Research and analysis

HPR volume 14 issue 7 (8 April)

Updated 23 December 2020

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COVID-19 guidance: fifth update

Updated infection prevention and control (IPC) guidance for health and social care settings was published on 2 April, including new guidance about personal protective equipment (PPE) for NHS teams likely to come into contact with patients with coronavirus (COVID-19).

The guidance, issued jointly by the UK government and NHS leaders from a range of medical and nursing royal colleges, and agreed by the devolved administrations, is applicable in all parts of the UK.

The updated guidance reflects that COVID-19 is now widespread in the community, meaning clinicians are more likely to see patients with the virus, some of whom may have minimal or no symptoms. The guidance is based on the best scientific evidence and the World Health Organization (WHO) has confirmed it is consistent with its recommendations in circumstances and settings with the highest risk of transmission.

The guidance recommends the safest level of PPE to protect NHS healthcare workers and specifies the type of PPE that should be worn in various healthcare and non-healthcare settings. It will protect stock levels from unnecessary use while supporting staff to use the right equipment.

The guidance:

  • advises that any clinician working in a hospital, primary care or community care setting, within 2 metres of a suspected or confirmed COVID-19 patient, should wear an apron, gloves, surgical mask and eye protection, based on the risk
  • advises that, in some circumstances, PPE, particularly masks and eye protection intended to protect a health or care worker, can be worn for an entire session and does not need to be changed between patients, as long as it is safe to do so
  • provides more detail on PPE use in various clinical scenarios, in community settings, such as care homes, and where individuals are cared for in their own homes
  • advises that clinicians should wear a higher level of protective equipment (listed in the guidance) when carrying out aerosol generating procedures (AGPs)
  • advises the use of aprons, rather than gowns, for non-AGPs, as well as thorough washing of forearms where there is a risk of exposure to droplets – advice that is consistent with the UK policy of ‘bare-below-the-elbows’ and evidence reviews of the risks of healthcare-acquired infections
  • recommends the use of FFP3 masks, a more rigorous requirement than recommended by WHO (which recommends FFP2 masks); however, FFP2 masks may be used safely if necessary

Single-sheet summary tables of PPE recommendations for various healthcare workers are also available.

Training videos

In addition to the above PPE-related guidance, other COVID-19 related guidance for the public and healthcare professionals is updated regularly.

Vaccine coverage report in this issue of HPR

Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): October to December 2019

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