Virus controls eased at height of pandemic

Government decision to water down guidance to hospitals is questioned as fears of staff infection rise

THE Government quietly relaxed strict controls to stop the spread of coronavirus in hospitals at the height of the crisis, The Daily Telegraph can reveal.

Whitehall officials watered down key aspects of infection control guidance for healthcare providers, who were also not told to implement social distancing until 18 days after the UK went into lockdown.

The findings are revealed following warnings by government scientific advisers that coronavirus appears to be spreading between hospital staff – potentially putting the whole country at risk of a second wave of infection.

Scrutiny of amendments made by Public Health England shows that, in January, providers were instructed to avoid using temporary staff when assessing possible Covid-19 patients because of the risk of spreading the virus.

But this was updated in mid-march to state that temporary staff were permitted after all.

The guidance published on Jan 10 said: “The use of bank or agency staff should be avoided.”

In mid-march, this sentence was removed and the only reference to temporary staff stated “bank, agency and locum staff should follow the same deployment advice as permanent staff ”.

Last night, experts warned that the safety of patients and staff had been jeopardised as a result of the change.

Dr Rinesh Parmar, chairman of Doctors’ Association UK, said: “The guidelines have been watered down because of resource shortages and I worry that staff and patients have been put at risk as a result.”

He added: “Whilst the science might suggest that [avoiding the use of temporary staff] is the right thing to do to prevent infections spreading from one area to another, the reality is that the NHS relies upon temporary staff all the time.

“It goes back to the NHS being 50,000 nurses short and 10,000 doctors short coming into the pandemic.”

Health chiefs have written to every hospital and GP practice, instructing them to take “further action to tackle infections acquired in the NHS itself ”.

The move was prompted by concern that Britain remains stuck in lockdown because it has been unable to get a grip on outbreaks in hospitals and care homes, which continue to leak out into local communities.

Professor Martin Mckee, professor of European public health at the London School of Hygiene and Tropical Medicine and a member of Independent Sage, said it was concerning that the Government eased the rules “given the evidence that agency and part-time staff played a major role in spreading infection between care homes”.

In January, the guidance made no mention of social distancing. This was only added for the first time on April 10 – 18 days after the general public went into lockdown – when staff were told “social distancing of 2m should be facilitated wherever this is possible”.

The Government also watered down early guidance recommending clinicians use a “buddy system”, in which a second worker watches for “inadvertent contamination”, especially in “highrisk procedures and PPE removal”.

Later versions only said the system should be used to monitor PPE removal “where possible”. The same guidance acknowledges this is often not the case.

“This is about the safety of staff and their family members,” said Dr Parmar. “If you’re contaminated when you leave, you potentially take that home, or you might finish your shift and go to Sainsbury’s to pick up your weekly shopping and spread it.”

Hospitals were also initially told that “as a general principle” doctors and nurses caring for Covid patients should not care for other patients “although exceptions may be necessary”.

This was changed on April 3 to state: “As a general principle, healthcare staff who provide care in areas for suspected or confirmed patients should not care for other patients. However, this has to be … based on local epidemiology and the configuration of the organisation”.

Prof Mckee said: “It is difficult to avoid the conclusion that many of these decisions are driven by expediency, although this has been true throughout the pandemic.

“Being generous, I suppose some of the measures might be argued for on the basis of greater access to PPE and improved understanding of how the virus is transmitted, but it would be helpful if this was explained clearly.”

A Department of Health and Social Care spokesman said yesterday: “The infection prevention control guidance is kept under constant review and has evolved in response to the changing epidemiology of Covid-19 and the emergence of new evidence and science.