Updated PPE guidance still ‘falls short’ of what is needed to adequately protect staff, says RCN

Current guidance means that the vast majority of health and care staff will wear nothing more than a thin plastic gown and a surgical mask.

James McKay
7 June 2021

It falls short of encouraging the widespread adoption of FFP3 masks.

The Royal College of Nursing (RCN) has warned that updated guidance on personal protective equipment (PPE) still falls short of what is needed to keep staff safe.


While the updated PPE guidance does encourage employers to undertake a risk assessment, it doesn’t encourage the widespread adoption of the highest level of protection for health and social care workers and doesn’t address the concerns of those working care homes and in the community.

The College has been calling for a precautionary approach to PPE since last year putting pressure on Public Health England (PHE) to recommend that all health and social care workers routinely wear FFP3 masks.

Current guidance means that the vast majority of health and care staff will wear nothing more than a thin plastic gown and a surgical mask to care for either suspected or confirmed cases of the virus.

In April the Scientific Advisory Group for Emergencies (SAGE) admitted that a higher standard of mask may be needed to help protect staff. They explained that while “conventionally classed as either airborne or droplet in a clinical context,” current evidence suggests SARS-CoV-2 falls between these two categories with transmission “possible through inhalation and mucous membrane exposure to a range of particle sizes, as well as potentially through fomites.”


A precautionary approach.

RCN Acting General Secretary and Chief Executive, Pat Cullen, said: “This new guidance focuses too much on aerosol generating procedures as the main risk and falls short of the precautionary approach we have been advocating. Those working in community settings, care homes and many other areas are being let down and remain unsure how best to protect themselves.

“As we see new variants of concern emerge, we continue to demand FFP3 masks are made more widely available and increased levels of ventilation as a standardised approach. This is in line with the advice from the WHO and the CDC on the risk of aerosol transmission.

“Along with many other organisations, we have consistently urged that the Health Secretary and Prime Minister provide greater protection for all nursing staff. However, this guidance fails to properly consider the voices of those who were forced to work without protection at the start of the pandemic and act on those lessons.

“Advocating a risk assessment with the hierarchy of control is welcome but needs to have considerable support and training for those on the front line to implement effectively.


“While some differences in operational details and organisational responsibilities may apply in Northern Ireland, England, Wales and Scotland, we need UK-wide guidance which provides a consistent and resilient approach.”

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