This information aims to support registrants in understanding how to apply the following Standards of conduct, performance and ethics during the COVID-19 pandemic.
6.1 You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible.
6.2 You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk.
6.3 You must make changes to how you practise, or stop practising, if your physical or mental health may affect your performance or judgement, or put others at risk for any other reason.
Working in a challenging environment
All of you are working in extremely challenging environments with many working on the frontline, and others are working in people’s homes or in private pracitce. Wherever you are based you are making difficult decisions to balance the provision of healthcare with the interests of your service users, the wider public, and yourself.
Knowledge of COVID-19 symptoms, modes of transmission and treatment is evolving and information is being updated on a regular, sometimes daily, basis, as you continue to provide care. The following information seeks to draw out some of the key resources/considerations for you.
COVID-19 guidance for infection control*
The four UK countries are adopting the official COVID-19 guidance for infection prevention and control in healthcare settings. This was produced jointly by the Department of Health and Social Care, Public Health Wales, Public Health Agency (Northern Ireland), Health Protection Scotland and Public Health England. It provides helpful information on:
- Standard infection control procedures (SICPs): the basic infection prevention and control measures necessary to reduce the risk of transmission of infectious agents from both recognised and unrecognised sources.
- Transmission based precautions (TBPs): are applied when SICPs alone are insufficient to prevent cross transmission of an infectious agent. They are additional infection control precautions required when caring for a patient with a known or suspected infectious agent
- Approaches in different care settings: this includes care homes, primary care, outpatients, home visits, ambulances, and emergency departments and acute assessment units.
- Aerosol-generating procedures (AGPs): aerosols generated by certain procedures healthcare professionals undertake can create additional risks. The guidance outlines the AGPs which are particular infectious and set out additional infection control measures for service users with suspected/confirmed COVID-19.
Personal protective equipment (PPE)
It is the responsibility of all employers to ensure healthcare staff have access to, and use, suitable PPE, and receive appropriate training about COVID-19 symptoms and modes of transmission.
Given the global shortages of PPE, Public Health England has published guidance on Considerations for acute personal protective equipment (PPE) shortages. This aligns with current evidence and Centers for Disease Control (CDC) and World Health Organization (WHO) guidance.
If you run your own private practice you will need to ensure you have sourced the appropriate PPE for the treatments you will be providing. You should check with your professional body for profession-specific guidance on where you can purchase PPE for your practice.
Where the appropriate PPE equipment is not available to you, you should use your professional judgement to decide the most appropriate approach; reducing the risk(s) of harm as far as possible. In doing so you should consider:
- If treatment can be delayed until PPE is available.
- If you can provide treatment remotely.
- If there are any other ways to minimise the risk of transmission.
If you feel that it is unsafe for you to provide treatment to a service user with confirmed/suspected COVID-19, you should raise this immediately with your employer.
If they instruct you to continue to treat the service user and you still have concerns about doing so, you should seek advice from your professional body or union as soon as you can.
We understand that in emergency situations this may not always be possible and so we would advise you to make a professional judgement, taking account of all of the information you have available to you.
If matters escalate, you can also speak to Protect (formerly Public Concern at Work), the whistleblowing charity that provides advice to individuals with whistleblowing concerns at work.
The approach set out above protects not only you from infection, but the wider population of service users you subsequently treat. We recommend you keep a record of any engagement you have with others during the decision making process and the reasons for any decision(s) you make.
Should any concerns be raised about your practice, including a refusal to treat service users with confirmed/suspected COVID-19 because of a lack of appropriate PPE, we will take account of:
- the circumstances and context you were working in;
- any steps you took to raise your concerns; and
- relevant resource, guidelines and protocols in place at the time.
This position is set out in the joint statement from Chief Executives of statutory regulators of health and care professionals.
Keeping up to date
The landscape is changing constantly, and you should keep up to date with current Government guidance. The following resources will help:
- COVID-19 guidance for health professions: provides guidance for primary care, those who have diagnosed a case within their facility, the investigation and clinical management of possible cases and guidance for ambulance trusts.
- COVID-19 guidance for first responders and others in close contact with symptomatic people with potential COVID-19: guidance for professionals and members of voluntary organisations who, as part of their normal roles, provide immediate assistance to a symptomatic person until further medical assistance arrives.
- COVID-19 guidance for sampling and laboratory diagnostics: information for clinical diagnostic laboratories regarding safety, sampling and packaging specimens associated with COVID-19.