Government Reaches Deals with US-based Company to Deliver 250,000 Clear Face Masks
A quarter of a million clear face masks are to be delivered to NHS and social care workers on the frontline to support those who use lip-reading and facial expressions to communicate.
UK AT Sector Welcomes the Essential Assistive Products List Survey
The British Assistive Technology Association and World Health Organisation GATE Programme are pleased to have received an overwhelmingly positive response to the UK APL (Assistive Products List) survey.
Initial organisational stakeholders aware of the initiative, met on 21st July and have subsequently committed to supporting the UK APL roadmap. The goal is to bring together all those using or connected to AT, to develop a list of which assistive products are essential for living a fully accessible life in the UK today.
Through establishing this first UK APL, we see that as a newly unified stakeholder community we shall be able to move forward to provide policy makers with the opinions and data they need to advance equitable access to high-quality AT in the UK.
As a group of stakeholders we will be a space for the voices of the UK AT ecosystem to hear each other’s concerns, and firstly work together to identify what barriers and gaps there are to accessing the most essential assistive products that people need in the UK in 2020-21.
To establish a comprehensive UK APL we are reaching out to all organisations and individuals who use assistive products, to complete the survey and make recommendations of which products that they feel should be considered for the final essential list.
The survey is based upon the WHO global template APL and is a guide for us to develop. We must devise an APL to represent our own experience in the UK today, so please take the time to complete the survey which can be found here: https://bit.ly/UKAPL and strengthen the message of how vital AT is in our lives.
Please connect to the group or groups of stakeholders that are important to your area of experience and knowledge. Links to where you can apply to join the specialised domain stakeholder groups are also found on this page.
Esther Dakin-Poole, the UK APL Coordinator would welcome all organisations, individual users and advocates to contact her. You can inform her about your work or lived experience and formally confirm your involvement. This will ensure that you or your organisation are fully represented and that you are kept informed of progress.
Remember, if you wear a pair of reading glasses or orthotics in your shoes, you use AT. AT is everywhere and luckily it is widely available in the UK for the many not just the few. Make your voice heard and take the survey today: https://bit.ly/UKAPL
More than Half a Billion Pounds to Help People Return Home from Hospital
People needing additional follow-on care after being discharged from hospital will be supported by a £588 million fund to cover adult social care or the immediate costs of care in their own home.
£588 million will provide up to 6 weeks of funded care and support for people being discharged from hospital
Funding could pay for additional support including domiciliary care, community nursing services or care home costs
Assessments for those needing funded long-term care or support to resume from September
People needing additional follow-on care after being discharged from hospital – including older people and those with disabilities – will be supported by a £588 million fund to cover adult social care or the immediate costs of care in their own home.
From 1 September, the NHS will be able to access the funding in order to provide up to 6 weeks of additional support so people can receive ongoing help with their recovery and rehabilitation after they leave hospital. This could include support in their home or access to services such as physiotherapy.
NHS Continuing Healthcare (NHS CHC) assessments will also restart from September ensuring those with complex health needs can continue to access the care they need for free.
Health and Social Care Secretary, Matt Hancock, said:
We know for the majority of people the road to recovery can be quicker when they receive care and support in the comfort of their own home.
This funding will help ensure people can be safely discharged from hospital knowing they will get the vital follow-on care they need to recover fully from treatment.
We’re also making sure those with complex health needs continue to receive the best support possible in the community.
Most people will be discharged back to their homes. However, it is anticipated that a very small proportion will need, and benefit from, short or long-term residential, nursing home or hospice care.
It remains the case that no one should be discharged from hospital directly to a care home without the involvement of the local authority, and that all patients are required to be tested prior to discharge to a care home. No care home should be forced to admit an existing or new resident who has tested positive for coronavirus if the home would be unable to cope with the impact of their illness.
Councillor Paulette Hamilton, Vice Chair of the Local Government Association’s Community Wellbeing Board, said:
We are pleased to see this further injection of funding to ensure that people can leave hospital as soon as is safe and return home wherever possible. We are also reassured by the commitment that no one will go into a care home without having been tested for the virus. Local government has asked for these commitments and will continue to play a key role in making them happen.
New guidance has been published to help hospitals safely discharge patients into the appropriate setting to maximise their independence and ensure they can remain in their own homes as much as possible.
A comprehensive care and health assessment for any ongoing care needs, including determining funding eligibility, will take place within the first 6 weeks following discharge to make sure individuals have the support they need.
The funding can also be used for urgent community response support to prevent someone being admitted to hospital. This can include providing urgent domiciliary care or nursing support, like basic wound care, in someone’s own home, rather than in hospital.
Case managers will ensure people are discharged safely, on time and that they have full information and advice about what is happening. This includes how individuals’ needs will be assessed and any follow up support that may be required. This approach applies to anyone discharged from NHS community and acute beds.
The funding is part of the £3 billion provided to protect and prepare health and social care in the event of a second peak of COVID-19 during winter and follows £1.3 billion funding made available via the NHS to support the discharge process in March.
The government has expanded the ONS infection survey to provide extensive, weekly data on the spread of infection, supporting rapid testing and diagnosis of COVID-19 both nationally and in areas of concern.
The new guidance, Hospital discharge service: policy and operating model, sets out the operating model for all NHS trusts, community interest companies, and private care providers of acute, community beds and community health services and social care staff in England. It replaces the hospital discharge service requirements issued on 19 March 2020 to support the response to the COVID-19 pandemic.
These new funding arrangements will apply up until 31 March 2021.
NHS CHC teams will work closely with community health and social care staff in supporting people on discharge pathways 1, 2 and 3, to ensure appropriate discussions and planning concerning a person’s long-term care options happen as early as possible during the 6-week discharge pathway. This close working and communication will also ensure time is allowed for the CCG to undertake the full NHS CHC assessment and for local authority staff to undertake Care Act assessments where it is needed.
all people admitted to hospital to receive care will be tested for COVID-19, and hospitals should share care needs and COVID-19 status with relevant community partners planning the subsequent community care.
as set out in the COVID-19 adult social care action plan, any individual being taken on by a home care or supported living care provider should be cared for as possibly COVID-positive until a 14-day period has passed, within their home.
if a care home provider does not feel they can provide the appropriate isolation for those coming out of hospital, the individual’s local authority should secure alternative appropriate accommodation and care for the required isolation period. Costs of providing alternative accommodation are covered by discharge funding provided via the NHS
Renewed KIDS SAVE LIVES Campaign to Increase Awareness & Fight Sudden Cardiac Death during COVID-19
Renewed KIDS SAVE LIVES Campaign to Further Increase Awareness and Fight Sudden Cardiac Death in the era of COVID-19.
The European Resuscitation Council has recently published a position statement on schoolteachers’ education and qualification in cardiopulmonary resuscitation (CPR) and COVID-19 resuscitation guidelines, including adapted recommendations for education, courses, and basic and advanced life support. Educating schoolteachers in CPR and qualifying them to teach it to children as recommended by the worldwide ‘KIDS SAVE LIVES’ (KSL) initiative may help considerably and sustainably to improve survival worldwide after sudden out-of-hospital cardiac arrest (OHCA). The COVID-19 pandemic emerged in China at the end of 2019 and challenged most healthcare systems and societies worldwide. Many countries reacted with various lockdown measures to limit the spread of infection and to reduce death rates. Fortunately, children have not been severely affected compared with older people, but concern was expressed about their potential role in spreading infection, which resulted in a limitation of school activities. Thus, we have to consider that the impact of social distancing on teaching and the fear of interacting with a victim potentially infected with COVID-19 could severely reduce the willingness of children and teachers to teach and to provide CPR. While local school organisation can vary widely in term of spaces, timetables, web-based lessons and face-to-face activities, we acknowledge the urgent need for a refurbished KSL campaign, specifically addressing obstacles to bystander CPR provision during a pandemic. Awareness of the importance of providing effective CPR in OHCA during the pandemic requires special activities and support to overcome these barriers. Focus should be brought on the role of the community in helping save lives, the risk-benefit balance for young rescuers with the chance of saving a life, the importance of personal protection against infection and of local measures for disease surveillance, e.g. through dedicated apps, contact tracing, testing, etc. As a specific campaign, the authors propose a renovated KSL logo for use during the COVID-19 pandemic and, in agreement with the European Resuscitation Council, calls the international community for specific initiatives to reinforce and adapt the KSL campaign to the current context. Far too many people are still dying following OHCA worldwide, and hundreds of thousands of deaths could be avoided. All the communities must overcome the fear of COVID-19 to help KIDS to learn to save lives.
You can still qualify if you started your job recently and you have not received 8 weeks’ pay yet. Ask your employer to find out more.
Linked periods of sickness
If you have regular periods of sickness, they may count as ‘linked’. To be linked, the periods must:
last 4 or more days each
be 8 weeks or less apart
You’re no longer eligible for SSP if you have a continuous series of linked periods that lasts more than 3 years.
Fit notes and asking for proof
You only have to give your employer a fit note (sometimes called a sick note) if you’re off sick for more than 7 days in a row (including non-working days).
You can get a fit note from your GP or hospital doctor. If your employer agrees, a similar document can be provided by a physiotherapist, podiatrist or occupational therapist instead. This is called an Allied Health Professional (AHP) Health and Work Report.
Proof if you’re self-isolating because of coronavirus
If you’re self-isolating and cannot work because of coronavirus, you can get an ‘isolation note’ online from NHS 111 if you’re off work for 7 or more days. You do not have to go to your GP or a hospital.
If you have a letter from the NHS or a GP telling you to take extra precautions because you’re at high risk of severe illness from coronavirus (known as ‘shielding’), it will include the period you should shield for. The letter is proof of your eligibility for SSP for days away from work in that period.
You may get more than one letter covering more than one shielding period. Contact your GP if you do not have a letter but think you should have one.
If you’ve been notified by the NHS or public health authorities that you’ve come into contact with someone with coronavirus, your notification is proof.
A revamped COVID-19 tracker app begins trials today on the Isle of Wight and among NHS volunteer emergency responders. The London Borough of Newham, which with Brent saw most COVID-19 deaths in the capital at the peak of the pandemic, will also be a trial site.
Over the coming days, people living on the Isle of Wight will receive a one-time activation code through the post, which will enable them to download the app. NHS volunteer emergency responders will be contacted by email.
The app is part of England’s NHS Test and Trace service, and works with both iPhones and Android devices.
The app will log the time and distance someone has spent near to anyone, even if they don’t know them. If that person later tests positive for COVID-19, the app will alert them and help them book a test. The app will also give users the risk level in their area based on their postcode, and if you have to self-isolated it will provide a countdown of the days before you can resume your normal activities.
Make business continuity and contingency plans and review them regularly. Keep the plans up to date and consistent with other local contingency plans, in particular those being developed by your local resilience forum.
Make sure you also have plans in place for the months after 31 December 2020 to ensure continuity of care for service users.
review your capacity and activity plans regularly.
make sure your business continuity plans cover the supply of staff you need to deliver services before and after 31 December 2020
you don’t need to change existing EU staff employment contracts
you must notify your local commissioner as soon as possible if there is any risk to service delivery
The EU Settlement Scheme
Tell any staff who are EU citizens about the EU Settlement Scheme. Help staff to apply if they need support.
Through the EU Settlement Scheme, EU nationals can register for settled status if they have been in the UK for 5 years or pre-settled status if they have been here for less than 5 years.
The scheme is free and it’s simple to register. The deadline for applications is 30 June 2021.
Irish citizens are not required to apply for the EU Settlement Scheme, although there are some circumstances where they may wish to. Non-Irish family members of Irish citizens will need to apply.
Recognition of professional qualifications
EEA and Swiss health and care professionals who are registered and practising before 1 January 2021 will continue to be able to do so from 1 January 2021.
For any professional registration queries, please contact the relevant professional regulator.
EU Third Health Programme
Successful bids for EU funding from the Third Health Programme made before 31 December 2020 will receive their full financial allocation for the lifetime of the project or joint action.
Help and contacts
Help with developing business continuity and contingency plans
Raise concerns about capacity and resourcing in the usual way.
It is important to tell your local commissioner and the Care Quality Commission as soon as possible if there is any risk to service delivery.
Help with supply of medicines and vaccines
Continue to manage medicine and vaccine supply issues in the way you usually do.
Report concerns about supply issues through your regional pharmacist.
Help with supply of medical devices, clinical consumables and non-clinical goods and services
Start by following your usual processes. Check with your supplier or other relevant teams in your organisation.
Check with your clinical lead if you can use a different brand or product. If you can use an alternative but you are concerned about the initial shortage, report it through your usual escalation channels. This will ensure that supply can be restored as quickly as possible.
Tell your local commissioner and the Care Quality Commission as soon as possible if disruption to the supply of medical devices, clinical consumables and/or non-clinical goods and services poses a risk to service delivery.
This page tells you what you’ll need to do from 1 January 2021. It will be updated if anything changes. For current information, read:
The Scottish Government has outlined exemptions for the wearing of face coverings in public.
The exemption guidelines state that people are exempt from wearing face coverings if it causes them difficulty, pain or severe distress or anxiety to wear one. There are various reasons why an autistic person might find face coverings distressing, such as:
The feeling it has on their skin
A sudden change to their normal routine
Not being able to see parts of their own or others’ faces
New Package of Measures and ‘Better Health’ Campaign Announced to Help People Lose Weight
New obesity strategy unveiled as country urged to lose weight to beat coronavirus (COVID-19) and protect the NHS.
Ban on TV and online adverts for food high in fat, sugar and salt before 9pm
End of deals like ‘buy one get one free’ on unhealthy food high in salt, sugar and fat
Calories to be displayed on menus to help people make healthier choices when eating out – while alcoholic drinks could soon have to list hidden ‘liquid calories’
New campaign to help people lose weight, get active and eat better after COVID-19 ‘wake-up call’
A raft of measures have been revealed as part of the government’s new obesity strategy to get the nation fit and healthy, protect themselves against COVID-19 and protect the NHS.
Obesity is one of the biggest health crises the country faces. Almost two-thirds (63%) of adults in England are overweight or living with obesity – and 1 in 3 children leave primary school overweight or obese, with obesity-related illnesses costing the NHS £6 billion a year.
The urgency of tackling the obesity time bomb has been brought to the fore by evidence of the link to an increased risk from COVID-19.
Living with excess weight puts people at greater risk of serious illness or death from COVID-19, with risk growing substantially as body mass index (BMI) increases. Nearly 8% of critically ill patients with COVID-19 in intensive care units have been morbidly obese, compared with 2.9% of the general population.
As the government continues to respond to this unprecedented global pandemic, ministers will today set out a comprehensive package of measures to help people take control of their own future by losing weight, getting active and adopting a healthier lifestyle.
Rather than focusing primarily on childhood obesity, the strategy represents a new focus on empowering adults to lose weight as well.
This plan is being launched alongside an exciting new ‘Better Health’ campaign, led by Public Health England (PHE), which will call on people to embrace a healthier lifestyle and to lose weight if they need to, supported by a range of evidence-based tools and apps providing advice on how to reduce the waistline.
