An Alliance of over 18 organisations, including DAUK, which has campaigned for over 16 months to give health workers the protection from Covid-19 they need in the workplace, welcomes new guidance which stipulates that Covid is spread by airborne transmission and that health workers are entitled to enhanced levels of protective equipment.

The Covid Airborne Protection Alliance (CAPA) and British Occupational Hygiene Society (BOHS) issued the following statement this afternoon:

The NHS and the wider healthcare system are still in the grips of dealing with the usual winter pressures along with the significant impact of COVID-19, not only on staff sickness levels but also with the ongoing delivery of services to meet the needs of the populations we serve. As a result, the challenges of ensuring the safety and resilience of the NHS and wider workforce along with patient safety are greater than ever, not withstanding the planned reduction in Covid restrictions announced 19^th January.

For the last 16 months the Covid Airborne Protection Alliance (CAPA) has been campaigning to influence IPC Guidance to ensure that all healthcare workers can access the right level of respiratory protective equipment to protect them from COVID-19. 

We have worked with the British Medical Association (BMA), Royal College of Nursing (RCN) and British Occupational Hygiene Society (BOHS) to support consistency of messaging to government, other key stakeholders and our healthcare workforce.

This includes alerting system leaders of the need to meet their legal responsibilities as laid out in the Health and Safety at Work Act 1974 etc for ensuring the safety of the healthcare workforce through the provision of appropriate respiratory protective equipment (RPE). 

We have evidence that over 30 NHS Trusts across the UK are now leading the way in how they assess workplace risk and provide staff with appropriate levels of RPE including FFP3. 

We are therefore pleased to see that, this week, the Government made important updates to two pieces of guidance which will help to keep healthcare workers, patients and the public safe. 

Dr Barry Jones, Chair of CAPA said:

“I’m delighted that the new IPC guidance makes it clear that healthcare workers can have access to enhanced levels of respiratory protective equipment without being restricted to the current list of aerosol generating procedures (AGPs) which is no longer relevant. 

“The IPC guidance however does not specify how COVID-19 is transmitted, placing risk assessment at the mercy of individual employers or managers views or assumptions on this key part of the risk assessment process. We are pleased the Cabinet Office guidance explicitly states that COVID-19 is spread by airborne transmission, close contact via droplets, and via surfaces. Airborne transmission is a very significant way that the virus circulates.”

“The Cabinet Office guidance is consistent with other government guidance such as that from the Department for Education (England), Coronavirus (COVID-19) and the use of face coverings in education settings (publishing.service.gov.uk) which  highlights that the Scientific Advisory Group for Emergencies (SAGE) has advised that Omicron might show more airborne transmission.

Professor Kevin Bampton, CEO of BOHS added: 

“System leaders now need to mobilise their health and safety and IPC leads to ensure appropriate risk assessments are carried out and the right level of RPE is provided in a safe and effective manner. This includes ensuring that fit-testing for FFP3 is available, and reusuable FFP3 equivalent masks can also be accessed.”

DAUK Chair, Dr Jenny Vaughan, said: 

“For far too long, far too many of our colleagues have been left exposed unnecessarily to Covid because their PPE was simply inadequate. The public were put at more risk as a result. This new guidance, issued after months of work by the CAPA, draws the clear line: no one should be expected to work to save lives if putting their own at risk avoidably was part of the deal. Now it is agreed. This should never happen and this is how the risks, not lives, are cut.”

Dr Christine Peters, Consultant Microbiologist FreshAirNHS commented: 

“As SARsCOV 2 transmits by travelling in aerosols produced when breathing, speaking and talking it is crucial that healthcare workers are provided with the correct RPE to ensure protection for them and their patients. We are delighted to see a change in guidance that advocates for this in line with WHO and urge all employers to ensure rapid roll out of respiratory level protection for this airborne infection”

Notes to editors 

Doctors’ Association UK (DAUK) is an organisation run by frontline doctors for frontline doctors. 

