Infection control and PPE in primary care: summary of new guidance August 2020

Publication date: 25 August 2020

The guidance on infection prevention and control has been updated. This guidance covers the whole of the UK and is applicable in all clinical settings. The aim is for a standardised approach across the UK. Where possible consultations should remain remote, unless clinically indicated.

Key information for primary care

Physical distancing

All GP surgeries should now be COVID-19 secure and encourage two metre physical distancing between both staff and patients where possible.

Hygiene messaging

Good hygiene messaging should continue to staff and patients including:

  • Regular handwashing
  • Good respiratory hygiene
  • Two metre physical distance (unless PPE is worn)
  • Frequent cleaning of environment and equipment
  • Face coverings advised for all visitors and patients within the GP surgery (unless exempt)
  • Extended sessional use of face masks in clinical and non-clinical areas within the healthcare setting

Vaccination

  • As contact with individuals is minimal when administering vaccines, the need for single use PPE (gloves and aprons) is not necessary.
  • Staff administering vaccines/injections must apply hand hygiene between patients and wear a sessional mask.

Please note, these changes DO NOT apply in adult social care settings in England where current infection control measures should continue.

Clinical episodes are now split into 3 risk groups

The majority of patients we will see in primary care are medium risk. In “respiratory clinics” patients will be high risk.

Risk levelMultiple factors to presentSome factors presentComplicating factors absent
High riskProven or suspected COVID-19

Untriaged patients where symptoms are not known prior to attendance.		No change in PPE use.

Single use gloves, apron, sessional use of FRSMII masks (if all within same COVID-19 cohort), single or reusable eye protection.		Face covering to be used be all patients.
Medium riskNo current COVID-19 symptoms and no SARS-CoV-2 test result.
Alternative arrangements should be considered to protect staff and other patients if patient unable to / exempt from wearing a face covering
Low riskNo COVID-19 symptoms and a negative test SARS-CoV-2 test result within 72 hours

Sessional use of FRSMII masks

Risk assess for apron, gloves and eye protection only if body fluid contamination anticipated




Specific indications for PPE items

Aprons / Gloves:

  • High risk patients for direct care within 2 metres
  • To protect clothes/ uniform when contamination anticipated
  • Changed between patients

Fluid resistant surgical face mask IIR:

  • Be worn with eye protection if body fluids, secretions or excretions onto nose/ mouth is anticipated
  • Used when delivering direct care within 2 metres of high risk patient
  • Be well fitting and not to be touched or allowed to dangle round the neck whilst being worn
  • Be replaced if damaged, soiled, damp, uncomfortable or difficult to breath through

Surgical face masks type II:

  • Used for a whole session (unless torn or wet)
  • Not to be touched whilst being worn

Eye protection:

  • When blood/body fluid contamination to eyes and face is anticipated
  • Not to be touched whilst being worn

Make sure to consider the impact of PPE on communication and to take communication difficulties into account.

About the writer

Dr Gail Allsopp

Dr. Gail Allsopp works for the RCGP as the Clinical Lead for Clinical Policy.