Clinical update - Face masks

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Over the last few weeks and in the build-up to the flu season, we are seeing increased demand on our 999 and local 111 services that is stretching and testing our response to patients.

We know the staff continue to work diligently and with great patient care and we thank you for that.

Despite not having a positive case of COVID-19 reported in the Trust since July, the number of people being required to self-isolate is now having an impact on our ability to consistently provide adequate staffing levels to respond to our sickest patients.

As a Trust we have seen increasing rates of crew members having to stand down and self-isolate because of being of being in contact with a crewmember that has become symptomatic and they have not taken the necessary PPE precautions when working together. The biggest example is that of not wearing face masks when together in the ambulance cab.

The wearing of masks has been advocated when working near both patients and colleagues to minimise contact and the potential spread of the virus. This is reinforced by NHS guidance.

An increase of COVID-19 is being experienced which could lead to an increase in positive cases being reported, we all need to do our best to protect ourselves, colleagues, and each other from the spread of the virus.

Please read and review the guidance for working in ambulances and non-clinical settings with steps and PPE needed for these scenarios.
Working safely during COVID-19 in Ambulance Service non-clinical areas

Section 3.8 looks at social distancing in vehicles and the advocated use of masks when partitions and separation are not possible. While alternate measures such as screens can be put in place on stations and AOCs, these measures are not possible in the vehicles where the 2m distance cannot be maintained.

In line with recommended guidance, it is always considered best practice and necessary to wear a face mask when traveling in the ambulance cab as part of a double-staffed ambulance when safe to do so.
As such, unless otherwise indicated to you, it should be considered mandatory to wear a face mask when in the cab of an ambulance.

We understand that there may be occasions when the wearing of masks is not possible due to exemption reasons (such as safety reasons for misting of glasses) and this can be discussed with local management

We have been in discussion with UNISON, and their position remains that they support the wearing of masks where safe and practical to do so. At their request, other measures such as bubble-working on relief and going back to base stations for breaks are being explored.

If you have any questions relating to any aspect of this article, please raise this with your local management team in the first instance who can liaise with local COVID-19 leads.

Please see also the full version of this clinical update below, which features a decision tree to help you determine when to wear facemasks and when you should not.


Keeping crews in their home area would help prevent the spread of the virus. Crews should not be tasked out of area, no cross border jobs. In exceptional circumstances, when a crew is tasked out of area, ie blue light run to Addenbrooke’s they should be returned to their home area “out of service” as soon as practicable. The incidents of +ve COVID test are low in Norfolk. We would like to keep it that way.
25 September 2020

I fully understand the reasons behind the need to implement this action.

However, when there are still numerous staff members on the same station all at the same time, working with different members of staff when relief, sent on various cover points. This seems to be minor problem which needs to be addressed. Maybe having close working bubbles, sending crews to their own stations for cover and meal breaks and enforcing the number of staff on stations, should have come at a higher priority, and realistically would reduce the possible spread/contamination of the crew and staff.

25 September 2020

Am I right then in assuming that, when a vehicle is placed on standby, that eating and drinking must then not occur in the cab as this would involve masks not being worn?

Why also has the trust not done more to rationalise Rota to reduce the number of people we are crewed with - currently a different person every shift?

24 September 2020

How can we be forced to wear face masks in the cab, when wearing glasses this is not safe when driving due to them steaming up making it dangerous!
24 September 2020

Am I correct in ssying the screens in AOC do not work because the air conditioning spreads the contaminated air through the room. There is inadequate fresh air flowing in the rooms especially if you are not by a window. Desk fans and open doors/windows need to be put in place to reduce the amount of isolated staff in certain AOC's.
23 September 2020

It is certainly worth sending staff back to base station for breaks and stand by, this would reinforce better social distancing and bubbling and be a far more effective measure.
22 September 2020

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