Their Communications Lead is Alan Taman:

press@dauk.org

07870 757309

The new guidance measures

The updated infection prevention control (IPC) guidance:

The Cabinet Office guidance:

Further details on routes of transmission of COVID-19, risk assessment and different types of RPE can be found on the RCN website

Covid Airborne Protection Alliance (CAPA) includes:

 ·      ARTP – Association for Respiratory Technology & Physiology·      BAPEN – British Association for Parenteral and Enteral Nutrition·      BIASP – British & Irish Association of Stroke Physicians·      BDA – British Dietetic Association·      BSG – British Society of Gastroenterology·      CBS – Confederation of British Surgery ·      College of Paramedics Natasha.Weale@collegeofparamedics.co.uk·      CSP – Chartered Society of Physiotherapy·      FreshAir NHS·      GMB Union·      HCSA – Hospital Consultants and Specialists Association·      Medical Supply Drive UK·      NNNG – National Nurses Nutrition Group·      QNI – Queen’s Nursing Institute·      RCSLT – Royal College of Speech and Language Therapists·      Unite the Union·      DAUK- The Doctors Association·      Trident HS&E 

BOHS British Occupational Hygiene Society

The Doctors’ Association UK are dismayed at the governments less than inflation uplift for NHS workers and call for “fair say on fair pay”.  

At a time when doctors have given their lives and livelihoods to this pandemic, with no 
clear end in sight, it is an insult that the Government sees a 3% uplift as fair remuneration. In support of member opinion, DAUK’s ‘Fair say for fair pay’ campaign demonstrated the extremes staff have been put through during the pandemic, risking their own lives, whilst the challenges to the NHS have never been greater. 

The government’s decision to exclude junior doctors, who make up more than 50% of doctors in the NHS, is callous in view of the large number of doctors in training who have worked tirelessly through the pandemic. Junior doctors, a term than encompasses all doctors from leaving university up until becoming a consultant, are at the forefront of the fight against COVID. Many have been redeployed from their area of expertise or training to work in COVID medical wards or in critical care. Not only has their training been disrupted but they have been expected to pick-up shifts and cover rota gaps due to the on-going understaffing.

The 3% offered does not come close to what staff deserve. Inflation this year is estimated at 3.7%, making the proposed rise a pay cut in real terms. 

We consulted with our members last night and the overwhelming majority of responders supported industrial action. We plan to hold an emergency meeting with members soon to formulate next steps and we request that the Government reconsider its position with immediate effect.

Dr Jenny Vaughan, Chair of DAUK: “Any improvement on the derisory 1% previously offered to NHS workers is welcomed, but 3% barely takes the edge off the erosion of doctors’ pay over two decades. Doctors in the NHS have suffered a 30% pay cut in real terms, and after inflation this “pay rise” will ultimately be a pay freeze. DAUK’s campaign ‘fair say for fair pay’ demonstrated the extremes staff have been put through during the pandemic – the effects of which are only starting to be realised. It is time to pay and we hope the BMA and the HCSA as well as allied health professional unions will join us in voicing our discontent – including taking industrial action.”

Dr Duranka Perera, junior doctor and DAUK Treasurer: “We are in an ongoing pandemic that has killed 128,000 people in the UK, including over a thousand colleagues. With staff shortages at critical mass and thousands more on the verge of burnout, no number of claps for the camera can change these cold, hard facts. The service and sacrifice of NHS workers over the past year is being treated with open contempt.

There is no time but now to pursue the most powerful form of resistance. This Government – one that saw fit to pay private Test and Trace consultants £7000 a day – must be held to account. Amidst the most testing era in NHS history, unions across all healthcare disciplines must come together to demand just compensation for the workers that put their lives on the line for their patients and their country. After over a decade of austerity and real terms pay cuts, a 15% pay increase is the bare minimum we at DAUK see as acceptable. If it requires industrial action to achieve this, then we wholeheartedly back that too.’

