Who do the recommendations apply to?
The recommendations apply to everyone working or visiting in a hospital setting.
The use of a surgical face mask applies for all staff when not in patient-facing clinical settings (where appropriate personal protective equipment (PPE) should be used in line with published guidance), including:
· clinical (medical, nursing, allied health, diagnostics etc) and
· non-clinical staff (administration, porters, volunteers, cleaning, estates staff, contactors working on NHS sites, etc).
The use of face coverings applies to all members of the public when in hospital, including those visiting patients or attending outpatient appointments.
This guidance does not cover the use of masks for inpatients nor the use of masks as personal protective equipment. This should be managed in accordance with existing guidance.
What is the difference between a face mask and a face covering?
All surgical face masks are classified as either Type I, IR, II, IIR, and are medical devices provided by the hospital.
Face coverings can be cloth or homemade and should cover the nose and mouth of the wearer.
What supplies of face masks will be made available?
Surgical face masks will be made available through hospitals’ usual PPE deliveries. Since Sunday, 7 June 2020 a larger quantity of surgical masks have been sent out each day to help hospitals prepare for the additional need. Initially extra deliveries have focused on type IIR masks, and type Is and IIs will also be delivered and will be clearly labelled so staff do not use these in clinical settings.
Outpatients and visitors
Why are we asking visitors/patients visiting the site to wear face coverings?
Outpatients or visitors coming to the hospital will need to wear face coverings to reduce the risk of transmitting coronavirus to others. Evidence has shown that those infected with COVID-19 can have very mild or no respiratory symptoms (asymptomatic) and potentially transmit the virus to others without being aware of it
Outpatients should be advised of the need to bring a face covering ahead of coming to hospital for planned and outpatient care (outpatient appointments etc); for example in appointment setting calls and confirmation letters.
What happens if an outpatient/visitor does not have a face covering when they come to the hospital?
If an outpatient or visitor does not have a face covering when they come to hospital, one should be provided by staff on arrival.
Local implementation plans should identify how this will be managed.
How do we communicate this new rule to visitors/outpatients?
The need for visitors/outpatients to wear a face covering when visiting the hospital site should be communicated through appointment letters, social media, local news stations/papers and through signage displayed at entrances to the site throughout wards and departments.
Staff should use any opportunity to inform patients of the rationale for face coverings. Consider using hospital volunteers to remind patients/visitors as they arrive on site. A face covering is not a medical/surgical mask. If outpatients and/or visitors do not have face coverings, the trust/hospital may need to provide surgical masks or consider having a stock of face coverings available.
A toolkit has been developed to support local communication with outpatients and visitors and will be made available to trust communications teams via regional communication channels.
What does this mean for shielding patients?
For those patients who are currently shielding, and who have been provided with a surgical face mask for their appointments, these should be worn. Where not already provided, patients should wear a face covering.
What about cloth/homemade/donated face masks?
Outpatient and visitor face coverings can be cloth and/or homemade (www.gov.uk/government/publications/how-to-wear-and-make-a-cloth-face-covering) All visitors will be expected to comply with two -metre social/physical distancing and the recommended hand hygiene measures.
Where applicable, visitors to high risk COVID-19 areas of the hospital or visitors of patients with confirmed COVID-19 must wear appropriate PPE as per the current IPC guidance https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control
Staff should comply with the guidance on wearing a surgical face mask (as appropriate when in clinical/non-clinical areas) while at work.
Does my face covering worn for religious beliefs/cultural practice qualify?
Face coverings worn as part of religious beliefs or cultural practice are acceptable, providing they are not loose and cover the mouth and nose.
What if an outpatient/visitor is unable to wear a face covering?
For some, wearing of a face covering may be difficult, and therefore all other measures must also be considered and introduced e.g. social/physical distancing, timed appointments; being seen immediately and not kept in waiting rooms. Individual risk assessments should be undertaken where required; for example, patients with mental health and learning disabilities. Such risk assessments must be documented.
What about the impact of masks on communication for people who are deaf or have a hearing impairment?
The use of face masks due to the coronavirus pandemic may have an impact on patients who are deaf or have a hearing impairment as they can block the face of healthcare workers and prevent the ability to use visual cues such as facial expressions and lip reading.
The Government's PPE procurement team has sourced an initially small number of clear surgical face masks to support communication with patients who may be deaf or hearing impaired. They are working with regions to identify where those are best distributed.
Where clear masks are not possible, the below diagram outlines some good communication tactics to consider supporting patients and visitors who are deaf or have a hearing impairment: