PPE

Free PPE for the frontline – Register with the PPE Portal 19/10/2020

For those who were previously unaware, the PPE Portal has changed from being an ‘emergency top-up’ system to meeting COVID-19 PPE requirements. Eligible primary care providers in England (including community pharmacists, optometrists, dentists, orthodontists and GPs) should now order PPE through the portal, free of charge, to meet the increased need that has arisen as a result of the COVID-19 pandemic. 

The DHSC has partnered with the NHS and the e-commerce industry to develop this service in order to ensure that those on the frontline have what they need. The overriding priority is to protect people and our wider communities, thereby reducing infections and saving lives. We must make sure everyone has the PPE they need so please do play your part in this collective effort.

Register and access the portal using your CQC/MHRA/NHSE/NHS BSA registered email. The latest guidance on what PPE items you can order (including order limits) is also available. Call the customer service team on 0800 876 6802 if you have any questions about using the PPE portal (including registration and queries or if you think you should have been invited but have not been). The team is available from 7am to 7pm, 7 days a week, to help resolve your queries.

The PPE portal will be the primary source of free COVID-19 PPE (including Flu vaccination requirements). However, if there is a severe disruption to distribution, in the first instance get in contact with your local authority or LRF. A gov.uk page will shortly be published with the local authority/LRF contact details. If this route is not possible, get in contact with the NSDR.

Register to the PPE portal for free PEE for all primary care providers  12/10/2020

The Department of Health and Social Care (DHSC) has published its strategy for providing personal protective equipment (PPE), detailing preparations for a second wave of COVID-19 alongside usual seasonal pressures. DHSC have stated that four-month stockpiles of each PPE category will be in place from November, to provide a continuous flow to health and social care workers treating COVID-19 patients. It will continue to buy centrally through to the end of March with further detail about post-March arrangements expected in due course.

Technical specifications for Personal Protective Equipment (PPE)  21/9/2020

The Health and Safety Executive and the Medicines and Healthcare Products Regulatory Agency have updated the technical specifications for PPE and Medical Devices during COVID-19 including FAQs, available here.

These specifications are also used in the central procurement process for PPE but local providers should also check any donations or locally procured PPE against these specifications alongside other established checks they undertake.  

Where there are significant concerns about a product’s CE mark and/or evidence to support its use, you should  approach the relevant regulator for a review of the product’s available data/information as outlined in the FAQs.

PPE Orders via Clipper portal  7/9/2020

There has been an increase in the volumes of PPE practices can order through the clipper portal: https://www.gov.uk/guidance/ppe-portal-how-to-order-emergency-personal-protective-equipment

The impact of face masks on communication for people who are deaf or have a hearing impairment  3/8/2020

The use of face masks due to the coronavirus pandemic may have an impact on patients who are deaf or have a hearing impairment as they can block the face of healthcare workers and prevent the ability to use visual cues such as facial expressions and lip reading.

The Government's PPE procurement team has sourced an initially small number of clear surgical face masks to support communication with patients who may be deaf or hearing impaired. They are working with regions to identify where those are best distributed.

Where clear masks are not possible, the attached diagram outlines some good communication tactics to consider supporting patients and visitors who are deaf or have a hearing impairment:

Face covering exemptions 3/8/2020

With face coverings now mandatory in many public places, we understand practices have had patients contacting them seeking verification of exemptions from their GPs. There is no requirement for an individual to prove that they have a valid case for exemption if they cannot wear a face covering, therefore, GPs are not expected to provide verification of exemptions.

It is not a legal requirement in health care settings for people to wear a face covering. Government advice says you should wear a face covering in enclosed spaces if you can, including places such as primary care services. However, a patient should not be refused entry to a premises or access to care if they are unable to, or refuse to, wear a covering. This should be clearly communicated to all patients.

Some people may feel more comfortable showing something that says they do not have to wear a face covering. This is a personal choice, and is not necessary in law, verbal communication of this is good enough. Template exemption cards are available for patients to print or download.

