Chamber and committees

1 .All staff on mental health wards should follow the UK IPC remobilisation guidance for all health and care settings, published on 21 August. This guidance is based on the latest scientific and epidemiological evidence. All staff engaged in direct patient care should wear a Fluid Resistant (Type IIR) Surgical Mask throughout their shift.

2. Fluid Resistant (Type IIR) Surgical Masks act as a two way barrier – protecting both the wearer and the patient or individual they are caring for. Where the person is suspected or positive for COVID-19 or any other infection, the staff are required to wear single-use gloves and aprons where they deem a risk of contact with blood or body fluids and a visor where there is a risk of splashing into the eyes.

3. Clinical Guidance for NHS Scotland: Using Physical Restraint for Patients with Confirmed or Suspected COVID- 19 was published on the Scottish Government website on 20 April. The guidance states that The Step Wise Management Plan for COVID-19 positive/symptomatic patients based on principles of least restrictive care should be implemented. It is vital that essential IPC precautions are reinforced including hand hygiene, social distancing where possible and wearing of appropriate personal protective equipment (PPE).

1. Both the UK Government’s New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) and Health Protection Scotland (HPS) have given careful consideration to the available evidence and, during the course of the pandemic, have reviewed what should be considered an AGP. Coughing is not considered an aerosol generating procedure (AGP) and therefore a Fluid Resistant (Type IIR) Surgical Mask (FRSM) is the appropriate face mask in the situation described.

2. FRSMs or Type IIR masks protect against droplet transmission and act as a two-way barrier, protecting both staff members and patients, with the FRSM or Type IIR mask conferriing 98% source control against droplet transmission.

1. On 21 August, new UK Infection Prevention and Control (IPC) remobilisation guidance for health and care settings was published. The guidance outlines key COVID-19 IPC measures such as the appropriate use of PPE, extended use of face masks and coverings, physical distancing, and outbreak management, as well as risk assessed patient care pathway scenarios to help guide the implementation of measures for safe and effective care.

2 Patients in medium or high risk pathways need to wear Fluid Resistant (Type IIR) Surgical Mask if this can be tolerated and does not compromise their care.

3 As part of remobilisation, Health Facilities Scotland have provided diagrammatic guidance to support health and social care to ensure physical distancing of 2m can be maintained in terms of bed, chair and desk spacing. This guidance uses a risk-based approach in terms of reducing the risk of transmission of COVID-19 to staff, patients and visitors using the hierarchy of risk control as legislated by the HSE.

4 More generally, NHS Boards have access to a risk assessment and guidance tool which helps both the employer and individual understand the workplace and individual risks.

5 We are aware that there is emerging evidence that people from Black, Asian and Minority Ethnic (BAME) background may be disproportionately affected by COVID19. The COVID-19 Occupational Risk Assessment Guidance, published on the Scottish Government website on 4 September, uses multiple personal characteristics including age, sex, ethnicity, BMI and underlying health conditions, to give an overall assessment of the the vulnerability of a member of staff. This will support managers to have supportive discussions with their staff members around their individual risk from COVID-19 in an occupational context.

Details are as follows:

The Scottish Government has collected, monitored and published data on NHS staff absences since the outbreak of this pandemic. Data is continually collated from Health Boards on overall absences in the NHS workforce, as well as on the number and rate of absences associated with Covid-19. Covid-19-related absences are recorded on staff displaying symptoms, self-isolating, confirmed to have Covid-19, Covid-19-related caring responsibilities and those contacted by tracers and told to isolate for 14 days.

For the week 30 September – 6 October 2020, a daily average of 1.0% of the workforce were recorded absent for reasons related to Covid-19. The rate of Covid-19 related absence has been steady and decreasing in recent months, with a rate below 2% since late July and below 4% since early May. We will continue to pay close attention to staff absence data in the coming months.

This data does not include whether NHS staff have been wearing (a) a surgical type two, (b) FFP2 and (c) FFP3 face masks when treating people with Covid-19.

1. In Scotland, all health and social care staff involved in direct patient/client care are required to wear a Fluid Resistant (Type IIR) Surgical Mask (FRSM) throughout their shift. This includes both care homes and care at home.

2. COVID-19 is primarily transmitted through droplets and only aerosolised during certain procedures called aerosol generating procedures (AGPs). When staff are dealing with patients who are either suspected, positive or where their status is not known (person not tested) staff engaged in AGPs must wear a single-use fluid filtering face piece (FFP3) mask, long-sleeved gown, gloves and a visor in line with the UK IPC Remobilisation Guidance.

The Scottish Government has collected, monitored and published data on NHS staff absences since the outbreak of this pandemic. Data is continually collated from Health Boards on overall absences in the NHS workforce, as well as on the number and rate of absences associated with Covid-19. Covid-19-related absences are recorded on staff displaying symptoms, self-isolating, confirmed to have Covid-19, Covid-19-related caring responsibilities and those contacted by tracers and told to isolate for 14 days.

For the week 30 September – 6 October 2020, a daily average of 1.0% of the workforce were recorded absent for reasons related to Covid-19. The rate of Covid-19 related absence has been steady and decreasing in recent months, with a rate below 2% since late July and below 4% since early May. We will continue to pay close attention to staff absence data in the coming months.

This data does not include whether NHS staff have been wearing government approved PPE or not.

COVID-19 is predominantly spread by the droplet and contact route. Fluid Resistant (Type IIR) Surgical Mask (FRSM) offer the correct level of respiratory protection for staff when caring for a patient who is suspected or confirmed COVID-19 positive.

In Scotland, we use Fluid Resistant Surgical Masks (FRSM), also known as Type IIR masks, which are different from Type II in that they provide protection for the staff member as well as 98% source control.

We are the only nation in the UK who have taken the approach in using FRSMs as part of the extended facemask use guidance for health and social care staff.

The Scottish Government holds a regular forum with a range of stakeholders including staff side representation which provides an opportunity for any issues with regard to PPE to be raised. In addition we also respond directly to correspondence received from both individuals and organisations.

Decisions on which type of PPE to use in different settings are based on clinical guidance, and as an employer the NHS is, under health and safety law, responsible for the protection of its staff. No price has never ever been used as a factor in deciding what product is to be issued.

The cost of PPE varies according to the negotiated cost of purchase on the market. The current cost of a single map of each type is as follows:

a)Type IIR mask: £0.16 (July 2020 onwards) – £0.70 (March/April 2020)

b)FFP2 mask (these are not used per guidance, and no longer purchased): £0.98 - £3.00 (March 2020)

c)FFP3 respirator masks: £1.85 - £6.00 (March 2020 to July 2020, prices are now near £2.00)