NHS England and NHS Improvement: Next steps on infection prevention and control (1 June 2022)

Summary

This letter from NHS England and NHS Improvement sent to clinical commissioning groups and trusts set out the changes to infection prevention and control measures following updates from the UK Health Security Agency.

Content

For health and care staff:

• Health and care staff should continue to wear facemasks as part of personal protective equipment required for transmission-based precautions when working in COVID-19/respiratory care pathways, and when clinically caring for suspected/confirmed COVID-19 patients. This is likely to include settings where untriaged patients may present such as emergency departments or primary care, depending on local risk assessment. In all other clinical care areas, universal masking should be applied when there is known or suspected cluster transmission of SARS-CoV-2, eg during an outbreak, and/or if new SARS-CoV-2 VOC emerge.
• Universal masking should also be considered in settings where patients are at high risk of infection due to immunosuppression eg oncology/haematology. This should be guided by local risk assessment.
• Health and care staff are in general not required to wear facemasks in non-clinical areas eg offices, social settings, unless this is their personal preference or there are specific issues raised by a risk assessment. This should also be considered in community settings.

For inpatients:

• Inpatients with suspected or confirmed COVID-19 should be provided with a facemask on admission. This should be worn in multi-bedded bays and communal areas, eg waiting areas for diagnostics, if this can be tolerated and is deemed safe for the patient. They are not usually required in single rooms, unless, eg, a visitor enters.
• All other inpatients are not necessarily required to wear a facemask unless this is a personal preference. However, in settings where patients are at high risk of infection due to immunosuppression eg oncology/haematology, patients may be encouraged to wear a facemask following a local risk assessment.
• Patients with suspected or confirmed COVID-19 transferring to another care area should wear a facemask (if tolerated) to minimise the dispersal of respiratory secretions and reduce environmental contamination.
• The requirement for patients to wear a facemask must never compromise their clinical care, such as when oxygen therapy is required or where it causes distress, eg paediatric/mental health settings.

For outpatients, UEC and primary care:

• Patients with respiratory symptoms who are required to attend for emergency treatment should wear a facemask/covering, if tolerated, or offered one on arrival.
• All other patients are not required to wear a facemask unless this is a personal preference.

For visitors:

• In inpatient settings where patients are at high risk of infection due to immunosuppression, eg oncology/haematology, visitors may be asked to wear a facemask following a local risk assessment.
• Visitors and individuals accompanying patients to outpatient appointments or the emergency department are not routinely required to wear a facemask unless this is a personal preference, although they may be encouraged to do so following a local risk assessment.