UK Clinician information: guidance on the use of personal protective equipment & testing for COVID-19

The safety of staff, doctors and patients is our number one priority at GenesisCare. We have been proactive in the UK and globally to ensure that sufficient supplies of PPE and infection control products are available to keep our staff, doctors and patients safe. All existing stock of has been fairly distributed to sites.

At GenesisCare UK we have been following Public Health England/World Health Organisation (WHO) advice on the use of PPE for COVID-19. As we learn more about the pathophysiology and presentation of COVID-19, we are adapting our practices pro-actively in advance of PHE and WHO, in order to ensure the maximum protection for our people and patients, whilst keeping our 14 UK sites COVID-free.

We have adopted the following PPE precautions for staff and doctors across our UK network effective immediately

Disposable gloves

Must be worn when providing direct patient care and when exposure to blood or other body fluids is likely, including during equipment and environmental decontamination. Non-sterile gloves are sufficient, except when performing aseptic procedures.

Disposable plastic aprons

Must be worn to protect staff uniform or clothes from contamination when providing direct patient care and during environmental and equipment decontamination.

Fluid resistant surgical face masks (FRSM)

Must be worn by all clinical staff during direct patient contact.

Long-sleeved fluid resistant disposable gown

Must be worn when there is a risk of extensive splashing of blood and/or other body fluids or when treating head and neck patients.

Eye protection / face visor

Must be worn when there is a risk of contamination to the eyes from splashing of secretions (including respiratory secretions), blood, body fluids or excretions or when treating head and neck patients. If using reusable safety goggles these must be cleaned with disinfectant wipes between patients.

FFP2 or FFP3 masks

Must be worn together with long sleeved gown, eye protection and gloves in case of contact with patient known to have COVID-19 and for aerosol generated procedures, which for GenesisCare only applies to nasendoscopy procedures in head and neck clinics.

  • We have allocated space in our centres for donning and doffing PPE
  • See PHE quick guides on donningand doffing full PPE

Click for our full PPE guidance

PPE during Cardiopulmonary Resuscitation (CPR)

Full aerosol generating procedure (AGP) and personal protective equipment (PPE) must be worn by all members of the resuscitation/emergency team before entering the room. Sets of AGP PPE is readily available where resuscitation equipment is being locally stored.

No chest compressions or airway procedures should be undertaken without full AGP PPE. If chest compressions or airway procedures are necessary, all staff undertaking these tasks MUST wear eye protection/face visor and long-sleeved fluid resistant disposable gown and an FFP2 or FFP3 respirator maskResus council guidance should be followed in all instances.

 

Use of PPE for non-clinical staff

Non-clinical staff (e.g. receptionists, admin staff etc.) practice social distancing and whenever possible maintaining distance of 2 metres from patients.

Non-clinical staff may choose to wear a FRSM (surgical face mask). If so, masks should be changed every 2 hours or if damaged or contaminated.

 

Testing patients and staff for COVID-19

Our global taskforce on COVID-19 have been working with global infection control experts and our UK Clinical Reference Group have held talks with several providers of test kits to ensure that we offer the right test for the right cohort of people.

As such and over the coming weeks, we will be rolling out a test programme for all staff and their close carers at home. Subject to final clinical review, we will likely take a hybrid testing approach utilising antibody point of care serology testing and PCR antigen testing via trusted UK laboratories. We will extend this programme to doctors who work on site, our centres and we’ll collect anonymised outcomes to evaluate the effectiveness of this testing programme.

We continue to consult our infection control specialists in the UK to roll out a similar testing programme for our high-risk patients during this pandemic. This testing capability for patients will begin in the next 2 weeks and will provide confidence to patients and their clinicians prior to embarking on essential cancer treatment.

 

GenesisCare position on SABR treatment in Oligometastic disease and radical cancer treatment

The SABR-COMET trial follow-up was extended beyond 5 years due to the continuous overall survival benefit demonstrated. The summary of study outcomes is as follows:

  • SABR-COMET was the first randomised trial demonstrating an impact of any ablative therapy on a primary endpoint of overall survival in patients with oligo-metastases
  • The effects of SABR on OS were larger in magnitude than previously reported, with a median OS benefit of 22 months (compared to 13 months in the original analysis), corresponding to an absolute benefit of 24.6% at 5-years
  • SABR did not result in a detriment in quality of life, and no new safety signals were apparent
  • A finding of a comparatively short median PFS benefit (6 months in this trial) in the setting of a longer median OS benefit generally indicates that post-progression treatment with SABR is influencing the OS benefit
  • Patients treated with SABR for oligometastases should undergo imaging surveillance with salvage SABR used if safe

SABR is indicated in case of 1-5 metastases when the primary tumour is well controlled and re treatment is possible on progression.

At GenesisCare, we are able to offer simple and complex SABR treatment in the following centres:

SABR as radical treatment offered at GenesisCare

Our MR Linac service at GenesisCare in Oxford is running a full operational service Monday to Friday, treating patients with radical and palliative intent with SABR.

Following recent publication of emergency COVID-19 radiotherapy guidance by the Royal College of Radiologists, we are best placed to deliver hypofractionated radiotherapy treatments in our MR Linac, with dedicated clinical oncology team on site to support planning adaptation and with remote planning capabilities also available. Our COVID-19 clean service gives patients the extra reassurance when they attend for treatment.

Patients with prostate, lung and pancreatic cancer can be treated radically in only few fractions, with excellent long-term outcomes and avoiding complicated and risky surgery.

We encourage all clinicians to consider SABR treatment during multi-disciplinary team discussions.

Refer for MRIdian
We welcome enquiries and referrals. Any patient referred for MRIdian treatment will be returned to the care of the referrer once treatment has been completed.

To refer to one of our MRIdian specialists
01865 224 864
oxford.enquiries@genesiscare.co.uk

Download a referral form

Protocol guidance and changes

Pancreatic

Neuro

Changes to patients chemotherapy treatments

Please ensure any changes to planned chemotherapy treatments including delays, dose reductions and cancellations of full or part treatments are communicated to the pharmacy and chemotherapy teams immediately using department group emails.

Could the changes notification be completed as early as possible to ensure any ordered dose can be stopped to minimise wastage.

Our key focus continues to be ensuring cancer patients receive the care they need in a safe environment. The clinical and non-clinical teams are working tirelessly to ensure our centres remain open and are able to treat patients without delay. Should you wish to talk to myself or Penny about any aspect of your patient’s care, please get in touch.

James McArthur

General Manager, UK

Penny Kechagioglou 

Chief Medical Officer, UK

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