Type IIR face masks from Cardinal Health – destroy affected lots 27/7/2020

The Medicines and Healthcare products Regulation Authority (MHRA) issued an alert on Monday to all NHS and social care providers, asking organisations to destroy affected lots of the type IIR face masks from Cardinal Health. This must be completed by 3 August 2020.

Face coverings for the public – exemptions 27/7/2020

Following the introduction of mandatory face coverings for the public in enclosed spaces, the government has now produced a poster which people who fall into an exemption category may wish to use. This does not change any of the criteria for who should wear one.  It simply provides the individual with something they can show, if they are comfortable/able to say they are exempt. The exemptions posters (or downloads to phones) are not required by law, nor do they have to provide one, nor should they be asked to provide evidence. These exemption details are available here.

Face coverings 27/7/2020

New government guidelines around the use of face coverings and masks in hospital settings were announced on Friday 5 June. Some of these recommendations are now being extended to primary and community healthcare settings.

This is an addition to existing national COVID-19 IPC guidance, which advises on appropriate personal protective equipment (PPE) usage in patient facing clinical settings and other measures to be taken to reduce transmission risk such as hand hygiene and social distancing

Central Alerting System - Medical Device Alert – Masks 20/7/2020

 (see attached) For Action and Information

Action by recipients: Care Trusts, Mental Health Trusts, Specialists Trusts, NHS Regional Offices, Learning Disabilities Trusts, Mental Health & Social Care Trusts, Ambulance Trusts, Mental Health & Learning Disabilities, Acute Trusts, Community Trusts

Information to recipients: Other contacts, Independent Healthcare Providers (registered with CAS), Clinical Commissioning Groups, Ofsted recipients, Social Care Providers (registered with CAS), Special Health Authorities, Regional Directors of Public Health, Director of Public Health, GP – Locum, NHS111 and Out of hours providers, GP Practices, Primary Care Networks

Title: Masks: type IIR from Cardinal Health – destroy affected lots

Broadcast content: Foam strip on the mask can flake and enter the wearer’s airway or mouth; ties and/or stitching may detach from the mask.

PPE Clipper portal 10/7/2020

The order limits on clipper have been revised:

GPs with fewer than 8,000 patients can order 100 IIR masks, 200 aprons and 400 gloves (200 pairs) per week.

GPs with 8,000 patients or more can order 200 IIR masks, 400 aprons and 800 gloves (400 pairs) per week.

https://www.gov.uk/guidance/ppe-portal-how-to-order-emergency-personal-protective-equipment

PPE Portal order limits for general practice and social care providers 6/7/2020

After considering the stock and demand levels of customers invited to the PPE Portal, the Department of Health and Social Care (DHSC) have adjusted the order limits based on size and type of provider. The NHS.net issues around receiving the eBay confirmation emails has now been resolved to allow registration on the Portal.

More information is available on the DHSC PPE Portal guidance page and the Portal customer service team can be reached on 0800 876 6802 for enquiries or registration support.

PPE and the risk of heat stress 24/6/2020

  • Wearing Personal Protective Equipment (PPE) in warm/hot environments increases the risk of heat stress.
  • Heat stress occurs when the body is unable to cool itself enough to maintain a healthy temperature. Heat stress can cause heat exhaustion and lead to heat stroke if the person is unable to cool down.
  • Measures to control the temperature of clinical environments and enable staff to make behavioural adaptations to stay cool and well hydrated should be made. Staff may require more frequent breaks and the frequency of PPE changes may increase, with a resulting increase in demand.

Click on the link to see alert: Central Alerting System: Personal Protective Equipment And Heat: Risk Of Heat Stress  

Reminder about ordering personal protective equipment (PPE) 22/6/2020

All GP practices can register on the new online PPE portal for ordering emergency PPE from a central inventory. This is to supplement (not replace) the wholesale supply route that already operates.