The measures in this world-leading plan include:
banning unhealthy food adverts – new laws will ban the advertising of food high in fat, sugar or salt (HFSS) on television and online before 9pm when children are most likely to see them. Ahead of this, the government will also hold a new short consultation on whether the ban on online adverts for HFSS, should apply at all times of day. Analysis published by Cancer Research UK from September 2019 shows that almost half (47.6%) of all food adverts shown over the month on ITV1, Channel 4, Channel 5 and Sky1 were for products high in fat, sugar and salt. This rises to almost 60% during the 6pm to 9pm slot – the time slot where children’s viewing peaks. Evidence shows that exposure to HFSS advertising can affect what and when children eat, both in the short term and the longer term by shaping children’s preferences at a young age. This is supported by the World Health Organization (WHO).
ending ‘buy one, get one free’ (BOGOF) promotions – new legislation will restrict the promotion of foods high in fat, sugar, such as ‘buy one get one free’ offers. There will also be a ban on these items being placed in prominent locations in stores, such as at checkouts and entrances, and online. In the UK we spend more buying food products on promotion than any other European country and a survey from 2018 shows that around 43% of all food and drink products located in prominent areas were for sugary foods and drinks, compared to just 1% for healthy items. Shops will be encouraged to promote healthier choices and offer more discounts on food like fruit and vegetables
calorie labelling – new laws will require large restaurants, cafes and takeaways with more than 250 employees to add calorie labels to the food they sell. Research shows eating out is becoming more common, particularly among families, with 75% of people visiting a restaurant, fast food eatery or getting a takeaway in the past week, compared to 69% in 2010. However, there is often a lack of information about the calorie content of these items and research suggests people consume around 200 more calories a day if they eat out compared to food prepared at home. This new measure will help people make healthier, informed choices as part of a balanced diet
alcohol calorie labelling – a new consultation will be launched before the end of the year on plans to provide calorie labelling on alcohol. Alcohol consumption has been estimated to account for nearly 10% of the calorie intake of those who drink, with around 3.4 million adults consuming an additional days’ worth of calories each week – totalling an additional two months of food each year. But research shows the majority of the public (80%) is unaware of the calorie content of common drinks and many typically underestimate the true content. It is hoped alcohol labelling could lead to a reduction in consumption, improving people’s health and reducing their waistline
expanding NHS services – weight management services will be expanded so more people get the support they need to lose weight. This will include more self-care apps and online tools for people with obesity-related conditions and accelerating the NHS Diabetes Prevention Programme. From next year doctors will be offered incentives to ensure people living with obesity is given support for weight loss and primary care staff will also have the opportunity to become ‘healthy weight coaches’ though training delivered by PHE. Separately, GPs will also be encouraged to prescribe exercise and more social activities to help people keep fit
front-of-pack nutritional labelling – we will launch a consultation to gather views and evidence on our current ‘traffic light’ labelling system to learn more about how this is being used by consumers and industry, compared to international examples. Our ‘traffic light’ scheme is popular, with 90% of consumers agreeing it helps them make informed decisions when purchasing food. Research shows that people who look at front of pack nutritional labelling are shown to have healthier shopping baskets, fewer calories, less sugar, fat and salt content and higher fibre content
Prime Minister Boris Johnson, said:
Losing weight is hard but with some small changes we can all feel fitter and healthier.
If we all do our bit, we can reduce our health risks and protect ourselves against coronavirus – as well as taking pressure off the NHS.
Health and Social Care Secretary Matt Hancock said:
Everyone knows how hard losing weight can be so we are taking bold action to help everyone who needs it. When you’re shopping for your family or out with friends, it’s only fair that you are given the right information about the food you’re eating to help people to make good decisions.
To help support people we need to reduce unhelpful influences like promotions and adverts that affect what you buy and what you eat. Taken together, supported by an inspiring campaign and new smart tools, will get the country eating healthily and losing the pounds.
We know obesity increases the risk of serious illness and death from coronavirus – so it’s vital we take action on obesity to protect the NHS and improve our nation’s health.
Dr Alison Tedstone, Chief Nutritionist at PHE, said:
These plans are ambitious and rightly so. Tackling obesity will help prevent serious illness and save lives.
The main reason we put on weight is because of what we eat and drink, but being more active is important too. Making healthier choices easier and fairer for everyone, and ensuring the right support is there for those who need it, is critical in tackling obesity.
These bold measures will help us tip the scales on obesity. The argument for action is the clearest it’s ever been.
Overconsumption of calories is one of the most significant contributing factors in becoming overweight. Figures show many adults are consuming 200 to 300 extra calories a day above recommended daily guidelines with children who are already overweight are consuming up to 500 calories more than they need every day.
The environment we live in plays a significant role in tackling obesity: the information they are given to make those choices, the choices we are offered, and the influences that shape those choices. This will support individual choice and give families a fairer chance to maintain a healthy diet and lifestyle.
The measures set out today signal a clear commitment from the government to support individual efforts and kickstart a national effort to tackle obesity.
This measure is widely supported by the public, with polling from 2019 shows that 72% of public support a 9pm watershed on junk food adverts during popular family TV shows and that 70% support a 9pm watershed online as well as academics, health and medical organisations.
Volume promotions like BOGOFs appear to be mechanisms to help shoppers save money, however data shows that they actually increase the amount we spend by encouraging people to buy more than they need or intended to buy in the first place. We buy almost 20% more than we otherwise would.
Face Coverings to be Mandatory in Shops and Supermarkets from 24 July – Oral Statement to Parliament
Health and Social Care Secretary Matt Hancock spoke about plans to make face coverings mandatory in shops and supermarkets from 24 July 2020.
Thank you very much Mr Deputy Speaker, and with permission, I would like to make a statement about coronavirus.
Thanks to one of the greatest national efforts in peace time, this deadly virus continues to diminish.
Yesterday’s figures show 530 new cases, down 90% since the peak.
162 patients are currently in mechanical ventilator beds with coronavirus – down around 95% since the peak.
The latest number of deaths recorded in all settings across the UK is 11 – the lowest figure since 13 March.
And according to today’s ONS data, for the third consecutive week, total deaths are lower than normal for this time of year.
Due to this substantial progress, we have been able to restore freedoms and carefully and methodically restore the fabric of this country.
However, we cannot let our progress today lead to complacency tomorrow and so we must remain vigilant to keep this virus under control.
Our strategy is to protect the NHS, get the virus down, and keep the virus down, while restoring as much of normal life as possible and our tactic is to replace national lockdown with ever more targeted local action as we work hard to defeat this virus once and for all.
Our NHS Test and Trace system gets stronger all the time and since launch 6 weeks ago, 144,000 people have now been asked to self-isolate, who otherwise simply wouldn’t have known that they had to.
Where we find clusters or outbreaks we take local action – tackling over 100 incidents a week. Mostly these are small, in an individual care home, or pub, or factory. But we are also prepared to take action on a wider basis if that’s what it takes, just as we did in Leicester.
Four permanent test sites and 10 Mobile Testing Units have been deployed across the city, meaning that Leicester now has the highest rate of testing in the country.
We have launched one of the biggest communications programmes that Leicester has ever seen – including targeted social media posts, website banners, radio ads, billboards and even bin stickers. And we have been working closely with all parts of the local community, including community leaders, local businesses, and the local football and cricket clubs, to get the message out.
We’ve also established a process for making decisions to lift the lockdown, with the first decision point later this week.
Mr Deputy Speaker, local action is one way in which we control the spread of the virus, while minimising the economic and social costs.
Another is to minimise the risk as we return more to normality. In recent weeks, we have reopened retail and footfall is rising. We want to give people more confidence to shop safely, and enhance protections for those who work in shops.
Both of these can be done by the use of face coverings. Sadly, sales assistants, cashiers and security guards have suffered disproportionately in this crisis.
The death rate of sales and retail assistants is 75% higher among men, and 60% higher among women than in the general population. So as we restore shopping, so we must keep our shopkeepers safe.
There is also evidence that face coverings increase confidence in people to shop.
The British Retail Consortium has said that together with other social distancing measures, face coverings can make shoppers feel even more confident about returning to the high street. And the Chair of the Federation of Small Businesses has said that small firms know that mandatory face coverings have a part to play, and I quote, “in the nation’s recovery both physically and financially”… And that he is “sure this [measure] will be welcomed”.
We have therefore come to the decision that face coverings should be mandatory in shops and supermarkets.
Last month, we made face coverings mandatory on public transport and in NHS settings.
This has been successful in giving people more confidence to go on public transport and to a hospital setting when they need to.
Providing people with additional protection when they are not able to keep 2 metres from others, particularly people they do not normally come into contact with.
Under the new rules, people who do not wear a face covering will face a fine of up to £100, in line with the sanction on public transport and just as with public transport, children under 11 and those with certain disabilities will be exempt.
The liability for wearing a face covering lies with the individual.
Should an individual without an exemption refuse to wear a face covering, a shop can refuse them entry and can call the police if people refuse to comply, the police have the formal enforcement powers and can issue a fine.
This is in line with how shops would normally manage their customers and enforcement is of course a last resort, and we fully expect the public to comply with the rules as they have done throughout the pandemic.
I want to give this message to everyone who has been making vital changes to their daily lives, for the greater good.
Wearing a face covering does not mean that we can ignore the other measures that have been so important in slowing the spread of this virus.
Washing your hands. Following the rules on social distancing and just as the British people have acted so selflessly throughout this pandemic, I have no doubt they will rise to this once more.
Mr Deputy Speaker, as a nation, we have made huge strides in getting this virus, which has brought grief to so many, under control.
We are not out of the woods yet.
So let’s all of us do our upmost to keep this virus cornered, and enjoy summer safely.
Early Signs of Hearing Damage in Young People Attending Loud Music Events
A new study published in the journal Hearing Research suggests that early signs of hearing damage may be seen in young individuals who attend loud music events.
According to the World Health Organization, more than a billion young individuals globally are at risk of noise-induced hearing loss, much of it being preventable.
Researchers at the University of Manchester performed a detailed evaluation of hearing health of 123 young adults (age, 18-27 years). The participants including musicians and non-musicians provided a comprehensive account of the amount of noise exposure they had experienced during their life.
The findings showed that all individuals participating in the study had clinically normal hearing as per pure-tone audiometry; however, those exposed to the highest levels of noise exhibited poorer functioning of the tiny hair cells in the inner ear which play a crucial role in hearing. Moreover, individuals exposed to higher noise levels had poorer conduction of sound signals from the auditory nerve towards the brain, which could adversely affect sound processing.
Surprisingly, no differences were observed in the amount of noise exposure between musicians and non-musicians, owing to the fact that both had relatively high levels of exposure to recreational noise.
The authors said: “Crucially, what our research reveals is that all young adults who engage in noisy recreational activities without using hearing protection are at risk of hearing damage. It’s likely that without a change in our attitudes towards noise exposure and hearing protection, we will see many more people presenting with hearing problems later in life.”
Gene Discovery in Fruit Flies ‘Opens New Doors’ for Hearing Loss Cure in Older People
Scientists at UCL have discovered sets of regulatory genes, which are responsible for maintaining healthy hearing. The finding, made in fruit flies, could potentially lead to treatments for age-related hearing loss (ARHL) in humans.
Globally one third of people (1.23 billion people) aged over 65 experience hearing loss, and while there are thought to be more than 150 candidate genes which may affect hearing loss, there is no unified view on how to use these to develop novel preventive or curative hearing loss therapies.
In the study, published in Scientific Reports, researchers at the UCL Ear Institute assessed the hearing ability of the common fruit fly (Drosophila melanogaster) across its life span (around 70 days*), to see if their hearing declines with age.
The fruit fly is a powerful model in biology and its ear shares many molecular similarities with the ears of humans, which make it an ideal tool for the study of human hearing loss. However, so far, no study had assessed the fruit flies’ hearing across their life course.
Using advanced biomechanical, neurophysiological and behavioural techniques**, the researchers found that the antennal ears of fruit flies also display ARHL with nearly all measures of sensitive hearing starting to decline after 50 days of age.
With this knowledge, the researchers turned their interest to the time before flies developed ARHL: they wanted to know if there were any ‘age-variable’ genes in the flies’ Johnston’s Organ (their ‘inner ear’), which have kept the ears healthy for 50 days of their lives.
Using a combination of molecular biology, bioinformatics and mutant analysis, the researchers identified a new set of transcriptional regulator genes: these are so called ‘homeostasis genes’, meaning they are the genetic actuators, so they control the activity which keeps the ear sensitive.
For researchers, one of the principle advantages of the fruit fly model is that it allows for easily testing the roles of individual genes by either increasing their function (overexpression) or silencing them (RNAi interference). Exploiting these tools, researchers also found that manipulating some of the homeostasis genes could prevent the flies from getting ARHL.
Lead author Professor Joerg Albert (UCL Ear Institute) said: “While many studies have been conducted into the hearing function of fruit flies, ours is the first to look at the mechanistic and molecular detail of their auditory life course.
“Our twin discoveries that fruit flies experience age-related hearing loss and that their prior auditory health is controlled by a particular set of genes, is a significant breakthrough. The fact that these genes are conserved in humans will also help to focus future clinical research in humans and thereby accelerate the discovery of novel pharmacological or gene-therapeutic strategies.
“Building on our findings from Drosophila, we have already started a follow-up drug discovery project designed to fast-track novel treatments for human ARHL.”
Dr Ralph Holme, Executive Director of Research at Action on Hearing Loss, said: “We urgently need to find effective treatments able to prevent or slow the loss of hearing as we age.
“Hearing loss affects 70% of people aged over 70 years old, cutting people off from friends and family.
“Action on Hearing Loss is proud to have been able to support this exciting research that has identified genes involved in maintaining hearing.
“It not only advances our understanding of why hearing declines with age, but importantly also opens the door to the future development of treatments to prevent it.”
Funding for this research was received from the Biotechnology and Biological Sciences Research Council (BBSRC), Action on Hearing Loss and the European Research Council (ERC).
*At 25 degrees, one day for a fly is equivalent (approximately) to one year for a human.
Department Name: EPD – PPE Team Bulletin No: STSU1 – 2020 Issue Date: June 2020 Target Audience: All industry Key Issues: Quality of KN95 face masks and lack of compliance with European standards
A substantial number of face masks, claiming to be of KN95 standards, provide an inadequate level of protection and are likely to be poor quality products accompanied by fake or fraudulent paperwork. These face masks may also be known as filtering facepiece respirators.
KN95 is a performance rating under the Chinese standard GB2626:2006, the requirements of which are broadly the same as the European standard BSEN149:2001+A1:2009 for FFP2 facemasks. However, there is no independent certification or assurance of their quality and products manufactured to KN95 rating are declared as compliant by the manufacturer.
Personal protective equipment (PPE) cannot be sold or supplied as PPE unless it is CE marked. The only exception is for PPE that is organised by the UK Government for use by NHS or other healthcare workers where assessments have been undertaken by HSE as the Market Surveillance Authority.
KN95 must not be used as PPE at work as their effectiveness cannot be assured.
Masks that are not CE marked and cannot be shown to be compliant must be removed from supply immediately. If these masks have not been through the necessary safety assessments, their effectiveness in controlling risks to health cannot be assured for anyone buying or using them. They are unlikely to provide the protection expected or required.
If any are CE marked, suppliers must be able to demonstrate how they know the documentation and CE marking is genuine, supported by Notified Body documentation showing compliance with the essential health and safety requirements as required by the Personal Protective Equipment Regulations (EU) 2016/425.
Relevant legal documents
Personal Protective Equipment Regulations (EU) 2016/425
Personal Protective Equipment (Enforcement) Regulations 2018
CTSI, in partnership with the Office for Product Safety and Standards (OPSS), are running a series of 1 1/2 hour webinars for businesses focusing on the identification, classification and the current easements for placing PPE on the market. This training will also be run alongside webinars for businesses that are importing, manufacturing or retailing hand cleansing products.
To book a place onto one of the next CTSI Business Training Webinars please follow the links below:
22 June Personal Protective Equipment (PPE) Product Requirements for Importers
CTSI is a training and membership organisation that has represented the interests of the Trading Standards profession since 1881 nationally and internationally. We aim to raise the profile of the profession while working towards fairer, better informed and safer consumer and business communities.
