff are under immense pressures and their safety has always been our highest priority.

‘The NHS Infection Prevention Control group has reviewed the latest evidence and has advised that PPE should continue to be worn as laid out in the current IPC guidance, with FFP3 masks required for staff undertaking clinical aerosol generating procedures. This is supported by WHO.

‘Emerging evidence and data on variant strains and transmission will be continually monitored and reviewed.’