PPE: getting it right

Both employers and clinicians have a duty of care to the patients they treat. It’s yet to be seen how the ‘extraordinary conditions’ of Covid-19 will affect how the standard of care is judged should any challenges be raised, but there is always an expectation that care should be as safe as possible. 

It is an employer’s duty to provide workers with the necessary equipment to undertake their job, and that includes access to PPE. It is a worker’s obligation to wear PPE when required. Where members do not have access to the correct PPE, they should raise this with their CSP steward. If any physiotherapist is notified of a disciplinary case or HCPC fitness to practise complaint involving their use of PPE, contact the CSP for support as soon as possible. 

The HCPC requires registrants to consider infection control and prevention (IPC). Public Health England (PHE) guidance currently determines levels of PPE that many healthcare workers must wear in a variety of different healthcare settings throughout the UK. Other regulated sectors such as education and social care have their own guidance. We understand the frustration created by the different guidance produced, particularly when a person could be receiving the same level of close contact from different people, each wearing different PPE, or none at all. 

Not negotiable 

Physiotherapists must wear appropriate PPE. This is not open to individual choice in deciding what PPE to wear, although we recognise guidance is not always clear-cut. PPE is one of the national strategies in place to reduce Covid-19 disease transmission.  Government guidelines implicitly assume that healthcare practitioners should wear PPE to protect themselves and their patients, although the detail of requirements are subject to change. Those who have an exemption from wearing PPE will need to review what roles they can undertake, as PPE is mandatory for all patient-contact roles. What could be the impact if you decide you are not going to follow the relevant PPE guidance for the sector you work in? Quite serious, it turns out. 

People who have been in contact with a person who tests positive for Covid-19 may be contacted as part of contact tracing programmes. Guidance from England and Northern Ireland explicitly sets out that if you can prove you were wearing the correct PPE at the time of contact, you will be exempt from any requirement to self-isolate. We believe this is implicitly the position in Scotland and Wales too.  

If you cannot do this, your patients may have to be contacted, and you will have to follow the current government guidance, which may include a period of self-isolation. 

Insurance 

What’s the insurance position? While it may not be possible to determine the intentions of a practitioner in choosing not to use correct PPE, it is expected that practitioners will use PPE based on statutory regulations, government guidelines and regulatory advice. If members have a need for physical contact with their patient, they should consider a wider level of protection. This is in order to negate the risks of a claim for negligent infection control. 

Any claim for negligence may be determined by considering the relevant guidance that was in force at the time the disputed event occurred, as well as the particular circumstances that led to the choice not to wear the correct PPE.  

What can you do to maintain optimal levels of practice? Quite simply – wear the appropriate levels of PPE as required by your sector of work. In addition, keep copies of the PPE guidance in force from time to time for your sector, including updates, and write down in the clinical record for each patient what PPE you wore.

Keep copies of your PPE and infection control and prevention (IPC) policies and procedures, and any risk assessment you use that contribute to your decisions to see patients in person face-to-face.

• Pip White and Euan McComiskie are CSP professional advisers 

The information on these pages was correct at time of printing