The Department of Health and Social Care (DHSC) developed the portal in partnership with eBay UK, NHS Supply Chain, the Army, Clipper and Royal Mail. Throughout May and June 2020, DHSC have been emailing GP practices, inviting them to register with the PPE portal. The emails should be coming from PPE Dedicated Supply Channel (please note this email address does not accept incoming emails): ppe.dedicated.supply.channel@notifications.service.gov.uk

Recognising signs of abuse or neglect: guidance for those working in the community 19/6/2020

The current lockdown restrictions mean that vulnerable children and adults may be particularly isolated. This means that the family, community and professional networks they usually rely on may be unavailable or hard to access.

The Home Office, in collaboration with a number of other Government departments, has produced information and guidance for those working in the community who may not be trained to recognise the signs of abuse of neglect. The guidance covers signs to spot and what to do if there is a concern. 

The guidance can be found on the Home Office Brandworkz portal, and includes print and online versions of the guidance, as well as a poster which can be downloaded and printed for display in staff rooms.

Face coverings for patients and PPE for primary care staff 15/6/2020

You may have seen that patients who are coming into a hospital setting are being asked to wear face coverings. Staff are also being asked to wear the appropriate PPE in public areas.

This is national guidance. However, this national guidance has not yet been extended to primary care.

In Barnsley we would like to support staff working in primary care by implementing this guidance in practices. As many of you are already doing, we would like to encourage all practices to ask patients to wear face coverings when they come in. To support this in part, we are working with some of the community sewing groups who are able to provide some face coverings that practices can keep as ‘emergency’ ones for people who don’t come in with one. This won’t be able to support large numbers but it is a start.

In terms of additional PPE for reception staff, or staff who can’t always maintain the social distance, we are working with BHF to help support practices to do this.

We are keen to support primary care staff in this way and will be using some of the national adverts to use on social media and in the Chronicle to ask people who are attending healthcare appointments (covers all settings) to wear a face covering (where they can).

Latest guidance on IPC and use of PPE 15/6/2020

In light of changing IPC/PPE guidance and the introduction of Test and Trace practices are strongly recommended to undertake a formal risk assessment of their workplace (or revisit previous risk assessments) to ensure all measures are in place to protect your staff and patients. The Infection Prevention Control (IPC) Specialist nurses at BHNFT are available for advice and can be contacted on 01226 432825 (Monday-Friday 8-5) or email bdg-tr.infectioncontrol@nhs.net

Further information regarding workplace assessment, including templates, can be found on HSE website here: https://www.hse.gov.uk/coronavirus/working-safely/index.htm

In primary care settings there are two relevant pieces of advice that should be followed. 

Please do also ensure you read and follow the latest guidance on the Test and Trace service announced by the Government last week to minimise community transmission of COVID-19, alongside the letter sent to organisations across the NHS on 9 June, asking you to take actions to minimise the spread of infections in the NHS. In particular the guidance on COVID-19: management of staff and exposed patients or residents in health and social care settings

We are also working with the IPC team to develop some remote training for practices. Could all practices please nominate a member of staff to lead on IPC for your practice and to access the training when it is available. Further information will be shared as soon as possible.

NHSE Communications re: face mask supplies for Hospitals 12/6/2020

NHSE are sending out facemasks ahead of the policy change on staff using facemasks in non-clinical areas of hospitals.

The guidance is likely to be published by PHE and will circulated as soon as available but this is unlikely to be today. 

  • On Friday the Secretary of State announced that all staff in hospitals in England will be provided with surgical masks which they will be expected to wear from 15 June. This is a change to previous guidance which focused on staff wearing face masks in clinical areas within 2 metres of a patient. (https://www.gov.uk/government/news/face-masks-and-coverings-to-be-worn-by-all-nhs-hospital-staff-and-visitors)
  •  Visitors and outpatients will also be asked to wear face coverings at all times, but hospitals may need to provide a mask or covering if the patient or visitor does not have one.
  •  Guidance is expected imminently and will be circulated to Trusts as soon as it is published.
  •  There is now an abundant supply of type IIR surgical masks in the national inventory which is more than adequate to meet current projected national demand.
  •  Since the weekend we have been pushing out a significantly larger quantity of IIR surgical masks to help Trusts prepare for the additional need. The guidance is likely to also enable staff to use type I and type II masks for non-clinical settings, but at this time we will continue to supply stocks of higher grade IIR masks daily, given the positive supply situation. 
  • If towards the end of the week you estimate you are now receiving too many masks then please contact your region to help advise the national team on appropriate delivery numbers. 
  • The NHS England communications team is pulling together a toolkit for Trusts’ communications teams to help them with visuals and information for visitors and outpatients.