CTSI’s members are engaged in delivering frontline trading standards services in local authorities and in businesses. www.tradingstandards.uk
BHTA Members Offer Urgent Support to NHS Wheelchair Service Customers
BHTA have brought together some of the major wheelchair service providers to ensure that, while the NHS is under extreme pressure, the needs of wheelchair users are fully supported.
If you are a wheelchair service customer and having difficulties obtaining service and maintenance support for your product, BHTA members will bring their combined resources together to respond urgently and help.
Many of the challenges wheelchair services and wheelchair users are experiencing are replicated across the country. Where there may be hot spots or shortfalls in services the group will look to see how they can support any specific areas that need their assistance.
The BHTA group will be liaising with other Wheelchair Groups and regional in-house services to try to mitigate wheelchair user’s problems with ongoing assessments, deliveries, service and maintenance.
The BHTA group are keen to support users that are just being issued with products for hospital discharge and for others, whose conditions are changing and need to be assessed as part of their ongoing clinical needs.
If you require assistance, please click on the link below and scroll over the map to find the nearest provider to you. Please do not hesitate to contact the nearest one, who may appear to be some distance from you, as many BHTA providers cover wide areas for wheelchair services.
Retailers who may be able to assist are shown in light green – their services will not be free of charge unless they are able to provide warranty cover – check when contacting them”
Don’t Forget to Return Your On-Loan Community Equipment – Help the NHS and Social Services
Community Bed and Equipment Collections Request
The provision of community equipment is a vital part of the process that allows patients to be discharged from hospital to be cared for safely in their own homes. Community Equipment Providers are continuing to support the NHS and Social Services at this difficult time, using infection control procedures and enhanced PPE (Personal Protection Equipment) to protect those whose homes they visit as well as their employees.
All Providers need your assistance to help facilitate more NHS patient discharges and free up more vital bed spaces. We are actively requesting those who no longer need loaned beds and Equipment to contact their equipment provider so that they can collect and re-cycle them. If you have a bed, or equipment, in your home that was supplied by the Community Equipment Service that you no longer need, please call your local Equipment Provider and they will arrange the safe collection and urgent recycling, so that the equipment may be used to help others now in need.
Contact details will be found on any documentation that has been left with you, or on a label on the equipment. If you do not have access to this please search on your local council website for “how to return equipment” or for “Occupational therapy”.
You can find your local council via the following link:
BHTA member, Moboa, have introduced three new cabins that offer body and hand disinfection, temperature measurement and face recognition.
When the person enters the cabin, there is the mist which is sprayed which works on the entire surface of the person – it’s hypoallergenic, does not irritate the face and does not damage to clothes. The mist is a natural biocide that occurs in the human immune system, so it is entirely harmless. The fluid used in the cabins is entirely natural and has the necessary certificates confirming the high efficiency to eliminate bacteria, fungi and viruses. One disinfection process takes 5-15 seconds.
Their cabins can increase the safety of patients, staff and the public, at the same time, and aims to reduce the spread of viruses. The cabin and the disinfection fluids have all the necessary EU certificates.
The Tissue Viability Society Coronavirus (COVID-19) and wound care information page to help all clinicians and to help patients.
Crest Medical Continue to Deliver Vital PPE to the NHS
Guinness Asset Management Invests £2.5 Million in Suntech UK, the Company Behind the Award Winning eFOLDI Mobility Scooter
Guinness Asset Management (“Guinness”) has invested in Suntech UK (trading as “eFOLDi”). eFOLDi is a design, inventions and manufacturing company specialising in innovative and lightweight mobility devices created to transform lives. Winner of The British Invention of the Year Award, the Surrey based business has been built off the back of the industry-changing eFOLDi Folding Mobility Scooter (the lightest in it’s class) leading to two years of rapid sales growth. There are plans to launch an even lighter model this year. It is eFOLDi’s mission to build an iconic brand for people with reduced mobility symbolising freedom, friendship and fun! As part of the investment, Guinness Fund Manager, Ashley Abrahams, will join the board of directors alongside experienced Non-Exec Chairman, Kevin Ronaldson, who has over 40 years’ experience advising growing companies.
eFOLDi is led by its ambitious and driven CEO, Sumi Wang, who helped design the original folding mobility scooter with her father, Jianmin Wang. Together, they have designed a product that is the best in class for lightweight mobility scooters. They serve the rapidly expanding market of people with reduced mobility, whether through age or illness, who wish to maintain as much independence and flexibility as possible. The eFOLDi folds to the size of a suitcase, ideal for transport and storage, and provides customers of all ages with a new lease of life.
Ashley Abrahams, Fund Manager at Guinness, said: “Guinness is delighted to be supporting Sumi Wang and her team during this exciting time of growth, expansion, and new product development. eFOLDi has a unique proposition that can make a real improvement to customers’ lives with innovation at the core. Sumi and her team have been very successful in driving the company forward and we very much look forward to working with them as they embark on the next stage of growth.”
Sumi Wang, CEO of eFOLDi, said: “We are extremely pleased to welcome Guinness onboard our exciting eFOLDi journey. Guinness is one of very few investors who has combined expertises in hardware manufacturing and personal mobility industries, and therefore will add tremendous value in the next stage of eFOLDi success. Personally I very much look forward to working with Ashley and the wider Guinness team – Together, we will take eFOLDi to a new horizon and beyond.”
Glen Waters, Head of Raise at PWC who advised on the investment, said: “We are pleased to have been able to support eFOLDi and Sumi Wang throughout this process. It is fantastic to see Guinness partner with the eFOLDi management team to support the next stage of the company’s development. We look forward to seeing the business realise its growth ambitions with Guinness’ support.”
Guinness was supported by Taylor Vinters LLP, Wilson Partners, and Glenesk Group.
eFOLDi was advised by PWC’s specialist SME Raise Team, supported by DWF LLP.
Published: 27th May 2020
Return to Workplace Advice – Webinar
Friday 22 May 2020
Dr Simon Joyston-Bechal, Turnstone Law
There are many areas to consider in the workplace and this presentation covers the government guidance’s as well as the liabilities that may be imposed upon us as we return with many areas to consider.
The key points of this Webinar are:
Health & Safety Law Conundrums during the Pandemic
Could we be prosecuted for COVID-19 exposures?
Managing difficult decisions relating to COVID-19
Can we keep operating if we are struggling with social distancing?
Working from home – how far do our duties extend?
Returning to work
Reporting under RIDDOR
About the speaker:
Dr Simon Joyston-Bechal
Dr Simon Joyston-Bechal is widely regarded as one of the UK’s leading health and safety lawyers. He is a director at Turnstone Law and previously qualified as a doctor, putting him in a unique position to deal with technical, safety and health-related legal issues. In addition to defending health and safety enforcement, he focuses on training senior management and advising organisations on legal preventive measures to reduce the likelihood of prosecution in the event of an incident.
Published: 22nd May 2020
Theraposture Video Assessments and Virtual Product Demonstrations Deliver Positive Outcomes
Theraposture, a specialist supplier of adjustable beds, chairs and care cots, has rolled out its new video assessment and demonstration service with positive results for clients and Occupational Therapists (OTs).
Theraposture continues to provide essential assistive equipment to keep vulnerable individuals and those with restricted mobility, independent and safe at home. As suppliers of medical devices, Theraposture provide an essential service in supporting private clients, the NHS and Social Care OTs. Trusted and proven products, such as the award-winning Rotoflex Turning Bed, have been designed to enable independent and safe bed transfers and as a result, can help individuals benefit from reduced carer contact. In many cases, the Rotoflex can ensure independence for those who would otherwise struggle, thus avoiding residential care settings and hospitals – essential for significantly reducing the risk of Covid-19 infection.
Theraposture are still firm believers in assessment-based provision hence have embraced technology to help with establishing suitability of a product. This results in less risk of infection to our clients and colleagues.
As an alternative to home visits, assessments and product demonstrations are being provided remotely by experienced equipment experts using video conferencing platforms such as Zoom and WhatsApp. This means that Theraposture experts can see the environment where equipment will be used and personally discuss and understand an individual’s situation. Products are demonstrated via video link from our demonstration room and in context to each person’s needs. Occupational Therapists also benefit from this service as they can join the platform – ensuring all stakeholders are included, whilst remaining safe.
WhatsApp is proving to be the most popular tool for delivering video assessments. Liam Braddell, Theraposture Sales Director, explains: “As an ethical business we are focused on providing a solution that meets the needs, wants and risks for each customer. To understand these, we need to assess each client however with many vulnerable people shielding, we have turned to technology to maintain this vital part of the process. Our live video assessments protect clients and give greater peace of mind during these challenging times. In our experience, most of our clients are delighted to have this option. If potential clients struggle with video calls, then supporting relatives or healthcare professionals assist, plus we always set up meetings so attendees just need to join.”
Liam continues: “Assessments are centrally booked by calling the Theraposture offices on 0800 834654. Detailed questions are initially asked regarding the user’s situation and we discuss which equipment might be considered. The equipment itself can be prepared in our showroom so that it is possible to view more than one product in an assessment. Once delivered, our 14-Day Suitability Guarantee begins. This ensures that should a product prove to be unsuitable, it can be returned for a refund, modified, or exchanged.”
Theraposture deliveries and service calls are carefully managed and comply fully with its COVID-19 safety policy. All customer-facing staff wear fully protective PPE and social distancing is strictly adhered to during home installations. Each situation is discussed in detail and is individually managed to ensure the upmost safety at all times.
Liam concludes: “We are finding that video assessments still provide us with a same level of detail as a home visit and more family members can join the conversation. Commonly relatives live too far away to join us for home visits whereas now they can get involved. It is key that video assessments are treated like home appointments with a specific date and time agreed in advance. Overall, it is more of an inclusive experience for clients, carers and supporting OTs.”
Walter, Occupational Therapist, Inclusion.me, added: “In the complex new world where we find ourselves working to support high needs in the community, I was really pleased to be able to move forwards on assessing needs and agreeing a safe product for my client who is being shielded at present. This was achieved by us agreeing a basic specification of need, a video call from a Theraposture equipment expert to the client’s mother/home and then by means of us tying up the details of the brief in a follow-up call. I welcome Theraposture’s willingness to find innovative ways of offering continuity of service at this complicated time and look forward to future virtual visits as a safe way of offering input to the most vulnerable of clients by removing avoidable delays through the use of remote technology to maintain distance.”
Published: 1st May 2020
COVID-19 Guidance: Information for NI Businesses & Employers
Coronavirus (COVID-19): Information for businesses and employers in Northern Ireland.
To help businesses and employers understand what the measures announced by the Chancellor mean for you, please use this page to navigate the latest guidance for people in Northern Ireland.
The UK Government has launched a Self-employment Income Support Scheme (SEISS) which will support self-employed individuals (including members of partnerships) who have lost income due to coronavirus (COVID-19). Details on how to apply can be found here.
The UK Government has published extensive guidance for employers, including details on how to prevent the spread of COVID-19 and what to do if someone is suspected or confirmed to have the virus.
UK Government support for businesses
The UK Government has set out a package of measures to protect public services, people and businesses through this period of disruption caused by COVID-19. Businesses in Northern Ireland can access the following schemes and announcements:
Businesses will receive government grants worth up to 80% of wages to keep workers in jobs. The Coronavirus Job Retention Scheme will pay up to £2,500 per worker each month, helping those who are self-isolating or caring for loved ones.
For innovative companies facing financing difficulties due to the Coronavirus outbreak, the Future Fund will provide government loans to UK-based companies ranging from £125,000 to £5 million, subject to at least equal match funding from private investors. The Future Fund will launch in May 2020.
Coronavirus (COVID-19) support is available to employers and the self-employed. You may be eligible for loans, tax relief and cash grants. Use this business support finder to see what support is available for you and your business.
Northern Ireland Executive support for businesses
As some aspects of business support are devolved in Northern Ireland, Invest NI has provided practical advice for business online here.
Businesses in Northern Ireland can access the following schemes:
COVID Small Business Grant – A small business grant of £10,000 for all businesses with a rateable value up to £15,000. This will be automatically paid into the accounts of eligible direct debit ratepayers. Registration is now open for other eligible businesses to apply.
Hospitality, Tourism and Retail Sectors Grant Scheme – A grant of £25,000 will be provided to companies in these sectors with a rateable value from £15,001 up to £51,000. This scheme went live on 20 April.
In his Budget Statement of 31 March, the Finance Minister confirmed a £100m package allocated to providing a three months rates holiday to all businesses in Northern Ireland. No application is required to avail of this. It will be shown as a 25% discount on the annual rate bill for business ratepayers.
The Budget Statement also provided for:
an effective 18% reduction in the Stormont determined portion of business rates (i.e. the non-domestic regional rate) compared to the 2019-20 figure;
an extension of the existing Small Business Rate Relief scheme for one year;
a deferral in the issuing of rates bills until June.
Specialist Rotoflex Turning Beds Deliver Critical Home Independence with Reduced Risk During COVID-19 Crisis
Theraposture, a respected supplier of specialist adjustable beds, chairs and care cots, continues to provide vital support to vulnerable individuals during the COVID-19 outbreak through its award-winning Rotoflex bed and enhanced services.
As suppliers of medical devices and assistive technology, Theraposture provides a vital and essential service and is able to continue operating safely. This market leading expert is recognised as an essential supplier and has the backing of the NHS, the BHTA and the major charities it works with.
The equipment that Theraposture provides is vital for ensuring customers remain independent at home and avoid residential care settings. For example, by using the Rotoflex Bed it is likely that less external help is needed for bed transfers and therefore the risks of spreading the Coronavirus are massively reduced.
The patented Rotoflex is a specialist bed that will safely and consistently help users get into bed, get out of bed and to stand up without the need of hoisting, stand aids or carers. The Rotoflex takes the user from a seated position to a lying position at the touch of a button. Equally the bed also helps users from a lying position to a seated position from where they can be safely helped to their feet. Vertical lift technology can then raise users, so they achieve a safer standing transfer intentionally without being tipped forward. This proven and trusted product provides independence, and as a result reduces the need for carer givers.
Liam Braddell, Theraposture Sales Director comments: “Our mission is always to provide independence, care and comfort at home through quality and proven adjustable beds, chairs and care cots. This ethos is now more relevant than even before with social distancing, isolation and shielding to beat the spread of Coronavirus. Our solutions are designed to help individuals stay at home safely and with peace of mind – with the ability to reduce or eliminate care costs. With the increased risk of infection between clients and carers, the need for products that facilitate mobility at home is imperative.”
Theraposture has introduced enhanced COVID-19 focused protocols and services so that its assistive products are still available to individuals who are at increased risk because of the need for carers coming into their homes. Many users of Theraposture products live with Multiple Sclerosis and Parkinson’s. These progressive debilitating conditions can make daily tasks like beds transfers difficult and sometimes dangerous. With a solution such as the Rotoflex bed, the immediate and future needs and risks are fully met. This means that users could avoid residential care, hospital stays and the need for care packages. In addition, without appropriate and effective assistive equipment in the home, the risk of injury from falls is increased which can lead to undue pressure on the NHS. This furthers the risk of infection from COVID-19 hence Theraposture is continuing to provide products and equipment servicing if requested and where appropriate.
Theraposture’s key workers are operating with utmost caution and protection as per the government’s latest guidance which is continually reviewed. New services have been introduced such as group video client assessments which support end users and Occupational Therapists so duty of care can be maintained.
