Council chair issues urgent PPE appeal to ministers

Health ministers in all four UK countries have been sent a letter from CSP Council Chair Alex MacKenzie imploring them to act to ensure that CSP members who are working with and providing respiratory treatment for patients with confirmed or suspected COVID19 are provided with the correct personal protective equipment (PPE).

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CSP Council Chair Alex MacKenzie

Without it, the letter states, ‘physiotherapy staff across the UK are being placed under unacceptable risk’.

In the strongly worded correspondence, sent yesterday (31 March), Ms MacKenzie tells ministers that many physiotherapists are being encouraged to work without appropriate protection, and that action from NHS trusts to protect staff is inconsistent. She points out that the PPE, as well as protecting practitioners, is necessary to protect patients and minimise the spread of the virus.

The CSP has also highlighted this issue with NHS England/NHS Improvement and Public Health England but is yet to have a response.

The full text of the letter (adapted by country) reads:

I am writing to escalate our concerns that physiotherapy staff across the UK are being placed under unacceptable risk through not being provided with the correct personal protective equipment.

Physiotherapy staff are delivering urgent respiratory care to patients with COVID-19 in intensive care and other healthcare settings. They provide essential treatment within an arm’s length of patients who are confirmed or suspected of having COVID-19 to clear sputum from their chests and clear their airways. This exposes physiotherapy staff to viral loads on a regular basis.

Many report being encouraged to see patients without having the appropriate level of personal protective equipment. We are aware that some CSP members have even been threatened with disciplinary action if they raise concerns. While some individual NHS trusts have taken action to protect their staff, this is not consistent, and it undermines the goals of stopping the spread of the virus to reduce deaths and protect the NHS, as well as being at odds with legislation on health and safety at work.

CSP members working and providing respiratory treatment for patients with confirmed or suspected COVID19 must be provided with the correct PPE.  Full PPE is required for airway clearance techniques within 1 metre of suspected or confirmed COVID patients. This means an FFP 3 mask, eye protection, gown and gloves. 

Other physiotherapy treatments, such as exercise to regain mobility, need to be risk assessed to identify what level of PPE is needed, from droplet precaution with surgical masks to full PPE where necessary. Anything less is unacceptable given the viral loading physiotherapists will be exposed to on a regular basis. 

The CSP has raised this issue with NHS England/NHS Improvement and Public Health England, including providing evidence of the issue at the weekend, and requested a change in the current guidance on PPE. We have heard nothing back from them.

As you will be aware, Public Health England is coordinating the guidance on behalf of the Department of Health and Social Care, Public Health Wales, the Public Health Agency Northern Ireland and Health Protection in Scotland.

We are sure you will agree that we have a moral obligation to protect staff working in those situations and a duty to the country to keep our NHS strong in the face of this unprecedented crisis. 

 We are writing to ask that you and your team intervene to address this issue as a matter of urgency.

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