The BMA has said it ‘will support’ any GP practice that continues to ask patients and staff to wear face masks.
NHS England updated its guidance earlier this month to say that patients who enter GP practices in England are no longer required to wear a face mask unless they have respiratory symptoms.
But the BMA said that practices must be ‘able to exercise discretion’ to protect patients and staff.
Its latest GP bulletin said: ‘People who come to GP practices are more likely to be ill or clinically vulnerable, so it’s vital that practices are able to exercise discretion to protect patients and staff.
‘Especially in the context of rising abuse towards practice staff, people must be assured that if practices are asking them to continue wearing masks this is for the safety of everyone in the building.’
It added: ‘The BMA will support practices and doctors who continue to ask patients and staff to wear face masks where they feel this is necessary.’
The BMA also said local risk assessments for staff coming into contact with Covid are ‘particularly important now that the requirement for social distancing and mask wearing is no longer obligatory’.
It added: ‘It is still the employer’s responsibility to ensure safe working for staff, and thus a risk assessment should still be carried out and appropriate mitigations.’
The BMA has revised its guidance on Covid risk assessments for GP practices, which said that practices ‘might be vulnerable if their risk assessment does not include Covid-19 whilst prevalence remains significant’ due to these legal obligations.
It set out various examples of risk scenarios, including that GPs conducting face-to-face consultations in a ‘small poorly ventilated room’ and receptionists working with no partition and/or ‘inadequate or uncertain’ ventilation remain at ‘high risk’.
Suggested control measures included:
- Introducing virtual consultations and having certain staff working from home, conducting ‘as many consultations as possible remotely’
- Considering video-conference staff meetings rather than face-to-face even when all participants are in the building
- Continued triage and ‘cohorting’
- Testing or screening of patients and staff
- Social distancing of patients and staff with one-way systems
- Using respiratory protective equipment (RPE) such as FFP3 for employees in high-risk scenarios and at least FFP2 for those in medium-risk scenarios
However, the guidance added that practices ‘will need to review those mitigations that potentially reduce the standard of care, such as limiting face-to-face consultations, once the disease prevalence decreases’.
And it said they should ‘be aware of other direct implications’ such as staff burnout, increased costs from locum support and PPE procurement and ‘reduced QOF compliance’.
It added: ‘The legal requirement to reduce risk to as low as reasonably practicable acknowledges that there is a balance between what could reduce risk and what is practicable.’
NHS England’s updated guidance said patients, apart from those with respiratory symptoms, are ‘not required’ to wear a face mask unless they wish to as a ‘personal preference’.
Practice staff should continue to wear face masks as part of PPE when working with suspected or confirmed Covid patients, including those working with untriaged patients, under the guidance.
It also said that in non-clinical areas such as offices and social settings, staff do not need to wear masks unless it is their personal preference or if there are issues raised by risk assessments.
Any IPC measures beyond the updated guidance are a matter for ‘local discretion’, it added.