Liam concludes: “We continue to receive high numbers of calls from existing and potential new customers seeking solutions for increased safety at home. Our Rotoflex bed is an exemplary product that delivers a proven alternative to domiciliary care and relocation to residential or nursing care. Add to this our comprehensive OT-led advice and partnership with Parkinson’s UK, we are helping to support the NHS and reduce unprecedented pressures on social care.”
Published: 17th April 2020
Chancellor Waives Duties and VAT on Vital Medical Imports
Chancellor waives import taxes on vital medical equipment including ventilators, coronavirus testing kits and protective clothing.
goods arriving from outside the EU will not be subject to customs duty or import VAT
move will reduce red tape to ensure frontline health workers get vital equipment quickly and removes barriers to those who want to donate supplies to the NHS
The Chancellor has waived import taxes on medical equipment crucial to the fight against coronavirus – reducing red tape to ensure equipment gets to frontline health workers faster.
NHS suppliers will no longer have to pay customs duty and import VAT on specific medical goods coming from outside the EU, including ventilators, coronavirus testing kits and protective clothing.
The removal of the tariffs, which can be up to 12 per cent on the price of these goods, will mean more vital supplies are flowing into the UK to help the brave frontline workers treating patients with coronavirus.
Chancellor Rishi Sunak said:
We are taking decisive action to ensure our NHS has everything it needs to fight this outbreak.
Waiving import taxes on vital medical equipment such as ventilators will speed up and increase the supply of critical items going to our frontline health workers.
Dealing with coronavirus is a collective national effort and I will do everything I can to help us win this battle.
The changes, which were introduced last Friday, will also make the UK more attractive to companies who want to produce or donate supplies to fight coronavirus.
The move helps deliver on the Chancellor’s promise to do whatever extra resources the NHS needs to cope with the outbreak
The list of goods exempt from import taxes includes ventilators, COVID-19 testing kits, face masks, protective garments and eye protectors, amongst hundreds of other vital products to tackle the outbreak of coronavirus. The types of goods covered by the UK’s new duty-free rules was created by the Department of Health.
Health and Social Care Secretary Matt Hancock said:
We are working around the clock to ensure that our heroic frontline NHS and social care staff have all they need to tackle coronavirus.
The removal of import taxes for these goods will help clear the way for even more equipment to reach the frontline.
International Trade Secretary, Liz Truss said:
We are removing tariffs and barriers on essential medical supplies imported into the UK to ensure our front line workers have everything they need to treat people suffering from Covid-19.
As I agreed with my G20 trade minister counterparts this Monday, we will work together to keep trade flowing and ensure the supply of essential goods and services.
Under the current rules, importers require a duty deferment account with HMRC backed by a guarantee. Importers of these critical goods would need to increase the level of their guarantee to cover any additional duty due.
This new approach, in place until 31 July 2020, will allow companies to import goods critical for our fight against coronavirus at a faster rate and reduce costs significantly.
The relief can be claimed from HMRC immediately by state organisations, including state bodies, public bodies and other bodies governed by public law who are supplying the NHS. Other approved organisations wanting to supply the NHS can also apply to HMRC
All imports will continue to arrive through the same channels and face the same checks as before, so there is minimal chance of fraud. Companies benefiting from the relief also need to first be approved by HMRC.
The EU’s disaster relief regulation can be used in relation to COVID-19. This allows certain items that are needed to deal with C-19 to be imported free of VAT and customs duties.
Between 16 March and 3 April 2020, NHS Supply Chain presented a daily webinar series to trusts. These webinars will continue to run for the foreseeable future (but now every Tuesday and Thursday), as they will continue to update on products, processes and activity to support the current COVID-19 response.
Accessing Webinar Recordings
See NHS Supply Chain’s Useful Links section to access the latest recordings or to register for webinars. Following NHS trust feedback, the webinars will now take place at 4pm.
A page listing the most frequently asked webinar attendees’ and customers’ questions relating to the COVID-19 response is available on the NHS Supply Chain website.
Guidance on Social Distancing for Everyone in the UK
Background and scope of guidance
This guidance is for everyone, including children. It advises on social distancing measures we should all be taking to reduce social interaction between people in order to reduce the transmission of coronavirus (COVID-19). It is intended for use in situations where people are living in their own homes, with or without additional support from friends, family and carers. If you live in a residential care setting guidance is available.
We are advising those who are at increased risk of severe illness from coronavirus (COVID-19) to be particularly stringent in following social distancing measures.
This group includes those who are:
aged 70 or older (regardless of medical conditions)
under 70 with an underlying health condition listed below (ie anyone instructed to get a flu jab as an adult each year on medical grounds):
being seriously overweight (a body mass index (BMI) of 40 or above)
those who are pregnant
Note: there are some clinical conditions which put people at even higher risk of severe illness from COVID-19. If you are in this category, next week the NHS in England will directly contact you with advice about the more stringent measures you should take in order to keep yourself and others safe. For now, you should rigorously follow the social distancing advice in full, outlined below.
People falling into this group are those who may be at particular risk due to complex health problems such as:
people who have received an organ transplant and remain on ongoing immunosuppression medication
people with cancer who are undergoing active chemotherapy or radiotherapy
people with cancers of the blood or bone marrow such as leukaemia who are at any stage of treatment
people with severe chest conditions such as cystic fibrosis or severe asthma (requiring hospital admissions or courses of steroid tablets)
people with severe diseases of body systems, such as severe kidney disease (dialysis)
What is social distancing?
Social distancing measures are steps you can take to reduce social interaction between people. This will help reduce the transmission of coronavirus (COVID-19).
They are to:
Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough
Avoid non-essential use of public transport when possible
Work from home, where possible. Your employer should support you to do this. Please refer to employer guidance for more information
Avoid large and small gatherings in public spaces, noting that pubs, restaurants, leisure centres and similar venues are currently shut as infections spread easily in closed spaces where people gather together.
Avoid gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media
Use telephone or online services to contact your GP or other essential services
Everyone should be trying to follow these measures as much as is practicable.
We strongly advise you to follow the above measures as much as you can and to significantly limit your face-to-face interaction with friends and family if possible, particularly if you:
are over 70
have an underlying health condition
This advice is likely to be in place for some weeks.
Handwashing and respiratory hygiene
There are general principles you can follow to help prevent the spread of respiratory viruses, including:
washing your hands more often – with soap and water for at least 20 seconds or use a hand sanitiser when you get home or into work, when you blow your nose, sneeze or cough, eat or handle food
avoid touching your eyes, nose, and mouth with unwashed hands
avoid close contact with people who have symptoms
cover your cough or sneeze with a tissue, then throw the tissue in a bin and wash your hands
clean and disinfect frequently touched objects and surfaces in the home
What should you do if you develop symptoms of coronavirus (COVID-19)
The same guidance applies to the general population and those at increased risk of severe illness form coronavirus (COVID-19). If you develop symptoms of COVID-19 (high temperature and/or new and continuous cough), self-isolate at home for 7 days. You can find the full guidance at stay at home.
Getting assistance with foods and medicines if you are reducing social contacts
Ask family, friends and neighbours to support you and use online services. If this is not possible, then the public sector, business, charities, and the general public are gearing up to help those advised to stay at home. It is important to speak to others and ask them to help you to make arrangements for the delivery of food, medicines and essential services and supplies, and look after your physical and mental health and wellbeing.
If you receive support from health and social care organisations, for example, if you have care provided for you through the local authority or health care system, this will continue as normal. Your health or social care provider will be asked to take additional precautions to make sure that you are protected. The advice for formal carers is included in the Home care provision.
What should you do if you have hospital and GP appointments during this period?
We advise everyone to access medical assistance remotely, wherever possible. However, if you have a scheduled hospital or other medical appointment during this period, talk to your GP or clinician to ensure you continue to receive the care you need and consider whether appointments can be postponed.
What is the advice for visitors including those who are providing care for you?
You should contact your regular social visitors such as friends and family to let them know that you are reducing social contacts and that they should not visit you during this time unless they are providing essential care for you. Essential care includes things like help with washing, dressing or preparing meals.
If you receive regular health or social care from an organisation, either through your local authority or paid for by yourself, inform your care providers that you are reducing social contacts and agree on a plan for continuing your care.
If you receive essential care from friends or family members, speak to your carers about extra precautions they can take to keep you safe. You may find this guidance on Home care provision useful.
It is also a good idea to speak to your carers about what happens if one of them becomes unwell. If you need help with care but you’re not sure who to contact, or if you do not have family or friends who can help you, you can contact your local council who should be able to help you.
What is the advice if I live with a vulnerable person?
Understandably, you may find that social distancing can be boring or frustrating. You may find your mood and feelings are affected and you may feel low, worried or have problems sleeping and you might miss being outside with other people.
At times like these, it can be easy to fall into unhealthy patterns of behaviour which in turn can make you feel worse. There are simple things you can do that may help, to stay mentally and physically active during this time such as:
look for ideas of exercises you can do at home on the NHS website
spend time doing things you enjoy – this might include reading, cooking, other indoor hobbies or listening to the radio or watching TV programmes
try to eat healthy, well-balanced meals, drink enough water and try to avoid smoking, alcohol and drugs
keep your windows open to let in fresh air, get some natural sunlight if you can, or get outside into the garden
You can also go for a walk or exercise outdoors if you stay more than 2 metres from others.
Further information on looking after your mental health during this time is available.
What steps can you take to stay connected with family and friends during this time?
Draw on support you might have through your friends, family and other networks during this time. Try to stay in touch with those around you over the phone, by post, or online. Let people know how you would like to stay in touch and build that into your routine. This is also important in looking after your mental wellbeing and you may find it helpful to talk to them about how you are feeling.
Remember it is OK to share your concerns with others you trust and in doing so you may end up providing support to them too. Or you can use a NHS recommended helpline.
Advice for informal carers
If you are caring for someone who is vulnerable, there are some simple steps that you can take to protect them and to reduce their risk at the current time.
Ensure you follow advice on good hygiene such as:
wash your hands on arrival and often, using soap and water for at least 20 seconds or use hand sanitiser
cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
put used tissues in the bin immediately and wash your hands afterwards
do not visit if you are unwell and make alternative arrangements for their care
provide information on who they should call if they feel unwell, how to use NHS 111 online coronavirus service and leave the number for NHS 111 prominently displayed
find out about different sources of support that could be used and access further advice on creating a contingency plan is available from Carers UK
look after your own well-being and physical health during this time. Further information on this is available here
Summary of advice
* if one member of your family or household has a new continuous cough or high temperature ** if you live alone and you have a new continuous cough or high temperature *** noting cinemas, theatres, pubs, bars, restaurants and clubs are now all required to close. If you meet others when you are outdoors (for example, on a walk) ensure that you stay at least 2 metres away **** for example via telephone or internet 1 such as anyone instructed to get a flu jab each year
NHS Support via Text Message for People with Symptoms of Covid-19
People staying at home suffering with suspected coronavirus symptoms will get regular check-ins from a new NHS messaging service launched today.
Daily texts will be sent by the NHS to new patients who register their Covid-19 symptoms and contact details with the 111 online service.
The messages will check how people are, and ensure that those who need help to get them through the isolation period receive it.
The text messages will be sent as a reassurance to those who contact NHS 111 online, complete the assessment, and leave basic information such as their age, mobile number and when their symptoms started.
Health and Social Care Secretary Matt Hancock said: “We are doing everything we can to protect the health of the nation during this outbreak, including supporting our fantastic NHS and social care workforce who are looking after people who have symptoms or are self-isolating.
“I know all too well that experiencing symptoms can be worrying, but for those living on their own it will be even more so. Alongside other measures, this new daily text service will reassure our most vulnerable that they are not alone, and also to help them manage their symptoms.
“Technology, combined with our heroic staff on the frontline, have played a huge role in battling this virus and I encourage everyone to use this new service.”
Professor Jonathan Benger, Chief Medical Officer at NHS Digital, said: “Across the country, people are playing their part in the battle to save lives and stop the spread of coronavirus by doing the right thing and staying home if they have got symptoms.
“However we know that for many this will be difficult. This new service will help people to get the encouragement, advice and support that they need.”
Dr Simon Eccles, Deputy Chief Executive, NHSX said: “This new service is vitally important to help the NHS to understand the impact of the virus on patients and its progression and spread across the country.”
People who don’t want to receive text messages will be able to opt out at any time.
People should visit the NHS.UK/coronavirus page as the first and best port of call for the most up to date information and advice.
The new text messaging service has been commissioned by NHSX and built by NHS Digital and the NHS Business Services Authority. The text messages will come from NHS Covid-19.
NHS to Open Two More New Hospitals to Fight Coronavirus
Two new NHS Nightingale Hospitals will open in Birmingham and Manchester to provide care to thousands more patients with coronavirus, chief executive Sir Simon Stevens has announced today.
The hospital based at the NEC in Birmingham will start with up to 500 beds equipped with the capacity to increase beds up to 2,000 if needed.
The hospital based at the Manchester Central Complex will provide up to 500 beds but could expand further to 1,000 beds for coronavirus patients across the North West of England.
The new hospitals will provide support for patients from across the Midlands and the North West.
Confirmation that the two new NHS Nightingale sites are going ahead came as Sir Simon revealed that the NHS has freed up 33,000 beds across existing NHS hospitals for coronavirus patients, the equivalent of 50 new hospitals.
The NHS chief executive, Sir Simon Stevens, said: “It will take a monumental effort from everyone across the country to beat this epidemic, but the NHS is mobilising like never before to deliver care in new ways, to thousands more people – starting with the opening of the first NHS Nightingale in London later next week.
“These are extraordinary steps the NHS is taking, and clinicians, managers and military planners are working day and night to create, equip and staff these hospitals from scratch and prepare for the surge that is likely to be coming.
“While we continue to pull out all the stops, we do need the public to play their part. Every single person in this country can make a difference by following the medical advice to the letter – stay at home, wash your hands, which will help stop the virus letting rip and will therefore save lives.”
The new hospitals will draw from predominantly NHS doctors, nurses and other healthcare professionals from across the country. A number of military medics will be on hand to care for patients too.
The new hospitals are part of a huge NHS mobilisation plan to deal with the growing number of coronavirus patients.
More than 18,000 doctors, nurses and other former NHS staff have already volunteered to return to fight the virus.
Staff members are then being put in touch with their local NHS services where a role based on their clinical skills and work history is found.
The opportunity to rejoin the NHS continues to be open to all former NHS staff from the last three years – even if they haven’t been contacted by their medical regulator.
All former staff that join the ‘NHS army’ are given a full induction and online training to help them to hit the ground running.
The renewed call comes after the NHS extended its ‘Your NHS needs you’ call to the general public, with already more than 725,000 people volunteering to help deliver medicines from pharmacies, drive patients to appointments, bringing patients home from hospital and making regular phone calls to check on people isolating at home.
details of the product(s) (including model name, description and intended purpose of use)
reasons why the product does not have a valid CE mark
clinical justification for requesting an exemption from the regulations for the product
explanation of any alternative products on the market and reasons why using these products would not be appropriate
numbers of product likely to be supplied under the exemption, plus an indication of how widely used the product is
expected time to gain/re-gain CE certification
We might ask you for more information once we’ve received your application.
Be aware that you are expected to have evidence that the device performs as intended. For example, performance data such as bench testing (including any that comply with a relevant standard – harmonised or other) and any study data you have.
To create more flexibility for manufacturers and availability of medical devices, we would not expect to receive a request for derogation of a CE-marked device where there is limited change to its intended use. For example, changing its use from ward use to include intensive care use. However, you should perform a risk assessment and contact your notified body for advice in the first instance.
