GPs buying own enhanced PPE to ward off Omicron wave

GPs have told Pulse of buying their own higher grade PPE to protect staff as the new Omicron Covid variant is sweeping over the country.

Current infection prevention and control (IPC) Government guidance recommends ‘face coverings or surgical masks (Type II or IIR) to prevent the transmission of SARS-CoV-2 and other respiratory infectious agents in health and care settings’.

The BMA has written to NHS England for clarity on the IPC guidance and request that GPs, who cannot order Respiratory Protective Equipment (RPE) centrally unlike hospital doctors, have access to ‘higher grade masks and are given guidance on how to keep safe in small and cramped surgeries’.

There is no system providing GPs with respirator masks or fit for testing, and NHS England’s supplies to GP practices of just fluid replacement surgical masks are ‘despite the known additional benefits of FFP3 masks’, the BMA said.

BMA GPC England chair Dr Farah Jameel said: ‘We see patients in poorly ventilated, small and cramped areas, without proper RPE and it’s just not safe for GPs, their teams or patients. With Omicron’s increased transmissibility and the rapid infection rates we now have in the community, it’s even more crucial that GPs have quick access to RPE.

‘We’re also keen to work with NHSEI in terms of how and where we see patients who have or are suspected to have Covid-19, whether that’s outside the surgery, or in specially designed separate Covid-19 hubs.’

Surrey GP partner Dr Dave Triska told Pulse he believes the recommended level of PPE was ‘barely adequate’ to deal with the Delta variant and is ‘completely inadequate’ for Omicron now.

Dr Triska said: ‘We have no formal issue of FFP2 or FFP3 for primary care at all in England, so you could be in a room seeing someone with definite Covid. And that’s as good as you get. This is why everyone’s investing [in better].

He added: ‘It seems ludicrous that our current guidance is to have a bit of paper in front of the face.’

Dr Triska said his practice has made the decision to switch all staff to a minimum of FFP2 for non-symptomatic patients, and industrial FFP3 reusable respirators for patients with infectious symptoms, ‘simply because we’ve got vulnerable people in the staff, we’ve got vulnerable people in our homes.

‘And the Government isn’t doing it, there’s still no guidance change on this. It’s very, very clear, [Omicron] is extremely transmissible.’

The surgery also has HEPA filters in all the rooms to improve ventilation, and Dr Triska said so far they have not had any Covid transmissions.

A record high of 93,045 cases of Covid were reported on Friday 17 December in the UK, having risen nearly 5,000 from the day before.

Dr Triska told Pulse providing adequate PPE for GPs would be a ‘quick resolution’ for the Government and NHS England who have ‘lost the moral incentive for GPs because we don’t trust them’.

He added that his advice to all GPs would be to get FFP3 masks ‘immediately’.

Dr Lizzie Toberty, North East GP and Doctors Association GP lead, told Pulse: ‘Two years into the pandemic, we should definitely have better PPE…. And surely health and safety laws would say that there is a responsibility on the NHS to provide adequate steps to keep us safe. And I don’t think that that’s there at the moment.’

She said: ‘It shows a disdain for staff, that in the same week Boris Johnson sent out a letter thanking us, we’re not being provided with the basics to enable us to look after our own health and therefore look after our patients.’

She also said it should be done centrally ‘from a practical perspective’, as she struggled to know which FFP3 mask was the right one when looking for herself.

East End GP Dr Selvaseelan Selvarajah also said he would not be waiting for the Government and NHS England to ‘change their mind about optimal PPE’ for GPs and has ordered himself a FFP3 mask after seeing many colleagues test positive, which is he said is ‘putting a lot of strain on the NHS and our ability to see patients’.

Suffolk GP Dr Sara Macbay bought her own FFP3 mask in the first wave of the pandemic. She said her LMC says that as the guidance for GP practices is for staff to wear surgical masks, it is not in ‘a position to lobby the CCG to provide FFP3 masks’. 

She said it was a ‘complete joke’ and ‘just wrong’ while GPs are having to see patients with respiratory illnesses who have not had a PCR test.

It comes as the Government is considering extending its free personal protective equipment (PPE) scheme for GPs for a further 12 months after March 2022.

The Government said last month PPE was the least effective in their hierarchy of measures in an update to IPC guidance.