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GPs should assume ‘most’ patients have Covid-19 and use PPE, says NHS England

GPs should now assume that ‘most’ patients have coronavirus (Covid-19) and use PPE on a sessional basis, NHS England has said.

Public Health England (PHE) published updated guidance yesterday that stopped short of explicitly recommending GPs use PPE for all patient contacts, although it suggested this may be necessary depending on ‘local risk assessment’.

But speaking in a live webinar yesterday evening, NHS England medical director for primary care Dr Nikki Kanani went further by recommending that GPs treat all patients as possible cases.

She said: ‘We now have to presume that most people will be Covid-positive.’

PHE national incident director for Covid-19 Dr Susan Hopkins added that GPs should take a ‘precautionary approach’ and use PPE on a sessional basis for all patient contact.

She said: ‘In this time of uncertainty when we know that there are high amounts of Covid-19 circulating in our communities and in our hospitals, people should be able to take a precautionary approach and therefore decide when they want to wear the PPE that is needed.

‘To keep people safe and to ensure they feel safe in their working environment, we are recommending that people can and should use PPE for the duration of the session to prevent infection.’

One of the ‘big things’ to change in the new guidance is the recommendation that GPs should use eye protection when seeing a ‘suspected or confirmed’ case of Covid-19, Dr Hopkins added.

She said: ‘Visors or eye protection should be part of the kits that get sent out and we have discussed with the supply chain how important that is to be done as rapidly as possible.’

Dr Kanani confirmed that eye protection ‘will be added to the kit’ being provided to GP practices.

PHE’s guidance published yesterday said that primary care professionals should use PPE when coming within two metres of a ‘possible or confirmed’ case of coronavirus. 

This should include a fluid-resistant (Type IIR) surgical mask; plastic apron; eye protection; and gloves, PHE said.

And it did stress, for all health professionals, that ‘ultimately, where staff consider there is a risk to themselves or the individuals they are caring for they should wear a fluid repellent surgical mask’.

It said this could be ‘with or without eye protection, as determined by the individual staff member for the episode of care or single session’.

It comes as a number of GPs calling the new ‘emergency’ helpline to request PPE have been redirected to their ‘usual suppliers’ to buy the items they need.

And some GPs have come together to share homemade PPE in attempts to compensate for the ongoing supply problems.