We expect to receive a high volume of applications for derogations.
We will prioritise applications based on the needs of the healthcare providers to increase the supply of critical devices and tests.
Leading Outsource CES Providers Working Together to Support NHS and Local Authorities
We are facing an unprecedented public health crisis, where only cooperation, understanding and resourcefulness will help to maintain our vital services. Following detailed discussions Medequip Assistive Technology, NRS Healthcare, Millbrook Healthcare, Ross Care and the British Healthcare Trades Association (BHTA) have agreed to work closely together to maximise continuity for local authorities and the NHS throughout the current Covid-19 crisis.
Optimising, planning and sharing information to ensure these organisations are able to provide maximum support for their services, senior directors from each business are now holding weekly conference calls to discuss key areas such as activity levels, geographical pressures and availability of qualified staff.
These levels of inter-company cooperation are designed to ensure best practice to maximise service user and employee protection, and will deal with the management of key equipment and PPE availability as well as specific area service continuity responses.
They are also extending to best practice utilisation of staff from other providers within geographic regions, such as individuals who have been furloughed and kept on payroll, and also potentially providing assistance to vulnerable groups with food and medicine distribution. This work is further enhanced by engagement with specialist teams set up by the NHS and local authorities across the country.
Working closely together, the five organisations are totally committed to ensuring safe continuity of service provision for the most vulnerable people in our communities.
Dr Simon Festing
Chief Executive Officer
British Healthcare Trades Association
Published: 26th March 2020
EU Regulators to Propose 1-Year MDR Delay
With patient health and safety as a guiding principle, the Commission announced on 25 March 2020 that work on a proposal to postpone the application date of the Medical Devices Regulation (MDR) for one year is ongoing.
The goal is to submit this proposal in early April so the Parliament and Council can adopt it by the end of May, its deadline for entry into force.
This will take the pressure off national authorities, notified bodies, manufacturers and other actors so they can focus fully on urgent priorities related to the coronavirus crisis.
Government Launches Coronavirus Information Service on WhatsApp
The new free to use service aims to provide official, trustworthy and timely information and advice about coronavirus (COVID-19), and will further reduce the burden on NHS services.
This will help combat the spread of coronavirus misinformation in the UK, as well as helping ensure people stay home, protect the NHS and save lives.
The GOV.UK Coronavirus Information Service is an automated ‘chatbot’ service which will allow the British public to get answers to the most common questions about coronavirus direct from government.
The service will provide information on topics such as coronavirus prevention and symptoms, the latest number of cases in the UK, advice on staying at home, travel advice and myth busting.
The service will also allow the government to send messages to all opted-in users if required.
To use the free GOV.UK Coronavirus Information Service on WhatsApp, simply add 07860 064422 in your phone contacts and then message the word ‘hi’ in a WhatsApp message to get started.
A set of menu options is then presented which the user can choose from and then be sent relevant guidance from GOV.UK pages as well as links to GOV.UK for further information.
Prof Yvonne Doyle, Medical Director, Public Health England, said:
This service will help us ensure the public has a trusted source for the right information about coronavirus, updated with the latest public health guidance and providing assurance that they are not misled by any of the false information circulating.
Matt Idema, Chief Operating Officer, WhatsApp, said:
At difficult times like these, people are using WhatsApp more than ever to connect with and support their friends, family and communities. We are pleased to be able to provide the UK Government with the communications tools to help them answer the public’s questions about the virus with reliable, timely health advice, in order to keep people safe.
Other recent Government communications include:
Earlier this week the government texted people across the UK to inform them of the new rules announced by the Prime Minister on 23 March 2020. Details here – https://www.gov.uk/government/news/coronavirus-sms-messages
The Government has also sent text messages to the vulnerable as part of the shielding package announced by the Prime Minister on 22 March 2020. Details here – https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
Guidance for Schools, Colleges and Local Authorities on Maintaining Educational Provision – Key Workers
Government issue guidance to parents whose work is critical to the COVID-19 response include those who work in health and social care and in other key sectors outlined below. Many parents working in these sectors may be able to ensure their child is kept at home. And every child who can be safely cared for at home should be.
Please, therefore, follow these key principles:
If it is at all possible for children to be at home, then they should be.
If a child needs specialist support, is vulnerable or has a parent who is a critical worker, then educational provision will be available for them.
Parents should not rely for childcare upon those who are advised to be in the stringent social distancing category such as grandparents, friends, or family members with underlying conditions.
Parents should also do everything they can to ensure children are not mixing socially in a way which can continue to spread the virus. They should observe the same social distancing principles as adults.
Residential special schools, boarding schools and special settings continue to care for children wherever possible.
If your work is critical to the COVID-19 response, or you work in one of the critical sectors listed below, and you cannot keep your child safe at home then your children will be prioritised for education provision:
It’s a good idea to check your workplace’s policy on absence from work. Employers might need to be flexible if asking for self-isolation notes. For example, an employee with severe symptoms might not be able to get a note straightaway.
If the employer needs to close the workplace
An employer may want to plan in case they need to close the workplace temporarily.
Some employers have been instructed to close by the government. Including cafes, pubs, restaurants, leisure centres, cinemas and theatres.
This might be a difficult time for both employers and staff. It’s a good idea to make sure staff have a way to communicate with the employer and other people they work with.
Financial support announced on 20 March
The government has announced new financial support for employers. This will cover most of the wages of staff who have been temporarily sent home because there is no work.
We’re monitoring government announcements to review our advice.
Employers have the right to tell employees and workers when to take holiday if they need to. For example, they can decide to shut for a week and everyone has to use their holiday entitlement.
If the employer does decide to do this, they must tell staff at least twice as many days before as the amount of days they need people to take.
For example, if they want to close for 5 days, they should tell everyone at least 10 days before.
This could affect holiday staff have already booked or planned. So employers should:
explain clearly why they need to close
try and resolve anyone’s worries about how it will affect their holiday entitlement or plans
If an employee needs time off work to look after someone
Employees are entitled to time off work to help someone who depends on them (a ‘dependant’) in an unexpected event or emergency. This could apply to situations to do with coronavirus.
A dependant does not necessarily live with the person, for example they could be an elderly neighbour or relative who relies on the person for help.
There’s no statutory right to pay for this time off, but some employers might offer pay depending on the contract or workplace policy.
The amount of time off an employee takes to look after someone must be reasonable for the situation. For example, they might take 2 days off to start with, and if more time is needed, they can book holiday.
If a dependant such as a partner, child or relative in the same household gets coronavirus symptoms, they should receive Statutory Sick Pay (SSP) as a minimum for this time. They’ll also need to follow self-isolation guidance on GOV.UK.
As schools in England, Scotland and Wales will be closing, this will have an affect on care and working arrangements. This may be an anxious time for parents, and employers will need to be planning cover at work.
If employees need emergency time off for child care or to make new arrangements, they can use:
talking to each other early on about time off that might be needed
agreeing regular conversations so both can plan ahead
agreeing flexible working instead of taking longer periods of time off, for example working from home or changing working hours to allow for child care
If any agreement is made, it’s a good idea for it to be in writing.
If someone has coronavirus symptoms at work
If someone becomes unwell in the workplace with coronavirus symptoms, they should:
tell their employer immediately and go home
avoid touching anything
cough or sneeze into a tissue and put it in a bin, or if they do not have tissues, cough and sneeze into the crook of their elbow
use a separate bathroom from others, if possible
If the unwell person lives alone, they must self-isolate for 7 days. If they live with others and is the first to have symptoms, they must self-isolate for 7 days. Everyone else in their household must self-isolate for 14 days.
If anyone else in the household starts displaying symptoms, the person with the new symptoms must self-isolate for 7 days. This is regardless of where they are in the 14-day isolation period.
Employers should consider some simple steps to help protect the health and safety of everyone during the coronavirus (COVID-19) pandemic.
It’s good practice for employers to:
be especially careful and take extra steps for vulnerable groups, including those who are pregnant, aged 70 or over, or who have a long-term health condition
hold meetings as remote calls and avoid travel as much as possible
make sure managers know how to spot symptoms of coronavirus and are clear on any relevant processes, for example sickness reporting and sick pay, and procedures in case someone in the workplace shows symptoms of the virus
make sure there are clean places to wash hands with hot water and soap, and encourage everyone to wash their hands regularly
provide hand sanitiser and tissues for staff, and encourage them to use them
make sure everyone’s contact numbers and emergency contact details are up to date
keep everyone updated on actions being taken to reduce risks of exposure in the workplace
Coronavirus: European Standards for Medical Supplies Made Freely Available to Facilitate Increase of Production
In the context of the Coronavirus crisis, the Commission is working with industry and Member States to maximise the availability of masks, gloves, gowns and other medical supplies. Efforts include increasing production by existing manufacturers, facilitating imports and activating alternative ways of producing equipment.
Upon the urgent request of the Commission, the European Committee for Standardization (CEN) and the European Committee for Electrotechnical Standardization (CENELEC), in collaboration with all their members, have agreed to immediately make available a number of European standards for certain medical devices and personal protective equipment. This action will help both EU and third-country companies willing to manufacture these items to swiftly start production and place products on the internal market more easily while ensuring a high degree of safety.
Commissioner for Internal Market Thierry Breton said: “We need to act collectively with urgency, solidarity, and audacity. I am encouraging manufacturers to increase and diversify production, building on positive examples such as textile and shoe manufacturers starting to produce masks and gowns. I will do everything possible to support their efforts. I am pleased to announce that following contacts with the Commission, CEN/CENELEC has agreed to make freely available the standards needed for such companies to be able to produce masks and other protective equipment.”
Today’s agreement has immediate effect. The 11 standards developed by CEN and potentially 3 additional ones developed jointly with ISO that are made available cover common filtering masks, medical gloves and protective clothing.
This initiative complements the Commission Recommendation on the conformity assessment and market surveillance procedures, which provides guidance to national bodies on allowing non CE-marked personal protection equipment that comply with the necessary health and safety standards to enter the EU market within the context of the Coronavirus.
How the free access to these standards helps increasing production
Providing free access to the national adoptions of these European standards helps both EU and third-country companies which are reconverting their production lines to manufacture quickly these critical items for preventing the coronavirus pandemic. The use of the standards will enable companies that use them to access the market for such fundamental medical and protection equipment quicker and to provide those in need with such medical equipment.
Normally, standards must be purchased and used in line with the intellectual property right rules, as the copyright of the standards lies with the organisations, which have developed the standards. The derogation from this business model is a strong European response, based on a sense of social responsibility and solidarity, to address the shortage problem of protective equipment deriving from the Covid-19 epidemics.
European standards are an essential pillar of a fully functioning internal market. They reduce costs, promote innovation, ensure interoperability between different devices and services, and help companies to access markets.
To support EU product legislation, the Commission can request the development of European harmonised standards to facilitate compliance by manufacturers of the relevant requirements. Once agreed and referenced in the Official Journal of the European Union, these harmonised standards become part of EU law and allow companies an easy and direct access to the internal market for their products, while ensuring a high degree of safety for consumer.
European legislation for medical devices and personal protection equipment does also rely on harmonised standards. In our common effort to face the corona virus outbreak, the Commission and the European Committee for Standardization (CEN) have agreed to make a number of harmonised standards for important protective equipment like face masks and single-use gloves freely available to those companies that are willing to start producing these items.
BHTA Appeals to Government to Include the Medical Device and Assistive Technologies Sectors as “Key Workers”
In light of the news that school closures have already started, the BHTA has appealed to government to clarify the definition of “key workers”, and to include the medical device and assistive technology sector. BHTA has today written to DHSC, MHCLG, NHS England and Local Government to urgently seek greater clarity.
The healthcare industries provide services which will be vital as the NHS comes under ever greater pressure. Beds will need to be released as quickly as possible and patients returned to their own homes where they can be kept safe and allowed to live independently. Members of our association are likewise involved in manufacturing key medical products and deliver services such as decontamination of medical devices.
Some members companies of the Association have identified that up to 40% of their service/production work force would have difficulty in continuing to attend to work which will then have a severe impact on their ability to continue to deliver these services to the NHS.
Clarity is also sought over what are deemed essential products and services. Products in this sector range from profiling beds needed urgently by hospitals, through to stoma and urology devices needed by patients both in hospital and at home, and to items such as stairlifts, bathlifts, and wheelchairs. It is vital that these continue to be delivered, installed, decontaminated, and repaired, for the safe care of patients in hospitals and care homes, and the safety of very vulnerable members of the public in their own homes.
Manufacturers, suppliers and service providers are all putting appropriate measures in place to keep their staff and their customers safe, but will need assistance, if key staff have had to self-isolate, in determining whether they can resume their duties. Extension of testing to this sector will help immeasurably in ensuring continuity of supply to the NHS and to vulnerable people, as will an assurance that they will be able to access protective garments such as masks to enable them to fulfil their duties.
Dr Simon Festing
CEO – British Healthcare Trades Association
Published: 19th March 2020
National Care Force Launched to Fill Gaps in the Workforce
A National Care Force has been set up to help social care providers fill staff gaps with health workers and volunteers during the coronavirus outbreak.
The free online platform, powered by health technology firm Florence, works by allowing volunteers to book shifts available across the social care sector. Shifts are posted directly by the care providers who have joined.
The National Care Force has been launched in response to vital staff shortages expected to occur due to coronavirus.
With up to 80% of the UK population projected to become infected in the next 12 months – according to a Public Health England briefing for NHS officials – extra users and staffing gaps caused by the illness will add even more strain to care services already stretched before the outbreak.
Last night, the government announced an emergency bill that will allow recently retired NHS staff and social workers to return to work without any impact on their pensions.
Social care providers, healthcare workers and volunteers across the UK are able to register to use the platform now.
After going through compliance checks, including qualifications and criminal record, users update their profile with skills and experience.
Care providers follow a similar process, adding details about their care setting and skills required. The platform’s algorithm will match relevant positions to users.
Users apply for preferred positions, and the care provider will select a candidate. Everything is managed for free through the platform, which also stores reminders of upcoming shifts, and allows for cancellations.
Care professionals who can join include doctors, nurses, care workers, support workers, physiotherapists and occupational therapists. They can apply for shifts covering clinical staff rota gaps in a variety of care settings.
Anyone can join as a volunteer, regardless of work background. They can apply for non-clinical work, such as picking up shopping for those self-isolating, or providing services such as cleaning and laundry.
Florence co-founder Dr. Charles Armitage: “There is a desperate desire across the country for people to be able to do something to help but people don’t know how to channel their efforts.
“The National Care Force is a movement that will significantly impact the national effort against COVID-19 and allow everyone to play their part.
“As a company, we have vast experience in using technology to mobilise massive, flexible workforces. The whole Florence team is working nonstop to deliver this solution.”
What People are Telling Healthwatch: October – December 2019
Find out what the public has been telling Healthwatch about health and social care from October to December. This briefing also looks at and examines emerging themes across services, focusing on healthcare for trans people, and access to wheelchair services.
Between October and December over 8,690 people shared their experiences of using health and social care with Healthwatch. This briefing looks at 149 reports published by local Healthwatch, as well as individual feedback from the public. It aims to provide health and social care professionals with a summary of the issues people have raised with Healthwatch.
What issues do we look at?
Key issues the public have told them about primary care, hospital care, social care and mental health support.
The top questions people are seeking advice about.
In focus: Healthwatch take a closer look at what people are telling them about NHS funded wheelchair and home equipment services, as well as the issues trans people experience when it comes to health and care.
The blogs on each in focus section go in further depth about each topic:
Part of the MHRA’s role is the regulation of medical devices, including overseeing investigations into adverse events and promoting the safe use of devices in the UK.
