Coronavirus: Care homes welcome Scottish guidance requiring staff to wear face masks 'throughout' shift

Staff working in Scotland’s care homes and hospitals ‘in a clinical area’ must wear medical face masks ‘at all times throughout their shift’ from 29 June, according to new guidelines from the Scottish Government.

The guidance states medical face masks to be worn by staff ‘within residential healthcare settings like acute adult (inc. mental health) and community hospitals and care homes for the elderly’.

Scotland’s Cabinet Secretary for Health & Sport told the Scottish Parliament on 23 June: “Face masks will now be worn in hospitals and care homes for adults by all staff who have contact with patients or residents.

“This new measure is designed to reduce the risk of transmission from the person wearing the mask or face covering.

“Guidance on this for Health Boards and employers will issue this week and be effective from 29 June.”

The Scottish Government’s new guidelines advise staff to ‘use their professional judgement, and undertake a risk assessment, in instances where it is necessary to remove the medical face mask for a short period of time, and it is safe to do so'.

It gives the example of 'when the person they are supporting / caring for is showing signs of distress or to communicate with a person who lip reads’.

The guidelines state: ‘The face mask can be removed and replaced as necessary (washing your hands before the mask is removed), and as recommended during the shift, including e.g. if it becomes contaminated, damaged or moist.’

The government also advises in such circumstances that ‘where medical face masks are not worn, carrying out physical distancing is essential’.

Care homes have wanted such guidance since 29 April

The Scottish Government said it issued the guidance to prevent transmission of the virus by someone who may have contracted the virus but does not display any COVID-19 symptoms.

Scottish Care, which represents 900 of Scotland’s care homes, home care providers, day care centres and housing support services, said in a statement that it ‘welcomes this announcement, which we first called for on 29 April’.

‘We consider it to be one of a number of important measures in protecting residents and care home workers from coronavirus infection and spread and one which will be increasingly important as lockdown measures are eased.

‘It will be important to consider how professional judgment can be exercised around the wearing of masks when supporting individuals with dementia, those who lip read or who are experiencing significant distress'.

Scottish Care also said care homes must be able to continue accessing the number of masks required at a sustainable cost 'as demands on the supply chain are likely to increase’.

The guidelines state face coverings must also be worn by visitors to all care homes. Visitors’ face coverings can be of the same type already recommended by the Scottish Government for use on public transport. Care homes must supply visitors with a face mask, if required.

Scotland delivers type IIR masks

Scotland’s new guidelines follow World Health Organisation (WHO) guidance issued on 5 June about the ‘extended’ use of medical face masks by care staff.

The Scottish Government’s COVID-19 Nosocomial Review Group (CNRG) considered the new WHO guidance, as well as evidence from the SAGE Hospital-onset COVID-19 Working Group that the use of face masks can reduce transmission of COVID-19.

The WHO guidance recommends that a type I or II medical mask should be used to reduce the onward transmission of COVID-19 between staff.

NHS National Services Scotland (NSS) is delivering type IIR masks.

The Scottish Government stated: ‘We have taken account of the need to make sure there is sufficient supply of facemasks before introducing this new measure. In anticipation of the change, NSS [NHS National Services Scotland] is increasing supplies, including to local social care PPE Hubs’.

Calls for home care workers to be included in guidance

Currently, the guidance does not apply to home care workers but Scottish Care is now calling for an ‘extension of this announcement to health and care staff in the community, including in care at home settings.

Scottish Care stated: ‘These individuals are also at greater risk of infection transmission and spread, not least as visiting restrictions across the population ease. 'They require recognition and consistency in PPE use between themselves and colleagues in other health and care settings and sectors’.

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