Changes to our Covid secure environment guidance

In line with recent changes to the national ‘living with Covid’ guidance, we have reviewed the Covid secure measures we have in place and will be making the below changes with immediate effect.

We have carefully considered the national guidance, alongside our infection prevention and control guidance, the current prevalence of Covid, and the approaches our national and local healthcare partners are taking.

Thank you all for your patience, diligence and support in maintaining a safe environment for our patients and each other over the last two years.

These changes that we set out below will be carefully monitored, taking into consideration local prevalence and advice from infection control colleagues. The safety of our staff and patients remains important for us all.

 

Guidance on wearing facemasks

The routine requirement to wear masks will be removed from across CUH except in specific circumstances which are outlined below, and relate to high risk areas and where patients are being treated with respiratory conditions, are immunosuppressed, or exhibit symptoms of Covid-19.

Facemasks will continue to be available for those staff, visitors and patients who prefer to wear one.

 

Staff

Staff are however still required to wear masks in the following situations:

  • As part of PPE required for specific procedures, for example potential aerosol generating procedures
  • Emergency department and emergency transport services where patients have not been triaged
  • Where treating patients with confirmed Covid-19, or where there are suspected Covid-19 outbreaks (FFP3 masks should be worn if suspected or confirmed Covid cases)
  • Where patients are at high risk of infection (immunosuppressed)
  • With the above in mind, masks must continue to be worn in the following areas (this does not include the staff rest areas or offices in these areas):
    • Designated ‘red’ Wards – J3
    • Emergency areas – Emergency Department and transport (until patients are triaged, and FFP3 mask should be worn if suspected or confirmed Covid cases)
    • Adult critical care areas ( A2, A3, D3 & D4)
    • Infectious Diseases – N2, D10
    • Respiratory – N3
    • Oncology – C9, D9, C10, E10, L5 Haematology, Cancer Assessment Unit, Haematology Oncology day Unit, Oncology Clinic, Radiotherapy
    • Transplant and dialysis – G5, F5, Dialysis beds on C5
    • Paediatrics – C2, PDU, C3 (respiratory beds)

 

If a patient asks a member of staff providing their care to wear a mask, for whatever reason, we would expect the staff member to respect that request, unless there are specific reasons for not doing so

In all other situations, staff are not required to wear a mask, unless they have a personal preference to do so.

We understand that some staff will be anxious about this change. Please do discuss any concerns with your line manager in the first instance.  We have always sought to respond to individual needs and make reasonable adjustments, including considering alternative working arrangements, or the continued use of appropriate PPE where staff are concerned about the impact this change will have on them.

 

Patients

Inpatients are required to wear a mask (if it can be tolerated) when they have confirmed or suspected Covid-19 and are in multi-bed or diagnostic wait areas or being transferred from one area of care to another.

Outpatients should wear a mask if they have respiratory symptoms requiring emergency treatment.

In all other situations, patients are not required to wear a mask, unless they have a personal preference to do so or they are in a high risk group (e.g. immunosuppressed).

 

Visitors

Visitors should wear masks when visiting red wards and areas where patients are at high risk of infection:

  • Designated ‘red’ Wards – J3
  • Emergency areas – Emergency Department and transport (until patients are triaged, and FFP3 mask should be worn if suspected or confirmed Covid cases)
  • Adult critical care areas ( A2, A3, D3 & D4)
  • Infectious Diseases – N2, D10
  • Respiratory – N3
  • Oncology – C9, D9, C10, E10, L5 Haematology, Cancer Assessment Unit, Haematology Oncology day Unit, Oncology Clinic, Radiotherapy
  • Transplant and dialysis – G5, F5, Dialysis beds on C5
  • Paediatrics – C2, PDU, C3 (respiratory beds)

In all other situations, visitors are not required to wear a mask, unless they have a personal preference to do so.

 

Visiting

There are currently no further changes to our visiting guidance which is available on our website. We regularly review our guidance for red areas and the emergency department and will update you on any changes.

Reminder of previous Covid secure guidance updates

  • The social distancing arrangements we had in place for the last two years are no longer required (the exception is in clinical areas when caring for patients with confirmed or suspected respiratory illness).
  • Face-to-face meetings on-site are allowed, however, we ask that you first consider whether it would be more appropriate or easier to hold a meeting virtually.
  • Face-to-face training on-site is allowed.
  • On-site events such as conferences, graduations, drop-ins, ceremonies, etc. can be held.
  • The local Covid secure environment health and safety risk assessment is no longer required. However, COSHH risk assessments should be carried out in areas such as laboratories that handle or process respiratory viruses.
  • The hybrid approach to flexible, digital and home working that has been implemented during the pandemic requires some further consideration. In the short term, an individual’s and team’s approach should be discussed between the employee, team and line manager and retained where beneficial to the groups involved. We will issue further guidance as soon as possible.

If you have any questions please email covid.secureenvironment@addenbrookes.nhs.uk

Guidance on ventilation

Natural ventilation
Maximising natural ventilation should be taken at every opportunity but only where safe to do so and where it does not compromise patient safety, security and/or fire arrangements.

Ways in which to maximise natural ventilation include:

  • Opening accessible windows and propping open doors (that are not fire doors), even for a short period of time (considering cold weather). This approach does not apply in areas which have existing air changing infrastructure such as operating theatres, critical care areas, endoscopy, D10 and C10.
  • Airing (purging) rooms on a frequent basis by opening all doors (not fire doors) and windows fully to maximise the ventilation in a room. It may be better to do this when the room is unoccupied or between uses.
  • It is important not to close windows or doors completely when people are using or occupying a naturally ventilated area. This can result in very low levels of ventilation.
  • In patient areas, windows can be opened however, please ensure that the window restrictors are in place and functioning correctly. Any defects should be reported to the Estates Helpdesk on 216696

Mechanical ventilation (including air conditioning)

  • In many areas mechanical ventilation is installed which provides fresh, heated (and in some areas cooled) air to rooms and extracts stale air. These can be identified by the presence of grilles/diffusers fitted to ceilings.
  • Air conditioning units and other recirculation systems can remain in operation.
  • It is not energy efficient to keep windows and doors open whilst running an air con unit, but where you need to increase the rate or supplement it with natural ventilation then this is permitted for the purposes of safety.
  • Use of portable fans should adhere to the Trust’s Use of portable fans procedure available on Merlin.
  • Local air cleaning and filtration units can be used to reduce airborne transmission where it isn’t possible to maintain adequate ventilation but this is generally restricted to areas carrying out AGPs and must be approved by IPC team before installation