The MHRA continues to receive reports of incidents relating to bed rails and associated equipment. These incidents are concerning as some have led to patient harm or death, primarily from entrapment.
This publication has been updated to reflect changes in devices and practices, as well as information gained from the investigation of adverse incidents.
Who this guidance is for:
This document is aimed at all users, carers and staff with responsibility for the provision, prescription, use, maintenance and fitting of bed rails. This includes:
Medical Device Safety Officers (MDSOs) for onward distribution
medical device trainers
care home managers and staff
carers in the community and care-at-home staff
community equipment stores (CES) and loan store managers
health and safety or risk managers
hospice managers and staff
nurses in hospitals and the community
those responsible for purchasing beds and bed rails
This document identifies areas for safe practices, so that policies and procedures can be reviewed and put in place. This includes:
meeting legal requirements
planned preventative maintenance.
It also identifies areas of good practice, such as:
checking and ensuring that a bed rail is necessary
the need for good communication between bed occupant and carers or staff
checking compatibility of the bed rail, bed, mattress and occupant combination
taking into account the use environment and possible interaction with any other equipment, accessories or devices present in that environment
correct fitting and positioning of the bed rails initially and after each period of use
re-assessing the changing care needs of the bed occupant.
This document is not intended to replace clinical decision making.
Bed rails are used extensively in acute, community and home care environments to reduce the risk of bed occupants falling out of bed and injuring themselves.
However, MHRA continues to receive reports of adverse incidents involving these devices. The most serious of these have led to injury and death by asphyxiation after entrapment of the head, neck or chest.
Most incidents occurred in community care settings, particularly in nursing homes. These could have been prevented if adequate risk assessments and appropriate risk management had been carried out. Clinicians should carefully consider the benefits and risks of bed rails before they are used for an individual bed user.
NHS ‘Never events’ are defined as ‘serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented by healthcare providers. NHS ‘Never events’ number 11 (1) covers chest or neck entrapment in bed rails.
For the purpose of this document the term bed rail will be adopted, although other names are often used, e.g. bed side rails, side rails, cot sides, and safety sides.
In general, manufacturers intend their bed rails to be used to prevent or reduce the risk of bed occupants from falling and sustaining injury. They are not designed or intended to limit the freedom of people by preventing them from intentionally leaving their beds; nor are they intended to restrain people whose condition disposes them to erratic, repetitive or violent movement.
They may be CE marked as medical devices to show they meet the requirements of the Medical Devices Regulations (2), in combination with, or as an accessory to, the bed if their intended use meets the definition of a medical device. Rigid bed rails can be classified into two basic types:
integral types that are incorporated into the bed design and supplied with it or are offered as an optional accessory by the bed manufacturer, to be fitted later.
The integral type is involved in far fewer adverse incidents than the third-party type, usually because risks associated with installation and compatibility are reduced. Bed rails should meet recognised product standards that include acceptable gaps and dimensions when fitted to the bed (See Legislation and Standards).
Bed rails, which fit under the mattress or clamp to the bed frame should not be confused with bed grab handles (also known as bed sticks or bed levers) which are designed to aid mobility in bed and whilst transferring to and from bed.
Bed grab handles can pose the same hazards to users as bed rails, and their use should be carefully considered, risk assessed and documented.
Bed grab handles are not designed to prevent patients falling from their bed. Bed grab handles come in a variety of sizes and designs (Figure 4). They should not be used as, or instead of, bed rails.
Bed rails are often used at the same time as medical devices or equipment. This would naturally include a bed frame and a mattress. Other bed equipment could include pressure-relieving surfaces either passive or active, or other systems such as monitoring equipment depending on the bed occupant’s needs.
The decision to use bed rails should always consider the bed occupant’s care needs, the environment it is used in and what other equipment is or may be present.
Hazard and areas of risk
The use of bed rails is associated with a number of direct and indirect risks to bed occupants, as well as the possible benefits from reducing the risk of falls. Direct hazards include entrapment and entanglement either within gaps in the rails themselves, between the rails and the mattress or between the rails and the bed frame. In the most serious cases, this has led to asphyxiation and death of bed users if they have trapped their head between rails or been unable to free themselves from a position and suffered postural asphyxiation. Severe limb damage has also been reported in cases where someone has become entangled in bed rails. Figure 5 shows the main areas of the bed-bed rail system where entrapment may occur.
Indirect hazards are also present: cases have been reported where bed users have been confused or disoriented and have tried to get out of the bed by climbing over the bed rails. Users have then fallen from a greater height than would otherwise be the case, increasing the severity of injury.
3. Risk management and use assessment
When medical devices are prescribed, issued or used, it is essential that any risks are balanced against the anticipated benefits to the user. The process of understanding, evaluating, addressing and recording these risks is known as risk management.
Where manufacturers cannot remove or reduce risks during the design and manufacturing processes, subsequent warnings of any remaining risk should be clearly displayed in the user instructions and product markings. These risks must constitute acceptable risks when weighed against the benefits to the bed user. Any such warnings or limitations to use, including the necessary maintenance schedules throughout its intended life, should be considered both during procurement and by prescribers, passed on to all users and carers of the equipment and steps taken to ensure that they are understood and complied with.
Users, carers and prescribers need to follow the manufacturer’s instructions for use and any warnings about associated risks. The equipment should only be used and maintained in line with the manufacturer’s instructions for use.
There are many bed rails on the market, having a variety of fitting and operation methods.
The possible combinations of bed rails, beds and mattresses (and other equipment in the environment), together with the differences between bed occupants, means that a careful, thorough and individual risk assessment is necessary if serious incidents are to be avoided.
Risk assessments should be carried out before the initial prescription of bed rails and then reviewed and recorded after each significant change in the bed occupant’s condition, replacement of any part of the equipment combination and regularly during its period of use, according to local policy.
It is unlikely that one type of bed and bed rail will be suitable for a wide range of users with different physical sizes and needs.
The points to consider during a risk assessment include:
Is it likely that the bed user would fall from their bed?
If so, are bed rails an appropriate solution or could the risk of falling from bed be reduced by means other than bed rails (see Alternatives to rigid bed rails)?
Could the use of a bed rail increase risks to the occupant’s physical or clinical condition? (See Case Study 1)
Has the bed user used bed rails before? Do they have a history of falling from bed, or conversely of climbing over bed rails?
Do the risks of using bed rails outweigh the possible benefits from using them?
What are the bed user’s views on using bed rails?
What configuration of bed, mattress and rail system is being used?
Our adverse incident investigations have shown that the physical or clinical condition of bed occupants means that some are at greater risk of entrapment in bed rails. Those at greater risk could include older people, adults or children with:
confusion, agitation or delirium
repetitive or involuntary movements
high or low body mass (which may change entrapment risks)
impaired or restricted mobility
Variable levels of consciousness, or those under sedation.
Risk assessments should account for any characteristics which might put the bed user at greater risk from use of bed rails.
The decision to use bed rails should be made with the consent of the bed user whenever possible. The reasoning for the decision to issue bed rails should be effectively communicated and recorded, including to the carers or family members when this is appropriate.
CASE STUDY 1 – Inappropriate prescription leading to fall
A bed occupant died after climbing over the bed rails and falling. The user touched the bed position control and raised the bed to its maximum height. They then tried to get out of the bed by climbing over the rail, only to fall and suffer a broken neck. The additional height of the bed rail likely increased the severity of the injury.
Advice – If bed users are known to be in a confused state, then bed rails may serve to increase the overall risk of injury. A risk assessment should have identified the hazard of leaving bed controls accessible and the potential for an increased fall height.
We provide an example of a risk assessment checklist, produced using feedback from prescribers of bed rails and the findings of adverse incident investigations in Appendix 1 – Example adult entrapment risk assessment checklist.
Please note that the example checklist should not be adopted or used without adequate consideration of a specific bed occupant’s needs and local policies.
The checklist should be used in conjunction with the guidance in this document, together with the judgement of the nurse, therapist, bed user and carer involved.
Alternatives to rigid bed rails
Alternatives to bed rails may be considered, such as:
‘netting’ or mesh bed sides
ultra ‘low height’ beds that minimise the risk of fall injuries
positional wedges to reduce movement across the bed
alarm systems to alert carers that a person has moved from their normal position or wants to get out of bed.
fall mats that can be placed beside the bed to reduce the severity of the impact if the bed occupant does fall
Each of these options may act to introduce different hazards even as they reduce the risk of bed fall injury or the risk from bed rails, and so should be managed appropriately.
4. Purchase and selection
Adjustable or profiling beds usually have compatible integral type bed rails available from the manufacturer; these are preferable to other systems that may not fit as well. In all cases it is essential that the selection process follows a risk assessment considering the needs of the bed occupant and the use environment.
Third party bed rails require particularly careful selection.
If bed rails are being purchased for stock, general factors can be considered at the purchase stage:
the types of bed they are likely to be used on; specific models or range
whether they meet any recognised product standards regarding dimensions
Risk assessments should be carried out before use and then reviewed and recorded after each significant change in the bed occupant’s condition, replacement of any part of the equipment combination and regularly during its period of use, according to local policy. An example of a risk assessment checklist is included in Appendix 1.
The manufacturer’s instructions for use should contain information on the selection of the mattress, including dimensions and other characteristics, to reduce the risk of entrapment. They should also contain information on compatibility with other equipment and whether they are suitable for children or small adults.
For more information on gaps permitted by device standards, please see Appendix 2 – Bed rail dimensions in BS EN 60601-2-52 and Appendix 3 – Bed rail dimensions in BS EN 50637. Note that the values expressed in standards are primarily intended for the manufacturers of medical devices.
In all cases it is essential that the selection process follows a risk assessment considering the needs of the bed occupant.
In community care environments it is common for beds and bed rails to have been acquired from different sources. Often bed rails from unknown sources are found to be in use and in many cases they have been found to be unsuitable or unfit for purpose.
Bed rails for divan beds (domestic) are mainly of the third-party type, not tailored for one specific bed or mattress length and width, or a specific mattress density.
CASE STUDY 2 – Unsuitable combination of a bed and a bed rail
A bed rail intended for use on a domestic divan bed was used on a hospital type bed. This produced a large gap between the bottom of the bed rail and the bed when the mattress was compressed.
A child slipped feet first between the bed rail and the bed. The gap was not large enough for the child to pass completely through and the child was trapped at chest level and died from postural asphyxiation.
Advice – Assess the possible gaps between rails and other equipment, particularly in the high-risk areas shown in Figure 5 during the rail fitting process.
What to avoid
From our investigations, the MHRA has identified a number of issues that, if they had been avoided during the selection process, may have reduced the likelihood of adverse incidents occurring. For example, avoid:
gaps of over 60 mm between the end of the bed rail and the headboard which could be enough to cause neck entrapment.
gaps over 120 mm from any accessible opening between the bed rail and the mattress platform
using bed rails designed for a divan bed on a wooden or metal bedstead; this can create gaps which may entrap the occupant
using insecure fittings or designs which permit the bed rail to move away from the side of the bed or mattress, creating an entrapment hazard
using only one side of a pair of bed rails when the other side is against a wall if this is not specifically permitted by the manufacturer – the single rail may be insecure and move. Some manufacturers supply a mattress retainer for use with single sided bed rails which reduces this risk.
mattress combinations whose additional height lessens the effectiveness of the bed rail and may permit the occupant to roll over the top. Extra height bed rails are available if mattress overlays are to be used
mattress and bed rail combinations where the mattress edge easily compresses, introducing a vertical gap between the mattress and the bed rail.
The length, width and height of the mattress should be checked to ensure that these dimensions are within the limits specified by the bed manufacturer and do not introduce gaps that could increase the risk of entrapment. If the mattress is not the right size, the bed rails may not fit properly and create entrapment gaps. Some manufacturers may also specify the density of static mattresses.
Suitable evaluation of a patient before providing a bed rail is a skill. Organisations responsible for the provision, installation and maintenance of rails should ensure that those carrying out these tasks are appropriately trained in the competent use of these devices, in the skills needed to properly conduct a risk assessment in accordance with local policy and that they understand the risks posed by this equipment.
Organisations should develop processes to ensure that staff are appropriately trained and that risk assessments are carried out and recorded to a suitable standard.
Those responsible should be aware of how and when to arrange for maintenance and to report faults. Depending on the environment, this could include care staff, family members or the bed user themselves.
6. Special Considerations
Use in the community
Most reported injuries relating to bed rails are now from incidents that take place in community settings.
Use of bed rails in the community comes with additional challenges. There may be greater variability in available equipment, and it can be more difficult to maintain equipment appropriately than in hospitals. Those responsible for day to day care may be less aware of the serious risk that can be present with improper use of bed rails.Any subsequent changes in the patient situation and the associated risks may mean greater chance of inappropriate bed rail use.
Wherever bed rails are used to reduce fall risk, a risk assessment should be made, and the rails should be regularly assessed for suitability and for correct function. Carers should be aware of the risks, should have access to the instructions for use supplied with devices and should know when to carry out or request reassessment of the needs of the bed user.
CASE STUDY 4 – Mattress too light to keep bed rail in correct position
Some designs rely on the weight of the divan or standard mattress to keep the bed rails in position. A lighter mattress can allow the rails to move away from the side of the bed, creating an entrapment gap, or can allow the rails to fall off the bed completely.
Advice – Check the compatibility of any installed equipment, the suitability of this for the bed user and that all these devices are fitted correctly.
Use with children and small adults
The majority of bed rails on the market are designed to be used only with individuals over 1.46 m in height (4’ 11”), which is also the height of an average 12-year-old child. A risk assessment should always be carried out on the suitability of the bed rail for the individual child or small adult, as bar spacing and other gaps will need to be reduced.
When purchasing or making assessments of bed rails for children, seek guidance on suitable rails from the manufacturers and assess their compatibility with the size of the individual and the specific circumstances of use. A new standard for medical beds for use with children has been published: it is not yet clear how many products are available that comply with the standard (See section Standards).
It is recommended that all gaps between the rail bars should be a maximum of 60 mm.
CASE STUDY 5 – Insufficient risk assessment which failed to account for the user’s body size
A bed rail was supplied to the parents of a child being cared for in the community. No assessment of the child’s physical size was carried out to determine if an entrapment hazard existed: in this case the gap between the horizontal bars of the bed rail was too large. The child slipped between the bars and asphyxiated as a result of head entrapment.
Advice – Risk assessments should include an evaluation of the suitability of the equipment for the physical characteristics of the intended user.
Adjusting or profile beds
Most adjustable and profiling beds feature integral bed rails that are incorporated into the bed design or are offered as an optional accessory by the bed manufacturer. We have found they are involved in far fewer adverse incidents than the third-party type.
The bed rails will be CE marked to show they meet the requirements of the Medical Devices Regulations (2) in combination with, or as an accessory to, the bed.
Some beds have a single-piece bed rail along each side of the bed; these require care in use because when the bed profile is adjusted entrapment hazards can be created. These are not always obvious when the bed is in the horizontal position.
Split bed rails (one pair at the head end and one pair at the foot end) also require care in use because the space between the head and foot end rails may vary according to the bed profile adjustment. Therefore, on some designs, entrapment hazards may be created when the bed is adjusted to profiles other than flat.
Use the rails as instructed by the bed manufacturer.
Active mattresses, hybrid mattresses and mattress overlays
Active, dynamic or hybrid mattresses or mattress overlays may be prescribed in order to reduce the risk of pressure injury. As these will raise the resting level of the user relative to the top of the bed rail, the effective height of the rail will be reduced. In turn this may increase the risk of the bed user falling from bed. Highly compressible surfaces may also create additional entrapment hazards.
