20 Jan 2021
Professional associations and trade unions including the British Dietetic Association, representing healthcare workers across the NHS, have today (20 January 2021) demanded that Matt Hancock, the Health and Social Care Secretary, personally intervenes urgently to ensure that all healthcare professionals have access to FFP3 personal protective equipment (PPE) when working with patients with suspected or confirmed Covid-19.
The call comes just days after it is revealed that a shocking 49,000 hospital staff are off work because of Covid-19, which is leading to huge frontline staffing pressures. Despite this, the recent report from the Independent High Risk Aerosol Generating Procedures (AGPs) Panel failed to recognise professionals’ pleas for better PPE for frontline healthcare workers for a wider range of procedures.
“Don’t let the air we share be what kills us”
The Alliance argues that current PPE guidance does not do enough to keep healthcare professionals safe - most staff are being infected on wards whether they are performing the riskiest procedures or not. In addition to aerosols from AGPs, the impact of aerosols from coughing in crowded areas, often with poor ventilation, adds to the overall risk to staff.
Given all this, the Alliance is urging a precautionary approach. In the absence of high-level evidence, significance must be given to the consensus of the national AGP Alliance, representing the concerns of multidisciplinary members.
Dr Barry Jones, Chair of the AGP Alliance said: “The first duty of any Government is to protect its citizens. The first duty of any Health and Social Care Secretary should be to protect healthcare staff and their patients.
“The Government regularly and rightly praises healthcare professionals. This is no longer enough. So, Mr Hancock, we are begging you, don’t let the air we share be what kills us. Stop praising us and start protecting us.”
“NHS staff being treated as guinea pigs”
Chief Executive of the Royal College of Speech and Language Therapists Kamini Gadhok MBE added: “The new, highly transmissible Covid-19 variants are a game-changer for the thousands of healthcare workers who are facing the toughest challenge of their working lives.
“The Government’s decision not to change its PPE guidance is wholly unacceptable and plain dangerous. It puts the lives of healthcare workers and the patients they care for at unnecessary risk. Time is of the essence. What we need now is a common-sense approach.”
The time has now come for Government to update their PPE policy to maximise the safety and welfare of healthcare professionals.
HCSA - the hospital doctors’ union President Dr Claudia Paoloni said: “It is astonishing that PPE guidance has not caught up with the risks of a more transmissible variant which renders previous studies on airborne infection of questionable value. The ‘science’ cannot yet tell us the level of danger hospital staff are facing due to flimsy surgical masks which do little to filter viral particles.
“Again, it seems NHS staff are being treated as guinea pigs rather than the most precious resource we have in dealing with this terrible pandemic. They need the best protection to tackle Covid-19 not a poundshop approach - do we really need to see hospital workers fall sick and die before changing tack on FFP3?”
Tracy Nicholls, Chief Executive of the College of Paramedics, added: “Our profession has suffered devasting losses due to Covid-19 and paramedics are at the very sharp end of this virus, day after day.
“This is about protecting our patients as well as paramedics and ambulance staff so more needs to be done at pace to really make a positive impact on both. Undertaking an urgent review would go a long way to making staff feel truly valued and far less vulnerable.”
BMA council chair Dr Chaand Nagpaul said: “It is encouraging to see more representatives from across the health sector add their weight to the argument for better protection for frontline health care workers, highlighting just how serious this matter is.
“This is why the BMA wrote to Public Health England last week, highlighting that current PPE guidance needs to be urgently reviewed to ensure that greater protection is afforded to healthcare workers. It also comes at a time when the NHS is at risk of being overwhelmed and loss of healthcare staff from the frontline due to illness could be devastating for services. We have seen 50% of doctors in our recent BMA survey say that absence from colleagues due to Covid is already affecting patient care.”
Independent High Risk AGP Panel Report
As Government continues to fail to adequately protect healthcare professionals on the frontline of the Covid pandemic, the Chief Medical Officer-funded Independent High Risk AGP Panel has finally published summary recommendations on high risk AGPs.
The report is disappointing and fails healthcare professionals in several important ways. In particular, it concludes that the evidence is insufficiently robust, when in reality there is simply a lack of evidence. Expert consensus for best practice is a standard approach in the generation of many clinical guidelines where high-level evidence is lacking. All healthcare professionals must have access to FFP3 PPE when working with patients with suspected or confirmed Covid-19.
No mention or consideration is made of the new variants despite it having been known about for many weeks, rendering the review already out of date.
The Panel has acknowledged that there is no evidence to suggest healthcare professionals are safe while conducting several of the procedures the AGP Alliance consider to be higher risk. Despite this, no change is being recommended.
In fact, the AGP Panel report states that the review was not tasked to clarify whether existing PPE offers sufficient protection to healthcare professionals. This makes it difficult to tell who is deciding on lifesaving PPE guidance. Public Health England and NHS England both state that they use the guidance of the Independent High Risk AGP Panel before changing recommendations whilst the Panel has itself stated that it was not tasked with advising on the efficacy of PPE.
About AGPs and the AGP Alliance
Aerosol Generating Procedures (AGP) are medical procedures that cause a patient to produce fine particles, called "aerosol" that can spread Covid-19.
The AGP Alliance was set up to ensure that procedures that our members undertake are recognised as Aerosol Generating Procedures in relevant policies and guidance to ensure our members receive the appropriate level of PPE to do their jobs safely.
The AGP Alliance is formed of a range of organisations, including professional bodies and trade unions:
- BAPEN – British Association for Parenteral and Enteral Nutrition
- BASP – British Association of Stroke Physicians
- BDA – British Dietetic Association
- BSG - British Society of Gastroenterology
- College of Paramedics
- CSP – Chartered Society of Physiotherapy
- HCSA - Hospital Consultants and Specialists Association
- NNNG - National Nurses Nutrition Group
- RCSLT – Royal College of Speech and Language Therapists
- UNITE the Union