Covid: Innovative PPE solutions for ENT procedures protect staff and promotes patient confidence
With healthcare workers still appealing for better PPE almost a year after the first lockdown, one specialist clinical services provider in London has implemented outstanding measures to protect staff against Covid-19 airborne transmission.
Communitas Clinics provides NHS ENT, dermatology and teledermoscopy intermediate services in the community in London and the South East on referral from local GPs.
Communitas Clinics CEO and Operations Manager, Christian Lyons explains “Within ENT, nasendoscopy is one of the riskier procedures for consultants as it brings them in close contact with patients faces.
“A tiny camera is inserted in the nasal passages which can cause a patient to sneeze. Visors aren’t a practical option as for nasendoscopies and other ENT procedures they need to use an eyepiece.”
In the autumn, Communitas Clinics devised an innovative screen to be used in addition to PPE specified in standard guidance, allowing such examinations to take place safely. This combines smooth, easily cleaned Perspex surfaces with a hole for the camera to be fed through with a disposable sleeve allowing flexibility of hand movements during an examination. Air filtration systems were also introduced to further reduce the risk of catching Covid-19 through airborne spreading. Since the measures were introduced, waiting times have returned almost to pre-Covid levels.
“There’s a secondary issue to think about here,” adds Lyons. “Because as well as the concerns about the safety of healthcare workers, there are members of the public suffering unnecessarily with pain and discomfort because they are frightened of being infected during these procedures and so are not speaking to their GPs about their symptoms.”
Referrals have dipped during what is normally a busy winter period – due to colds and infections - for these types of appointments which cover nasendoscopy, anterior rhinoscopy, oral examination and nasal cautery.
“It’s a twofold problem; people are nervous of approaching their GP and attending appointments, and GPs are under the impression that wait times are out of control - but our own wait times are under four weeks. In the meantime, medical conditions that are easily treatable may be worsening, which could lead to longer term repercussions for the individual and, ultimately, the NHS.
“We’ve worked hard to find and implement solutions to PPE concerns. It’s not been easy but we feel it is an area of huge importance both for healthcare workers and patients.”
There was a ripple effect from Communitas’s efforts: during the government's roll out of the guidance on COVID infection control measures for ENT procedures, Head of Quality Anna Bernard was able to provide support to ensure local NHS hospitals also had sufficient air filtrations systems suitable for the room sizes being used.
So far, the screens have been deployed in three of the NHS clinics managed by NHS service provider Communitas, Brigstock Family Practice in Croydon, Hally Stewart Clinic in Herts Valleys and Westland Medical Centre in Havering.
“The screens and other measures we’ve put in place give high levels of protection. Our consultants feel much happier and our patients have confidence when they come for their appointments.
“It’s taken thought and creativity to get to this point, but it has resulted in near-normal waiting times and safety as high as it can be.”