The bed, mattress and rail system should be assessed in all configurations as these risks may not be obvious in a single arrangement. The risk assessment should consider the ‘worst case’ condition in particular: for example, the effective height of the top of the bed rail with the bed plus a fully inflated active mattress, or the highest point reached when an alternating cell mattress is used.
Before and during use of specialist mattresses with bed rails, consider:
the reduction in the effective height of the bed rail relative to the top of the mattress may allow the occupant to roll over the top of it; extra height bed rails may be required
the risk of entrapment in the vertical gap between the side of the mattress and the bed rail may be increased with an easily compressible overlay and/or mattress edge
if the standard mattress is replaced with an air mattress or lightweight foam mattress, third party bed rail assemblies (including the mattress and bed occupant) can tip off the bed when the bed occupant rolls against the bed rail. This is because many third-party bed rails rely on the weight of a standard mattress to hold the assembly in place.
CASE STUDY 6 – Bed occupant fell over the top of the bed rails after additional equipment installed
A pressure ulcer reduction overlay was added to a bed that already had a bed rail fitted. The additional height of the combined mattress/overlay reduced the height of the bed rail. The bed occupant fell over the rail, sustaining a serious head injury.
Advice – Risk assessments should be revised when substantial changes to the bed system are made. Particular attention should be given when the effective height of the bed rail may be compromised.
Likewise, the use of patient turning systems for pressure relief carries similar risks of compatibility with other equipment in use and the patient themselves.
The risk assessment should consider the whole patient environment and possible interactions between any equipment that is in that environment.
Inflatable bed sides and bumpers
Inflatable or padded bed sides are not generally adjustable and may need to be used with a mattress and bed rails of particular dimensions. It is therefore important not to change the mattress or bed rails from the size or specification recommended by the manufacturer, to avoid creating entrapment gaps and instability. Inflatable rails may change shape when the bed occupant leans against them and this should be taken into account when carrying out the assessment of the risk of entrapment.
Some inflatable or padded bed sides house the mattress in its own ‘pocket’ or compartment, a feature which greatly reduces entrapment risks between the mattress and the side walls.
Inflatable bed sides need to be fully inflated to be effective. They may deflate over time so regular checks should be made to ensure this has not happened.
Care should be taken to use inflatable and padded bed sides correctly, as specified in the manufacturer’s instructions for use.
Bed rail bumpers, padded accessories or enveloping covers are primarily used to prevent impact injuries, but they can also reduce the potential for limb entrapment when securely affixed to the bed or rail, according to the instructions for use. However, bumpers that can move or compress may themselves introduce entrapment risks.
Bed and bed rail devices may have a useful lifetime measured in years and might be used in various locations with many different patients. Manufacturers should specify how devices should be used, cleaned and maintained so that they remain in good working order and continue to be safe to use.
MHRA adverse incident investigations have revealed that some incidents with bed rails have been caused by inadequate maintenance. Bed rails should be included in planned preventative maintenance schemes.
Bed rails should be maintained in accordance with the manufacturer’s recommendations in the instructions for use. Examples of common types of damage include:
Adjusters, clamps and fixings can wear, work loose, crack, deform or be missing completely, giving rise to unwanted free play which can increase important gaps.
Material fatigue can also occur. Bed occupants who rattle the bed rails can exacerbate this tendency.
Telescopic components can become loose or jammed, discouraging correct adjustment.
Plastic components can degrade due to age, exposure to light and some cleaning chemicals.
Poor transport and storage can also cause damage to components.
Duvets, blankets, sheets and valances may need to be removed to check these areas properly.
Bed rail assemblies should be traceable, for example by using the manufacturers serial number, the Unique Device Identification number (when available) or labelling with an in-house number. This will assist in ensuring that every device is regularly inspected and maintained in a satisfactory condition. Traceability also allows devices to be suitably identified should a safety issue arise, such as a manufacturer recall due to a fault. Records should be kept of inspections, repairs and maintenance completed on bed rails. Suppliers of the bed rails should be contacted for advice and replacement parts.
Bed rails found to be unsuitable or in poor condition should be withdrawn from use and appropriately destroyed. If they are kept or stored, MHRA has received incident reports of them finding their way back into use. Manufacturers should be able to advise on the expected working life of their products.
When not in use, bed rails should be stored in matched pairs in a suitable area where they will not get damaged.
CASE STUDY 7 – Bed rails in poor condition from lack of maintenance
A care home had fitted third-party bed rails to a resident’s divan bed. One of the bed rails moved away from the side of the bed, creating a gap in which the resident became trapped and died as a result.
Advice – This incident could have been prevented if appropriate installation and maintenance checks had been in place, and if users were more aware of the correct configuration of the device.
Follow the instructions for use supplied by the manufacturer. Typical aspects to check during planned maintenance include:
presence of rust – this can affect the ease of adjustability of telescopic tubes
welded joints are sound, not showing signs of cracking or failure
cracking of paint or coating – can point to deeper structural failure
flaking or peeling chrome plating – can cause lacerations
missing locking handles and fixing clamps, clamp pads and other components
loose fixings – these affect the rigidity of the assembly. Nuts should be of the self-locking type
free play in joints – this can point towards loose, worn or incompatible components
stripped threads on bed frame clamps – does not allow them to be tightened securely
bent or distorted components
damaged plastic components
The frequency of inspection should be addressed by local policy, specific to the conditions of use and the recommendations in the manufacturer’s instructions for use. Defective devices should be withdrawn and replaced, if appropriate, quickly.
For more information on this topic, refer to our publication ‘Managing Medical Devices’ (3).
8. Legislation and Standards
Health and Safety at Work Act
People responsible for making decisions on the provision of bed rails and the care of people for whom they have been provided need to be aware of their duties under relevant health and safety legislation.
The Health and Safety at Work Act (4) places duties on:
Employers and self-employed persons – to avoid exposing those not in their employment (e.g. members of the public and patients) to health and safety risks.
Employees – to take reasonable care for the health and safety of themselves and others affected by their acts, and to co-operate with their employer on health and safety obligations.
The Management of Health and Safety at Work Regulations
The Management of Health and Safety at Work Regulations (5) require that employers and the self-employed should make a suitable and sufficient assessment of the risks to the health and safety of persons not in their employment which arise out of or in connection with their undertaking.
Employers also need to ensure that all employees who are responsible for selecting, fitting, maintaining and checking bed rails have received appropriate training.
Mental Capacity Act
The Mental Capacity Act (6) protects those who may not be able to make decisions about their own care and treatment. Those that lack capacity may or may not benefit from the use of bed rails. Whenever possible, the views of the patient should be accounted for when considering the use of bed rails.
All care professionals should understand their obligations under this act, and organisations should ensure that these requirements can be implemented effectively.
Medical Device Regulations
All products classed as medical devices are currently subject to the medical device directive (7). This will include many beds and bed rail systems intended for use with patients. This directive details the requirements for manufacturers to meet before applying a CE mark on their device and placing it on the market. To do this, they must comply with the essential requirements listed in Annex I of the directive. This includes requirements such as making sure that the design of equipment is suitable for the products intended purpose, that the device is labelled appropriately and is supplied with instructions for use (where these are necessary for the sage use of the device). The directive also contains requirements for manufacturers to implement a quality management system, and maintain suitable post-market surveillance of devices.
In 2017 the Medical Device Regulations (MDR) was published and will replace the Medical Device Directive once the transition period is over in May 2020 (2). In a similar process to the MDD, manufacturers will have to comply with the General Safety and Performance Requirements listed in Annex I of the MDR.
Not all beds or fall protection equipment will be classed as medical devices. This will depend on the intended use described by the manufacturer and without a clear medical purpose the definition of a medical device may not be met. In these cases, the product should still meet the requirements imposed by general consumer protection legislation.
Manufacturers may opt to demonstrate compliance with aspects of the medical device directive by making sure their products meet agreed standards. When purchasing or specifying equipment, it may be desirable to confirm what technical standards are met by the device. This should be available either in the device instructions for use or from the manufacturer themselves.
The current harmonised medical bed standard is:
BS EN 60601-2-52: 2010+A1:2015 “Particular requirements for the basic safety and essential performance of medical beds”.
This standard contains requirements for the dimensions and function of medical beds intended for adults and includes information on the permissible gaps between rails and the rails and the bed frame.
A separate standard has now been published that covers beds intended for use with children (and others of small stature):
BS EN 50637:2017 “Medical electrical equipment. Particular requirements for the basic safety and essential performance of medical beds for children”.
As this is a recent document, it may be some time before manufacturers market beds which meet this standard. Standards such as these are primarily intended for manufacturers to demonstrate that the products they supply are suitable to be CE marked and placed on the market. The dimensions and measurements that they specify may not be appropriate to conduct in a clinical environment (for example requiring the use of tools with precise dimensions and mass) and may not assure safety if they are uncritically applied to all bed users.
Previous medical bed standards were largely replaced by BS EN 60601-2-52, but older beds may have been assessed against these earlier standards. Previous standards include:
BS EN 1970:2000 “Adjustable beds for disabled persons”.
BS EN 60601-2-38:1997 Revision 1 “Medical Electrical Equipment – Part 2. Particular requirements for the safety of electrically operated hospital beds”.
9. Adverse Incidents
An adverse incident is an event that causes, or has the potential to cause, unexpected or unwanted effects involving the safety of device users (including patients) or other persons.
Adverse incidents can be caused by:
shortcomings in the device itself
inadequate instructions for use
insufficient servicing and maintenance
locally initiated modifications or adjustments
inappropriate user practices, including inadequate training
inappropriate management procedures
the environment in which devices are used or stored
We strongly encourage everybody (patients/users/carers) to report all adverse incidents to us. By reporting to us we can:
collate information to identify trends in device safety and performance
disseminate advice to the healthcare professions to prevent adverse incidents and promote good practice for use and maintenance of devices.
Who to report to:
If you are member of the public and live in England, Northern Ireland Scotland or Wales you should report it via the MHRA Yellow Card Scheme.
Healthcare professionals in England can report adverse incidents or near misses via the Yellow Card system
Professional users in Wales, Scotland and Northern Ireland should report via their local incident reporting system and/or their national incident reporting authority. You can find more information on our Report a problem with a medicine or medical device page
10. References and Bibliography
Never Events list 2018. London; 2018.
Regulation (EU) 2017/745 of the European Parliament and of the Council of 5 April 2017 on medical devices [Internet]. 2017. Available from: https://eur-lex.europa.eu/
MHRA. Managing Medical Devices. London; 2015.
Health and Safety at Work etc. Act. 1974 p. Chapter 37.
The Management of Health and Safety at Work Regulations 1992. UK;
Mental Capacity Act. 2005.
Directive 2007/47/EC of the European Parliament and of the Council of Europe [Internet]. 2007. Available from: https://eur-lex.europa.eu/
Haugh J, O Flatharta T, Griffin TP, O’Keeffe ST. High frequency of potential entrapment gaps in beds in an acute hospital. Age Ageing. 2014;43(6):862–5.
Anderson O, Boshier PR, Hanna GB. Interventions designed to prevent healthcare bed-related injuries in patients. Cochrane Database Syst Rev. 2012;(1).
Healey FM, Cronberg A, Oliver D. Bedrail use in English and Welsh hospitals. J Am Geriatr Soc. 2009;57(10):1887–91.
Healey FM, Oliver D, Milne A, Connelly JB. The effect of bedrails on falls and injury: A systematic review of clinical studies. Age Ageing. 2008;37(4):368–78.
NPSA. Bedrails; reviewing the evidence; a systematic literature review. 2007;
Appendix 2 – Bed rail dimensions in BS EN 60601-2-52:2010+A1:2015 Medical Electrical Equipment. Particular requirements for basic safety and essential performance of medical beds.
BS EN 60601-2-52:2010
Height of the top edge of the side rail above the mattress without compression
Where a speciality mattress or mattress overlay is used and the side rail does not meet ≥ 220mm a risk assessment shall be performed to assure equivalent safety
Gaps between elements within the perimeter of the side rail and between the side rail and mattress platform
Gap between headboard and end of side rail
Most disadvantageous angle between headboard and side rail
Gap between foot board and end of side rail
< 60mm OR > 318mm
Most disadvantageous angle between foot board and side rail
Distance between open end of side rail(s) and mattress platform
The gap between the open end of the side rail and headboard is not relevant to this position reference
Gap between split side rails
< 60mm OR > 318mm
When in most disadvantageous position
Gap between side rail and mattress in ‘plan’ elevation
120mm aluminium cone is positioned between mattress and side rail to determine if gap is acceptable or not.
Note that compliance to this standard requires the use of specific measurement tools, rather than basic distance measurements alone. It is intended to be used by manufacturers. For this reason, it is recommended that end users do not use solely these measurements as the sole basis for evaluating suitability of a bed rail installation.
Appendix 3 – Bed Rail Dimensions in BS EN 50637:2017 Medical electrical equipment. Particular requirements for the basic safety and essential performance of medical beds for children.
BS EN 50637:2017
Fully enclosed openings within a side rail, head/foot board, mattress support platform
Fully enclosed opening defined by the side rail, its supports and the mattress support platform
Partially enclosed opening defined by the head board, mattress support platform and side rail
Partially enclosed opening defined by the foot board, mattress support platform and side rail
Except when gap between side rail and foot board is >300mm
Partially enclosed opening between segmented or split side rail and the mattress support
Except when gap between side rails is >300mm
Partially enclosed opening defined by lowest point of a side rail, the adjacent side rail support and mattress support platform, to the outside of the side rail supports
Other openings defined by accessories (e.g. IV poles, fracture frames) and side rails, head or foot boards and or mattress support platform. Not shown in figures.
Distance between mattress support platform and the lowest point of the side rail outside the side rail support AND The angle between the side rail and mattress support platform at the range of the mattress height defined by the manufacturer ± 2 cm
<40mm AND Angle between mattress support platform and side rail interface >75° over the entire range of mattress heights from minimum recommended height minus 2 cm to the maximum recommended mattress height plus 2 cm.
Gap between head board and adjacent side rail
Gap between segmented or split side rails with both side rails raised
<40mm OR >300mm
For a gap >300mm: the gap shall be >300mm or <400mm for the entire vertical distance
For all medical beds except junior beds: gap between side rail and foot board. Other openings defined by accessories (e.g. IV poles, fracture frames etc.) and side rails, head board, foot board, and or mattress platform
For junior beds: gap between side rail and foot board. Other openings defined by accessories (e.g. IV poles, fracture frames etc.) and side rails, head board, foot board, and or mattress platform
<40mm OR >300mm
For a gap >300mm: the gap shall be >300mm or <400mm for the entire vertical distance
Region defined by side rail/head board/foot board and the mattress for cribs and cots
Cone tool does not sink below the mattress surface by 50% or more of its 60mm diameter.
Region defined by the side rail/head/foot board and the mattress for junior beds and oversize cots
Perform test OR Gap between side rail/head/foot board and mattress <30mm
Cone tool does not sink below the mattress surface by 50% or more of its 60mm diameter.
Note that 50637:2017 defines different sized beds: cots, oversized cots, cribs and junior beds. Please see the text of the standard for full definitions or contact the manufacturer of a particular bed in your control that complies with this standard.
Compliance to this standard requires the use of specific measurement tools, rather than basic distance measurements alone. It is intended to be used by manufacturers. For this reason, it is recommended that end users do not use solely these measurements as the sole basis for evaluating suitability of a bed rail installation.
