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GPs advised to ‘risk assess’ patients who refuse to wear a mask

by Costanza Pearce
14 August 2020

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NHS England has said practices should ‘risk assess’ any patients who refuse to wear a mask, and said it would ‘fully support’ them in deciding to only provide care via a remote appointment.

Earlier this month, NHS England told practices that they cannot refuse to treat patients who will not wear a face covering.

But in an email bulletin to GPs today, NHS England said that providing care remotely is an option when patients will not wear masks, although it stopped short of saying practices can turn away all such patients. 

It said the GP standard operating procedures have been updated to say that practices should do a risk assessment and consider taking steps such as offering the patient a mask, booking the patients into a quieter slot or even providing care remotely rather than face-to-face.

Government guidance for the public has also been updated to say ‘face coverings are needed in NHS settings, including hospitals and primary or community care settings, such as GP surgeries’.

NHS England’s bulletin said: ‘The safety of both our staff and our patients is of paramount importance and face coverings or face masks should be worn by patients in a practice setting, in line with government guidance. 

‘We expect that all patients who are able to do so will follow these recommendations.’

It added: ‘For the small number of patients who may not follow this guidance we fully support practices in ensuring that they can take all reasonable steps to identify practical working solutions with the least risk to all involved. 

‘Practices should undertake a risk assessment which should consider, for example: 

  • Offering the patient a mask, if the patient is willing to wear one;
  • Booking the patient into a quieter appointment slot, or in a separated area;
  • Providing care via a remote appointment.’

NHS England added that practices can also give surgical face masks to ‘symptomatic’ patients to ‘minimise the dispersal of respiratory secretions and reduce environmental contamination.

The Medical Protection Society (MPS) urged NHS England to ‘put pressure’ on the Government to make face masks mandatory in practices ‘as a matter of urgency’.

MPS medicolegal lead for risk prevention Dr Pallavi Bradshaw said: ‘We are pleased NHS England has adopted a more reasonable and practical approach for GPs and practices dealing with patients who refuse to wear face coverings.

‘We urge them to now put pressure on the Government to extend the mandatory use of masks to all healthcare settings as a matter of urgency.’

It comes as over eight in 10 members of the MPS think a face covering should be mandatory when attending any healthcare setting, including GP practices.

Last month, Public Health England guidance said that GPs, all clinical and non-clinical staff as well as patients should wear a face mask in practices if they are not ‘Covid secure’.

It followed widespread confusion around whether staff and patients should be wearing face masks in practices.

A version of this story was first published by our sister title Pulse.