 

HSE safety alert issued against KN95 facemask 12/6/2020

The Health and Safety Executive (HSE) is warning against the use of KN95 facemasks as Personal Protective Equipment (PPE).

safety alert has been issued today, Thursday 11 June 2020, urging all employers and suppliers not to purchase or use KN95 facemasks as PPE.

Products manufactured to KN95 requirements rely on a self-declaration of compliance by the manufacturer.  There is no independent certification or assurance of their quality.

This respirator has been identified as suspect by HSE experts and locally arranged testing has confirmed they would not meet requirements, including to protect against the ongoing coronavirus pandemic. About 90% of the PPE concerns and queries currently being received by HSE involve KN95 masks which are often accompanied by fake or fraudulent paperwork.

KN95 has not been a principal source of PPE for the NHS, who has already made the decision not to supply this respirator to frontline clinicians fighting the coronavirus pandemic.

PPE - Guidance for general practice 10/6/2020

All GP practices can register on the new online personal protective equipment (PPE) portal for ordering emergency PPE from a central inventory. This is to supplement (not replace) the wholesale supply route that already operates.

The Department of Health and Social Care (DHSC) developed the portal in partnership with eBay UK, NHS Supply Chain, the Army, Clipper and Royal Mail. Throughout May and June 2020, DHSC has been emailing GP practices, inviting them to register with the PPE portal. The emails should be coming from PPE Dedicated Supply Channel - ppe.dedicated.supply.channel@notifications.service.gov.ukPlease ensure that you are regularly checking your email accounts, including your ‘junk items’ registered with the CQC/MHRA in order to ensure that the invite is received and actioned.

Current order limits mean GP practices can order one combined pack, containing 50 IIR masks, 200 aprons and 400 gloves (200 pairs), per week or up to this amount of separate items. These limits may change over time.  Orders through the portal should arrive within 48 hours if placed before 1pm. Orders placed after 1pm will be subject to an additional 24-hours.

If providers have any queries, please contact customer services on 0800 876 6802. 

PPE update for community pharmacy 5/6/2020

There have been sales of Type IIR face masks to community pharmacy wholesalers over the past two weeks. NHS England understand that pharmacy wholesalers now have adequate supplies for pharmacy teams to access supplies of personal protective equipment (PPE) and this remains the most effective route for supplies to community pharmacies. If PPE cannot be accessed via this route it remains the case that pharmacies should contact the Local Resilience Forum and if they cannot help contact the national supply disruption service. NHS England are currently developing a new online system so that pharmacies can report any problems they are having accessing PPE, and this will support future allocations

PPE Portal 29/5/2020

Earlier this week the Government announced that GPs and small care homes can register on the PPE Portal, a new online portal for ordering emergency personal protective equipment (PPE) from a central inventory, to supplement the wholesale supply route that already operates. The Department of Health and Social Care developed the portal in partnership with eBay UK, NHS Supply Chain, the Army, Clipper and Royal Mail. Please note The PPE Portal has been tested with the sector and is now being scaled up nationally over the coming weeks. During this phase of the roll-out, GPs and small residential and domiciliary social care services will be invited to register on the portal.

COVID-19 tests and testing kits 18/5/2020

Information for members of the public, patients, professionals and industry about COVID-19 tests and testing kits, including how they work, the different types of tests and the specifications manufacturers need to follow can be found here

PPE supplier – Henry Schein 29/4/2020

Given the Coronavirus outbreak and the resulting increase in demand for PPE products from existing customers, we have been informed that unfortunately Henry Schein will no longer be able to supply GP practices with PPE. 