Coronavirus: Action Plan – A Guide to What You can Expect Across the UK
This document sets out what the UK as a whole has done – and plans to do – to tackle the coronavirus (COVID-19) outbreak, based on experiences of dealing with other infectious diseases and influenza pandemic preparedness work.
initiative is designed to empower care home staff to deliver a robust health
assessment after a resident falls and make informed decisions around moving
them from the floor.
UK, more than 1,000 residents a day living in care homes will fall and although
more than 50% are uninjured they need help getting up again. This ground breaking initiative aligns best
practice in post fall management with policies that reduce both hospital
admissions and ambulance call outs.
Lisa Elmy from East Suffolk CCG says, “We are committed to supporting the care homes in our region to provide the best possible care for residents. This initiative provides training in the ISTUMBLE health assessment tool, combined with a Mangar Camel lifting cushion, so providing staff with the skills and equipment they need to move residents safely and with dignity.”
Mangar Health CEO Simon Claridge says, “We have been delighted to work with Ipswich and East Suffolk on this initiative and witness the enthusiasm of care staff from across 86 homes in the area who have attended our training sessions. The UK healthcare sector recognises that avoiding hospital admittance, where it is safe to do so, is critical and similar projects to this one in other parts of the country have already seen care home resident hospital admittance numbers reduce by up to 80%.”
care homes may call for an ambulance to help with lifting a fallen resident but
regularly wait 4 hours or more for support to arrive. As a non-life-threatening event, these calls
are not categorised as urgent, however, the longer an elderly resident is on
the floor waiting for assistance, the greater the impact on long term
health. Ideally a resident should be
lifted within 10 minutes of a fall in order to reduce the likelihood of an
associated condition developing.
South Central Ambulance Service Supporting Public Hearts Scheme
South Central Ambulance Service has supported the launch of the Public Hearts Scheme in Reading, aimed at improving public access to life-saving automated external defibrillators (AEDs).
Founded in 2017 at Gloucestershire Constabulary by PC Matt Hammond, the Public Hearts Scheme is a partnership between the local licensed venues, South Central Ambulance Service (SCAS) and Thames Valley Police and is expanding across the Thames Valley area.
Licensed venues from across Thames Valley can sign up to receive a collection pot to help raise funds towards purchasing an AED for their premises, which currently cost around £800. Money raised beyond this amount then go to supporting further upkeep and maintenance of the devices.
Reading’s Business Improvement District (BID) has funded the first 11 defibrillators for Reading town centre.
For frontline ambulance staff at South Central Ambulance Service and Thames Valley police officers, as first responders to emergencies across the Thames Valley, having access to an AED can be incredibly important, particularly in the evenings when many community venues that house them may be closed.
By being housed in licensed premises, these can be used by members of the public as well as the emergency services. AEDs are designed to be easy to use by members of the public and don’t require any training to use them.
David Hamer, Operations Manager for Community Engagement and Training at SCAS, said: ““Sudden cardiac arrest is the leading cause of premature death; the earlier there is intervention by someone to start basic life support and apply an AED the better chance of a positive outcome for the victim.
“AEDs are simple machines that are easy to use. The user will be instructed what to do by the machine, so no formal training is required. They have been used by many untrained members of the public with lives being saved as a result. Never be afraid to use this lifesaving piece of equipment if you need to.”
Within the Thames Valley, the scheme is being led by Licensing Officer Sergeant Larah Fisher from Thames Valley Police, who added: ““After meeting with Matt Hammond from Gloucestershire Constabulary and hearing about the success of the scheme there, I knew it would be something that we could support in the Thames Valley.
“We contacted licensed venues across the force and everyone has been really keen to get the scheme running in their areas. It’s great to see the community coming together to fund the purchase of these devices. They are there for anyone who is unlucky enough to find themselves in a situation when it could be used to save a life.”
The Public Hearts Scheme officially launched in Reading on Valentine’s Day (February 14, 2020) with a number of venues across the town holding fundraising events to support towards the installation of more defibrillators around the city.
The NEC – the UK’s largest exhibition and events venue – has invested in a new Changing Places accessible toilet, continuing its commitment to customer-focused improvements and becoming one of the first exhibition venues to install the facility.
The toilet is the result of an accessibility audit and customer feedback, which highlighted the need for the resource. Larger than a standard accessible toilets, a Changing Places facility has more space to enable a wheelchair user and their carer to manoeuvre with ease, plus equipment including a height adjustable adult sized changing bench and hoist.
“The NEC is continuously looking to improve facilities for our customers to ensure we remain their venue of choice,” said Kathryn James, NEC Managing Director. “The need for a Changing Places toilet was highlighted during an accessibility audit and as a result of customer feedback, and we felt it would be of invaluable benefit for some of our customers. Based on the dwell time within the NEC, it’s important for customers to be able to relax and enjoy our facilities knowing there’s an appropriate environment for their personal hygiene. We pride ourselves on being an accessible venue; we’re located within two hours drive time of 40% of the UK’s population and we have 20,000 car parking spaces on site. We have physical links to Birmingham International Airport and the International Railway Station, in addition to being situated just off the M42 and M6 motorways. By continuing to improve the accessibility of our internal facilities with additions such as this Changing Places toilet, we’re adding further value to the visitor experience.”
Margaret Clough, a NEC customer who played a major role in the delivery of this project, said: “We work alongside Mencap as volunteers, and since I retired I’ve dedicated my time to campaigning for these facilities. I can’t believe the success we’ve had and I’m so excited about the progress we’ve made. We started out at campaigning for changes in airports, because that’s where this all began for us after so many humiliating experiences, and it’s just snowballed from there. This particular installation is fabulous because the NEC is setting the standard in a competitive business and I hope we’re now going to see more Changing Places facilities appear as a result.”
NHS Providers welcomes Jeremy Hunt as health select committee chair
Following the appointment of Jeremy Hunt as chair of the health and social care select committee, NHS Providers chief executive Chris Hopson has welcomed him into the new role.
In his new role, Mr Hunt will head a committee of MPs who scrutinise the performance of the NHS and government health policy.
Mr Hunt, who was the longest serving health secretary between 2010 and 2016, said he was “honoured” to be elected as chair of the select committee and would be pressing the government to move quickly to build a cross-party consensus over a funding settlement for care of the elderly.
Responding to the appointment, Mr Hopson said: “We look forward to working with Jeremy Hunt as the new chair of the health and social care committee, and continuing to build on the honest, open and constructive dialogue we shared whilst he served as secretary of state for health.
“For the coming year, we welcome Mr Hunt’s focus on patient safety, mental health, workforce and social care. These key areas fundamentally affect the ability of trusts to deliver high-quality patient care.
“We have outlined specific subjects we encourage the committee to hone in on to Mr Hunt, including NHS pensions and the clinical review of standards.
“Additionally, we have urged the committee to consider holding a wide-ranging inquiry on the NHS long term plan. This should include setting priorities, working out clear delivery timescales, and examining commitments on financial recovery, integrated care and broader system working.”
Image Credit: Stefan Rousseau/PA Archive/PA Images
Healthwatch England publishes 2019 annual report to Parliament
Sir Robert Francis QC, Chair of Healthwatch England has today laid the Healthwatch annual report to parliament, setting out to MPs and the Government the key issues people are feeding back about their experiences of health and care services in England.
“As the NHS focusses on reforming other areas of care, it needs to keep on talking to communities so that everyone gets the good quality care they need.” — Sir Robert Francis QC
Read the annual report
Last year, Healthwatch supported over 336,000 people to share their story about health and social care. These views resulted in over 7,200 recommendations to services about the improvements that people would like to see.
This year’s report is supported by an additional summary of what 40,000 people told us about how they would like the changes proposed in the NHS Long Term Plan to be implemented where they live.
Between March and June 2019, the Healthwatch network carried out 500 focus groups, attended 1,000 events and engaged tens of thousands of people online to find out what people want from the next ten years of the NHS.61% of cancer respondents provided a positive response versus 23% of respondents with dementia.
People affected by cancer, and heart and lung conditions said that they had a much better experience of care services than people with other conditions. For example, when asked ‘How would you describe your overall experience of getting help?’, 61% of cancer respondents provided a positive response versus 23% of respondents with dementia.
The positive feedback about cancer and heart and lung services appeared to be for a variety of reasons, including speed of diagnosis and treatment, access to rehabilitation, and quality of information and communication from professionals.
People affected by other issues, especially mental ill health, dementia or learning disabilities, told Healthwatch that this kind of support often wasn’t in place for them and that professionals did not give enough consideration to their full range of needs.
Seven steps the public think would improve wider NHS support
Better access to appointments People would like more appointment flexibility as well as the opportunity to discuss multiple health issues in one appointment.
Support available when needed The waits between follow up appointments can be too long, often meaning health conditions get worse. While people wait to see a specialist, they would like to see more opportunities for peer support to learn how others deal with the challenges and complications they face.
More online appointments As long as the opportunity to talk to professional’s face to face remains, people would like to see improved access to online appointments. This would be particularly helpful to people who live in rural areas who struggle to get to their GP.
Better personalised care People want to be treated as individuals, with more personalised information about how to look after themselves
Only ask once If medical records were shared more consistently, less time could be spent repeating health issues and more time talking about treatment and support
Help with travel People with limited access to transport want more thought given to how they travel to services far from home.
More help for carers Those looking after others want more support to help them have a break, as well as being more involved in decisions about treatment and support.
NICE is changing the way it produces and presents guidance: Get Involved
NICE Connect is a multi-year project to transform the way guidance is produced and presented, making it easier to use and ensuring people receive evidence-based high quality care in the right place at the right time.
Visit NICE Connect to register your interest and find out more.
NHS Funding Bill Enters Parliament
The NHS Long Term Plan Funding Bill will enshrine in law an extra £33.9 billion a year by 2024 for the NHS.
Secretary of State for Health and Social Care, Matt Hancock, will today introduce the NHS Long Term Plan Funding Bill to Parliament. The bill will enshrine in law an extra £33.9 billion every year by 2024 for the NHS to transform care.
The bill will include a ‘double-lock’ commitment that places a legal duty on both the Secretary of State and the Treasury to uphold this minimum level of NHS revenue funding over the next 4 years.
The bill will not seek to limit the NHS in deciding how funding is spent and where – a decision that is made by local clinicians for their local populations.
It will be one of the first pieces of domestic legislation to go through Parliament since this government took office, placing the NHS top of the domestic agenda.
The bill will place a legal duty on the government to guarantee a minimum level of spending every year, rising to £148.5 billion by 2024.
In the first stage of this annual funding increase, the government has already provided an extra £6.2 billion since April 2019, following the launch of the Long Term Plan in January 2019.
The bill provides safeguards that mean the Treasury will be required to ensure the annual supply estimates for the department’s NHS budget cannot be reduced, creating a legal exception that protects frontline NHS funding for the first time.
This comes on top of recent pledges:
to build 40 new hospitals up and down the country, backed by £2.8 billion
an extra £1.8 billion for capital spending, including £850 million for 20 hospital upgrades and urgent infrastructure projects
£450 million for new scanners and the latest in AI technology
Prime Minister Boris Johnson said:
“I have heard loud and clear that the priority of the British people is the NHS.
“Guaranteeing frontline services the biggest cash boost in history is another huge step towards making sure this treasured institution has everything it needs to deliver world-class care.
“There can be no doubting our commitment to the NHS. Putting our record funding commitment into law shows that we will stop at nothing to deliver on the people’s priorities.”
Health and Social Care Secretary Matt Hancock said:
“During the election campaign, we committed to boosting funding for our NHS over the course of the Parliament and ensuring these new resources get to the frontline so that patients receive the care they need.
“Today we are making good on that manifesto commitment by introducing the NHS Funding Bill, demonstrating this government’s ironclad commitment to the NHS.
“With this unprecedented bill, we will enshrine in law the largest cash settlement in NHS history – bringing the total annual budget to almost £150 billion within 5 years.
“This funding bill will empower the NHS and its world-class clinicians to deliver our bold plan for the NHS. They can do so safe in the knowledge this government is giving them the financial certainty and support to revolutionise prevention, detection, and treatment of thousands of patients over the coming decade.”
The Chancellor of the Exchequer, Sajid Javid, said:
“We are delivering on our promise to focus on the people’s priorities, with the NHS at the forefront. By enshrining the largest ever cash increase for the NHS in law, we will deliver a world-class health service that makes life in this country even better for people.”
£4.5m investment to bridge technology gap between the NHS and social care
The government has pledged to bridge the technology gap between the NHS and social care with a £4.5m investment.
The funding, which came with a £40m plan to reduce NHS staff login times, will be given to local authorities to develop digital adult social care projects to support the most vulnerable in society to live independently for longer.
The investment will also help improve information sharing across the NHS and social care.
As part of the plans, Health and Social Care Secretary Matt Hancock will commit to designing a model of what technology excellence looks like so that every health and social care provider knows what they need to do be outstanding in the next decade. The Department of Health and Social Care (DHSC) said providers’ digital capability would be assessed as part of the CQC’s inspection regime.
Examples of initiatives the money could fund include using assistive technology to establish normal behaviour for individuals living at home and prevent hospital admissions; creating shared care records which combine medical and social care information, with medical and care staff able to access the record; and allowing information held by a care provider to integrate into hospital IT systems as a person is admitted to hospital.
“I want to harness the best digital technology to improve care for patients and ease the burden on our staff. And to do that, we need to get the basics right. Too often, outdated technology slows down and frustrates staff, and prevents them from giving patients their full attention and the care they deserve,” Hancock said.
Professor Martin Green, Chief Executive of Care England, said the news is a “real step forward” in implementing tech to create efficiencies and ensure quality to care helping people lead meaningful lives.
“The focus on easing communications between the NHS and social care will reap great rewards, and the government must ensure that the benefits from greater efficiencies filter down to the social care providers who are investing their own money in new tech,” he added.
“Technology, if used well, will give NHS staff and workers in social care the ‘gift of time’ to care rather than administrate.
Guidance on the Legal Rights to have Personal Health Budgets and Personal Wheelchair Budgets
Guidance on the legal rights to have personal health and personal wheelchair budgets from the NHS.
This guidance document supports clinical commissioning groups and other relevant bodies to meet their duty to ensure eligible groups of people benefit from the legal right to have a personal health budget or personal wheelchair budget. This includes people eligible for NHS Continuing Healthcare, children and young people’s continuing care, people eligible for after-care services under section 117 of the Mental Health Act, and people in receipt of NHS wheelchairs.
What people want from the next ten years of the NHS
When the NHS Long Term Plan was published in January 2019 Healthwatch was asked by NHS England to engage people across the country about how people wanted the priorities to be implemented locally. Here’s what over 40,000 people told Healthwatch.
Between March and June 2019, the Healthwatch network carried out 500 focus groups, attended 1,000 events and engaged tens of thousands of people online to find out what people want from the next ten years of the NHS.
“As the NHS focusses on reforming other areas of care, it needs to keep on talking to communities so that everyone gets the good quality care they need.” — Sir Robert Francis QC, Chair of Healthwatch England
People affected by cancer, and heart and lung conditions had a much better experience of care services than people with other issues. For example, when asked ‘How would you describe your overall experience of getting help?’, 61% of cancer respondents provided a positive response versus 23% of respondents with dementia.
The positive feedback about cancer and heart and lung services appeared to be for a variety of reasons, including speed of diagnosis and treatment, access to rehabilitation, and quality of information and communication from professionals.
People affected by other issues, especially mental ill health, dementia or learning disabilities, told us that the support often wasn’t in place for them and that professionals did not give enough consideration to their full range of needs.
We have also produced What Matters Most in Easy Read and Large Print.