Neurosurgeon and DAUK co-vice chair Mr Dolin Bhagawati: “The figures put forward by the government show a breath taking level of wilful ignorance regarding the pressures that NHS staff have faced during the pandemic and will continue to face in the current wave of COVID-19 infections. With the NHS staring into an abyss of millions of patients on waiting lists, we need staff that are compensated appropriately for the skill sacrifice and commitment they have and continue to demonstrate. A Government that does not realise this is catastrophically out of touch. “

Nottingham GP Dr Shan Hussain: “GP Practices have delivered over 75% of Covid vaccinations whilst caring for 2 million patients with long covid, looking after rising numbers of patients on secondary care waiting lists, and continuing day to day GP work. All of us have worked incredibly hard without recognition, and for the pay rise to exclude more than half of practicing GPs shows how little the Government values Primary Care.”

GP Partner Dr Rosie Shire: “Since the start of the pandemic GP’s have been battling covid in the community and changing the way we work in response to the ever changing regulations. For the pay rise not to include all GPs shows how undervalued we are.”

We have sent the attached letter to the heads of NHS England, the Health Secretary and Chair of Healthwatch England requesting a review into why access to primary care is problematic, when as frontline GPs, we are consulting more patients than ever.

DAUK are happy to collaborate to share the views of our members on this issue and work together to find a solution that benefits both patients and the health service as a whole.

Dear Colleagues

CC. Sir Robert Francis QC, Rt Hon Matt Hancock, Sir Simon Stevens, Dr Nikita Kanani, 

We were very concerned to read the recent report in The Times, which states that patients are increasingly having a negative experience in terms of accessing their GP, leading to increased attendances to Emergency Departments. 

This report from HealthWatch confirms the health of the nation is suffering as general practice is drowning. Our experience as Frontline GPs, is that demand is going through the roof.

General practice is currently carrying out 7 million appointments per week, while delivering 75% of all Covid vaccinations and the largest ever flu-vaccination programme to date. Compared to pre-pandemic, primary care is offering a million more appointments per week. 

If primary care is having contact with 10% of the population each week and this is still not meeting demand there must be an urgent review to find out why. 

The introduction of e-consults has made us more accessible than ever, and has opened the gates to a lot of trivia, which still uses GP time and resources, sometimes inappropriately.

GPs are working flat out, and it is incredibly demoralising to find that our best is not enough. It is clearly not acceptable for huge proportions of patients to attend ED, when GP would be more appropriate. However, Practices are working at and beyond full capacity which has led to unprecedented levels of burnout, sick leave and tiredness amongst GPs. 

General Practice has been consistently underfunded over the last 10 years. Currently 90% of NHS contacts happen within primary care for less than 10% of the total budget. We desperately need a huge funding increase to aid much needed innovation, improvements in IT and infrastructure, and to increase staffing levels. 

We urgently call today for a reduction in bureaucracy, a focus on GP burnout and staff retention, and most importantly an analysis into why patients are struggling to access care so we can work towards finding a solution that involves the whole health service working together.

We would welcome a collaboration on this issue and would be happy to meet to discuss the views of our members to find a way forward together.

We look forward to your response

Dr Elizabeth Toberty

Dr Ellen Welch

On behalf of The GP Committee

Doctors’ Association UK

The Doctors’ Association UK welcome the drive by NHSE to encourage vaccine uptake amongst cohort 6 patients (those aged 16-64 with underlying health conditions) to ensure as many people as possible take up the COVID-19 vaccination. Local GP’s are continuing to arrange the majority of these jabs (and will continue to make contact with patients themselves), but NHSE’s text message campaign will provide patients with alternatives which may be more accessible for them, such as attending a vaccination centre or a pharmacy led service.

Dr Ellen Welch is a GP with the DAUK and says: “I have an appointment for my second vaccination today, which as a pregnant healthcare worker was important for me to have to feel protected. I would encourage everyone, especially those at increased risk, to make the most of this opportunity. To be able to return to a sense of normality, it is essential we vaccinate as many of the population possible.”