Please continue to follow the process for ordering PPE that was outlined in the Bulletin circulated on 21 April 2020

PPE alternatives 21/4/2020

Public Health England have now published additional advice, in line with World Health Organisation advice, on PPE alternatives staff can use in the event of shortages within existing organisations.

PPE escalations 21/4/2020

Attached is a communication for primary care on how best to escalate any stock issues with PPE. The Appendix is the list of providers who are getting push stock so hopefully that will help practices.

PPE 16/4/2020 

A dedicated page has been set up on our website about how health and social care services can access personal protective equipment (PPE). This information is aimed at providing clear advice to primary care, hospices, social care, home care providers and trusts about the arrangements for ordering and receiving essential items of PPE.

Personal Protective Equipment 14/4/2020

Updated guidance on Personal Protective Equipment (PPE) was published by Public Health England (PHE) on 2 April 2020. If social distancing of 2 metres from patients attending the pharmacy can be maintained there is no indication for PPE in a pharmacy setting. If this distance cannot be maintained, use of fluid resistant surgical masks (FRSM) is recommended. 

Community pharmacies should use the PPE stock that has been delivered to them and when needed order more from their wholesaler. More stocks of fluid resistant surgical masks are being made available to wholesalers to supply to community pharmacies on 9th April 2020. We recognise that some pharmacy staff cannot stay more than 2 metres away from symptomaticpeople and will need masks. Pharmacy staff working in dispensaries but unable to maintain 2 metres from their work colleagues do not necessarily need to wear masks. It would be extremely helpful, both to protecting longer term supplies to pharmacies and to keeping supplies going to other health professionals, if pharmacies limit the number of staff that have to be within 2 metres of the public to help manage the use of masks and maintain availability.

 PPE NHS Supply Chain update 14/4/2020

National Guidance has been provided regarding Helping Prevent Facial Skin Damage beneath PPE use of coverall as an alternative option for non-surgical gowns Please click on the links below:

Helping prevent facial skin damage beneath personal protective equipment

Approval by Health and Safety Executive for use of coveralls as an alternative option for non-surgical gowns

PPE NHS Supply Chain update 9/4/2020

The portal for GP, Adult Social Care, Dentist, Pharmacies and third sector is still being tested so is not available for registration. In the meantime stock will be sent to distributors (see attached) so people can continue to order direct with them.

PPE 8/4/2020

Practices may have notice some PPE kit has an expired date (and is sometimes overlaid with new date). This has been questioned with the National team and please be reassured that any expired kit has been retested and quality assured. They also informed us that overlaying with stickers with new date was stopped, as this was delaying distribution.

PPE Purchased by the Practice

We included in bulletin 12 information regarding plans to support access to PPE as an update for health and care sector providers about access to medical supplies and equipment during the current response to COVID-19 (see attached).

Please submit any invoices for costs incurred by the need to source PPE from private providers for reimbursement by the CCG

PPE FAQs for staff 7/4/2020

Following the recent PPE guidance which went out recently, please find an additional FAQ document.

Management of stock shortages 3/4/2020

Please find the attached ‘Management of Stock Shortages’ document which provides useful supporting information to managing OOS.

Update on plans to support access to PPE across the health and care system 3/4/2020

The attached communication ‘Plans to support access to PEE’ is intended as an update for health and care sector providers about access to medical supplies and equipment during the current response to COVID-19.

Summary of PPE recommendations for health and social care workers 3/4/2020

For primary care, ambulatory care and other non-emergency outpatient settings (including hospital outpatient clinics) plastic aprons, FRSMs, eye protection and gloves should be used for any direct care of possible and confirmed cases. Such PPE may be indicated for work in such settings regardless of case status, subject to local risk assessment (section 7).

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 with or without eye protection, as determined by the individual staff member for the episode of care or single session.

For health and social care workers working in reception and communal areas but not involved in direct patient care, every effort should be made to maintain social distancing of 2 metres. Where this is not practical use of FRSM is recommended.

