A GP practice in Leicester has reinstated face masks for all patients attending the surgery, as a ‘precautionary measure’ to protect vulnerable patients.
Canon Street Medical Centre asked patients visiting the practice to start wearing face masks again, a measure which has been supported by the local LMC and ICB.
Practice manager Mukta Modi told Pulse: ‘We are preparing for the autumn vaccination programmes and this is a precautionary measure to protect staff and our vulnerable patients.
‘This has been discussed with our patient participation group who have been very supportive.’
Leicester, Leicestershire and Rutland LMC chair Dr Grant Ingrams told Pulse: ‘The LMC would support any practice to carry out their own risk assessment and to implement what they feel they need to protect their staff and patients. The number of patients with Covid is increasing again.
‘Practices have to make a decision that suits them – if they feel the risk is going up, and that might be for different reasons. As an LMC we would back any practice that comes to this conclusion after a risk assessment.
‘We have a requirement to keep our staff, patients and visitors to the practice safe.’
An ICB spokesperson said current guidance for GP practices across Leicester, Leicestershire and Rutland advises that mask wearing in clinical areas ‘can be locally risk assessed by individual practices’.
They added: ‘It is for each practice to make their own decisions on mask-wearing for staff and face coverings for patients, as well as all other Covid precautions.
‘This guidance is in line with the current recommendations from NHS England.’
NHS England told Pulse that ‘local decision-making based on local circumstances’ is how settings should be deciding on any enhanced measures that may be appropriate.
Its most recent guidance around face masks said: ‘Outpatients (including urgent and emergency care and primary care) with respiratory symptoms who present for treatment should be asked to wear a facemask/covering (or offered one on arrival unless placed in a single room) if this can be tolerated and is deemed safe for the patient.
‘Outpatients without respiratory symptoms are not required to wear a facemask unless this is a personal preference.
‘The request for patients to wear a facemask must never compromise their clinical care, such as when oxygen therapy is required or where it causes distress, eg, paediatric/mental health settings.
‘Visitors and individuals accompanying patients to inpatient, outpatient appointments or the emergency department are not required to wear a facemask unless this is a personal preference.’
Patients had been required to wear face masks in GP surgeries during the pandemic until June last year.
Elsewhere, Lincolnshire LMC told Pulse that practices in the area will be monitoring any further developments on the evolving data around severity and transmissibility of the new variant.
Dr Reid Baker, LMC medical director, said: ‘Since the beginning of the Covid pandemic, practices have been cognisant of the IPC guidance and also performed their own risk assessments to appropriately protect their patients and staff.
‘While mandatory mask wearing is not currently implemented across Lincolnshire practices, this would be reviewed by our practices should the data or their risk assessments support that approach.
‘Our practices want to minimise direct risk of Covid (and any other infection) transmission to patients and staff.
‘If required, the implementation of wearing of face masks will be crucial to prevent staff illness that impacts on our ability to provide GP services at a time of already unprecedented and escalating demand and pressure on GP services.’
Last month, a report from the Royal Society concluded measures such as lockdown, social distancing and face masks were ‘unequivocally effective’ in reducing the spread of Covid-19 in the early days of the pandemic buying time for the development of vaccines and drug treatments.
READERS' COMMENTS [7]
Please note, only GPs are permitted to add comments to articles
This is not an evidence based decision.
https://www.cochrane.org/CD006207/ARI_do-physical-measures-such-hand-washing-or-wearing-masks-stop-or-slow-down-spread-respiratory-viruses
This is a very sensible approach, and I congratulate the GPs on doing their bit as leadership for community considerateness to the vulnerable – and also the security of continuity of services, given the risk of staff catching things off patients and having to take off work ill and to recover.
I would agree with AW that hand-washing does not reduce transmission of covid (and wish some truthfull information on this had been disseminated sooner and more widely), but it DOES reduce transmission of other infections, and should definitely be encouraged in all health-care premisses. Only about 4-8 % of men apparenlty wash their hands after toiletting, less after wiping noses, and about 70% of men have urine on their hands.
Masking has been proven to reduce transmission of various airborme viral infections, including SARS, MERS, and Covid, but FFP3 masks are more ffective than FFP2, which are in turn much more effective than loose-fitting blue surgical masks. and they more than ‘face-coverings’ and scarves, but all are better than nothing.
It is important for medics to lead on matters of community considerateness as well, and to improve hygeine generally.
All patients should be pre-screened to reduce risk of culpable transmission in the building, and particularly the risk of transmission to staff/GPs and secondary re-transmission to other vulnerable patients, as this is a requirement of GMC guidance to ‘consider the effect of (your own) health on the health of the patient’.
As we go into winter virus season as well as another bout of covid (with particular risks of chronic disease to all) any GP practice who ignore the risks, and do NOT promote masking of staff and patients, is likely to suffer staff shortages with consequent increase in work pressure, expenses, and chronic disability of staff. And potentially HSW negligence claims from infected staff and patients.
Wearing a mask is a very minor inconvenience, but demonstrates our consideration for the health of others, which cannot be a bad sign, can it? There has been positive evidence of the effect of proper masking for over 30 years, in medical journals and textbooks.
No point. No evidence.
Given the weak evidence for real world masks (especially the filthy damp rags routinely flapping below the noses or even chins of most patients) it seems utterly pointless to insist on masks any way, but it would be very unwise to reinstate mandatory masking.
Gobby punters would undoubtedly insist on their legal right not to be forced wear a redundant face nappy, leading to even more confrontation and staff abuse.
But do we really want to drag ourselves back the dark days of The Pandemic?
Covid 19 variants, like all viruses, are becoming more infectious and less deadly with each “successful “ mutation.
We have been bombarded by far more serious viruses from our patients pre-2020 without any thought of masks and miraculously survived.
Look, some people remain mask enthusiasts, others mask sceptics, and both could point to the mixed bag of evidence to back their case.
Surely a sensible compromise is to request and strongly suggest our patients mask up, but avoid compulsory mandates that lack solid real world evidence and antagonise the cynics.
Actually the Cochrane review is pretty clear I can the mask evidence (or lack thereof)…”Compared with wearing no mask in the community studies only, wearing a mask may make little to no difference in how many people caught a flu-like illness/COVID-like illness (9 studies; 276,917 people); and probably makes little or no difference in how many people have flu/COVID confirmed by a laboratory test (6 studies; 13,919 people). Unwanted effects were rarely reported; discomfort was mentioned”
Patients generally don’t like them and they totally destroy any hope of rapport during consultations. The only purpose they seem to serve is to ramp up the climate of fear for the population.
Cochrane is quite clear. The Danish study at proper community level with control group found no evidence for masks either. And then it transpires that many are laden with heavy metals and risk of us inspiring micro-fibres.
If an individual feels more comfortable in a face mask then I’m more than happy for them to wear one but don’t force others to wear one when the evidence is not on your side.
Pointless pseudoscience decision.
(Unless they are fitting FP3’s at the door that is)