DAUK’s Dr David Nicholl says: “We have learnt this week that of healthcare workers who are vaccinated, their families had a rate of COVID-19 at least 54% lower than the families of healthcare workers who were not. We already know that the vaccine is safe, we now know that it also brings protection to our nearest and dearest. This is especially important for the clinically vulnerable in the cohort 6 group. As such the Doctors’ Association UK would encourage anyone who gets called, to get vaccinated, to get themselves and those they love protected as quickly as possible”

Doctors’ Association UK concerned that Home Office delays are preventing Doctors from helping in pandemic. IHS refunds still not processed

The Doctors’ Association UK has written to the Home Secretary Priti Patel regarding two issues that are adversely affecting the NHS frontline’s efforts to combat the escalating coronavirus pandemic. These are specifically related to delays in issuing Biometric Residency Permits for doctors with valid visas to work in the UK and the ongoing delays in refunding the Immigration Health Surcharge, promised earlier this year.

Delays in issuing BRPs are preventing qualified doctors with valid visas currently in the UK from starting work in the NHS and helping to mitigate the increasing effect of staff sickness from the escalating rates of COVID-19.

This is exemplified by Dr Ahmad Ussaid, a respiratory specialist doctor with a visa approved who is currently in Leicester, a city hit particularly hard by COVID-19. However, he is unable to start work due to an ongoing delay providing him with a BRP, despite multiple contacts by email and telephone in addition to intervention by his MP. He remains ready to jump into the fray but unable to due to this bureaucratic hinderance, depriving him of an income and the NHS of a skilled doctor when the country needs them most.

Meanwhile numerous doctors have also contacted us regarding delays in refunding the Immigration Health Surcharge. A flagship promise made by the Prime Minister and reinforced by the cabinet was to refund the IHS. However, for many charged such as Dr Aqsa Ghanzanfar who has emailed the Home Office thrice, they still await refund of this for no clear reason. Others have been refused as they have paid form bank accounts from their country of origin which have been understandably closed on arrival to the UK.

Dr Dolin Bhagawati, a Neurosurgeon working in London and Editorial Lead for DAUK said:

“These prolonged and ongoing bureaucratic delays are simply unconscionable. We have trained doctors in this country who are ready and willing to help combat the pandemic but unable to work due to the Home Office not doing its job and supplying appropriate documentation.

Meanwhile promises made by the Prime Minister and the cabinet regarding refunding the IHS to NHS staff continue to remain unfulfilled. How can the NHS attract the best and brightest to the UK if the world sees a government unable to fulfil straightforward promises?

Unfortunately, the immigration rhetoric and policies of the recent past has led to many of our valued colleagues feeling crestfallen, unappreciated, and exploited. This country must reward those that come to its aid in its time of greatest need.

We call on the government to do its job to allow the NHS to do its part in leading the country through this national emergency.”

CONTACT

Press@dauk.org

The Doctors’ Association UK (DAUK) has been alarmed by the surge in cases and hospital admissions, especially in London and the South East. Doctors called for tighter restrictions well over a week ago expressing concern regarding the relaxation of the rules over the Christmas period.

NHS staff will support the movement of high-risk areas into Tier 4, but with cases surging many will be wondering if this is too little, too late.

Dr Samantha Batt-Rawden, President of DAUK and a senior intensive care registrar in the South East said:

“We realise how disappointing the new restrictions will be for many today, especially those in Tier 4 areas. However, doctors across the UK, but especially those in the South East are telling us that the surge in cases is already putting hospitals and critical care units under enormous strain. NHS staff are grateful to the public who have sacrificed so much to protect each other and our health service. But with the emergence of a new variant, sadly restrictions must be revisited. COVID will not take 5 days off over Christmas, and neither will NHS staff who do all they can to keep patients safe over the festive period.”

CONTACT Press@dauk.org

Even a fully staffed and rested workforce would find this combination a challenge. Before the pandemic, the NHS was short of 106000 staff. Now, a chronically short staffed and fatigued workforce looks at the upcoming winter with great trepidation.