For delivery of care to any individual meeting criteria for shielding (vulnerable groups) or where anyone in the household meets criteria for shielding, as a minimum, single use disposable plastic aprons, surgical mask and gloves must be worn for the protection of the patient.

Table 1 summarises PPE recommendations for health and social care workers by context for both NHS and independent sectors in secondary care inpatient clinical settings.

Table 2 summarises recommended PPE for primary, outpatient and community care settings.

Table 3 summarises recommended PPE for ambulance, paramedics, first responders and pharmacists.

Table 4 summarises recommendations where COVID-19 transmission is sustained.

Visual guide – summarises safe PPE

Updated PPE Guidance 3/4/2020

Please see attached letter: 'COVID-19 PPE Guidance Update' The updated PPE guidance has just been published on the gov.uk site:   https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control

Summary and key documents for primary care/community settings are outlined below:

  • enhanced PPE recommendations for a wide range of health and social care contexts
  • inclusion of individual and organisational risk assessment at local level to inform PPE use
  • recommendation of single sessional (extended) use of some PPE items
  • re-usable PPE can be used. Advice on suitable decontamination arrangements should be obtained from the manufacturer, supplier or local infection control
  • guidance for when case status is unknown and SARS-CoV-2 is circulating at high levels
  • recommendation on patient use of facemasks

Personal Protection Equipment (PPE) 1/4/2020

Please see attached ’20.03.31 – PPE NSDR Comms’ which provides an update on plans to support access to PPE Equipment across the health and care system.

In summary, if you have an urgent requirement for PPE please contact : The NSDR 24/7 telephone helpline is 0800 915 9964. If you don’t usually require PPE; the distributors that you should contact are;

Personal Protection Equipment (PPE) 1/4/2020

We know that one of the issues we’re hearing most from you is about PPE distribution. For immediate short-term issues National Supply Disruption Response (NSDR) are able to issue ‘pre-packed kits’ with a minimum of (100 Type IIR face masks; 100 aprons and 100 pairs of gloves) within 72 hours.
Primary care providers who raise requests for kits through NSDR must to be able to make arrangements to receive emergency delivery of these ‘pre-packed kits’ outside of business hours. The NSDR 24/7 telephone helpline is 0800 915 9964.

Personal Protection Equipment (PPE) 30/3/2020

We know that one of the issues we’re hearing most from you is about PPE distribution. For immediate short-term issues National Supply Disruption Response (NSDR) are able to issue ‘pre-packed kits’ with a minimum of (100 Type IIR face masks; 100 aprons and 100 pairs of gloves) within 72 hours.  Primary care providers who raise requests for kits through NSDR must to be able to make arrangements to receive emergency delivery of these ‘pre-packed kits’ outside of business hours.  The NSDR 24/7 telephone helpline is 0800 915 9964. 

PPE update 27/3/2020

Message from National team: This week significant volumes of PPE have been delivered for use by frontline healthcare workers.   On Tuesday 24 March 2020 we delivered 24.6 million gloves, 7.5 million facemasks and 1.9 million eye protectors among other protective equipment.   Wednesday (25 March) a further 7.6 million facemasks went to 236 NHS organisations alongside other key protective equipment.   We are keeping these issues under constant review and have set up a 24/7 helpline for healthcare providers to contact should they have concerns about their PPE stock levels. The NHS Supply Chain and NHS England is successfully identifying additional products and is bulk ordering them at pace. In addition NHS Supply Chain and PHE continue to explore UK based manufacturing options to provide further security of supply.  All advice to clinical staff, including safe systems of working and the of use PPE is available here 

Guidance on supply and use of PPE 25/3/2020

Please see attached letter regarding guidance and supply and use of PPE.

Guidance on supply and use of PPE 24/3/2020

Please see attached letter regarding guidance and supply and use of PPE.

Personal protective equipment (PPE) posters - 23/3/2020

  • https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/874312/PHE_11606_Putting_on_PPE_02b.pdf
  • https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/874313/PHE_1160