In Scotland, we are fortunate to have an internationally recognised infection prevention and control manual that is evidence based and which gives people the advice that they need on what PPE is required. There is no doubt that staff were under huge pressure, and there was a lot of anxiety about it. Gregor Smith has already talked about the fact that this was an unknown virus and we were uncertain about what it would do. Across the UK, we developed and agreed infection prevention and control guidance, which was issued in early April to emphasise and supplement what was already there. There was clearly anxiety from staff about whether they would need to wear a face mask and whether they would need that additional protection of a filtered face mask. Communication was very important, so that people knew what PPE they required.
There is no doubt that, at times, some people believed that they needed additional levels of protection to what the evidence suggested. They were not blameworthy. People were anxious and they were worried about treating people with Covid-19 and taking it back to their families, so we needed to work hard to explain and enable people to understand and to have confidence.
In the guidance that we issued in April, although we said that it was not required for staff who were not working within 2m and whose patients or—if it was social care—clients did not have Covid, we said that, if those members of staff wanted to wear a fluid-resistant surgical face mask, they could. We tried to be as facilitative as possible.
Again, we did not run out of PPE in Scotland, but there is no doubt that there were times when distribution, particularly to our care homes, was tight. The employer has the responsibility to provide PPE and, until we took over responsibility for providing that in care homes, that was the situation with distribution. My nursing and medical colleagues in our big hospitals would also say that, when a big delivery arrived, there was a lot of relief that the PPE would be there for people.
We are continuing to look at the evidence to determine whether our current PPE is right and proper. We have also produced guidance on how we care for people with Covid-19 or suspected Covid-19 as well as advice on how we care for people who do not have Covid-19, through the red and green pathways, as we remobilise the NHS. We gave people working in the green pathways discretion to wear filtered face masks if they were carrying out procedures that would require those face masks in the red pathways. We were facilitative so that we supported those who wanted to do that.
We need to constantly communicate and listen to staff, and our professional organisations are incredibly helpful in that. We work in partnership with them to get an understanding of what staff are finding challenging and what they are afraid of, so that we can respond. We are developing a series of webinars so that grass-roots staff can have full access to talk to the experts about what their concerns are, what they want to see developed and moved forward, and how greater assurance and advice can be provided.
We did not ask people at any time to reuse single-use PPE. That happened in other parts of the United Kingdom. We recognised that other parts of the United Kingdom were doing that, but we were never in a position in which that was required. Visors are manufactured to be reusable, and we gave instruction on how to appropriately use them. Similarly, there was sessional use. Normally in a surgical ward, a person would put on a mask to treat one patient but, with Covid-19, the expert advice was that there could be sessional use if that was wanted.
Some of the communication got mixed up along the way, and we have absolutely learned from that. We have provided posters, and we are working hard. We hope to have dialogue with the widest group of staff across Scotland in webinars, but we are constantly keeping that under review.