Waiting lists for extremely serious surgeries look set to double while more than 50,000 patients have not waited more than a year for NHS treatment. Given this, with the additional pressures of rising coronavirus cases, NHS workers need a viable and realistic strategy both to cope with the exhaustion they feel from the initial impact of the pandemic and the increased pressures the winter will bring. This will require genuine additional funding, rather than talking up and repackaging old promises. Further, there must be a strong focus on staff retention.

Without improved working conditions, DAUK fears the UK will witness increasing NHS workforce shortages with burnt-out staff quitting or reducing hours, resulting in even greater waiting lists. This will have knock on effects on an already strained economy with increased numbers of unable to work while awaiting treatment. Given this, this impending challenge must be treated with utmost gravitas.

To achieve such a strategy needs an inclusive team from all parts of the NHS contributing to a workable plan rather than relying on consultancies that have little experience on the ground.

In the immediate term, a functional and efficient testing system will go a long way towards helping to reduce the effect of coronavirus on the NHS and help reduce the burden on our services.

Protect Chief Executive Liz Gardiner said, “Whistleblowing is the best early-warning system in the NHS and now more than ever staff need to feel safe and supported when they speak up and that issues are properly investigated and resolved.

“We want NHS workers who are working under extremely difficult circumstances to feel reassured that they can get independent and confidential advice about whistleblowing by calling Protect.”

Protect handles around 3,000 cases each year through its free, confidential Advice Line. In addition, it trains businesses and organisations on best practice speak up arrangements.

If an NHS worker has a whistleblowing concern, NHS staff can raise the matter internally at the Trust, speak to their Freedom to Speak Up Guardian (England only), or call the NHS Whistleblowing Advice Line SpeakUp for signposting information. For NHS workers in Scotland, they can call the Alert and Advice Line. For strategic advice on how and where they can raise their concerns further, in addition to legal advice as to what their rights are in doing so, they can call the Protect Advice Line.

However, charity Protect says it has been approached by some NHS staff with concerns.

“Some NHS staff have told us they do not feel safe speaking up within their Trust and are not aware of what support channels exist. Our service at Protect is unique – we offer advice on how to raise concerns effectively, as well as explaining whistleblowers’ legal rights” said Protect’s Chief Executive Liz Gardiner.

Dr Jenny Vaughan, Learn Not Blame Lead, at Doctors Association UK, said, “Sadly the Doctors’ Association UK has been approached by many doctors who have been disciplined for raising concerns about lack of personal protective equipment (PPE) and been told not to speak to the press. Patient safety is never best served by driving staff concerns underground. Bullying of staff when they speak out about safety is completely unacceptable.”

She added, “Doctors and nurses on the frontline have a right to speak out if they or their families or patients could be at risk. Our health service, both private and public, will only benefit if we learn from each other’s experience and we have a Learn Not Blame culture.”

Protect has the support of a number of lawyers who have agreed to give further support to health and social care workers during the crisis.

Protect Chief Executive Liz Gardiner added, “We hope that employers will listen-up when concerns are raised – but we’re grateful to the many lawyers in our legal support network who have kindly agreed to help, including barristers Daniel Stilitz QC, Mukhtiar Singh, and Joseph England and solicitors Paul Daniels at Keystone Law, Leigh Day Solicitors and Slater & Gordon lawyers – but please call Protect in the first instance”.

If further law firms or Chambers wished to lend their support and advice during the Covid 19 crisis, Protect are co-ordinating whistleblowing support to key workers should it be needed.

Doctor Katie Sanderson, who works in acute medicine [and is a DAUK committee member] said “Healthcare workers are practising in very challenging conditions. It is crucial that everybody working in the NHS feels able to voice concerns openly, and that they are aware of the appropriate channels to do so. It is important that doctors and others are aware that free, high quality legal advice is available if they need it.”

Support for whistleblowing doctors:

ProtectProtect Advice Line – Tel: 020 3117 2520
Email whistle@protect-advice.org.uk

SpeakUp
NHS Whistleblowing Advice Line SpeakUp: 08000 724 725.

Alert & Advice Line – NHS ScotlandTel: 0800 0086112
Email: alertline@protect-advice.org.uk