Extended use of facemasks and face coverings guidance in hospitals, primary care and wider community healthcare settings (referred to as 'Healthcare settings'): Equality Impact Assessment

Sex

1. Background

Evidence from the Office for National Statistics^[41] shows that men are at greater risk of becoming seriously ill or dying from COVID-19 than women, however women's overall wellbeing has been more negatively affected.

Men are more likely than women to have certain underlying health conditions which increase clinical vulnerability to COVID-19, including cardiovascular disease, diabetes and ischaemic heart disease^[42].

Women are disproportionately represented in health care occupations^[43], with this comes an increased risk of exposure to COVID-19.

In line with expert advice provided by the JCVI^[44], the COVID-19 vaccination programme has been offering primary course and booster vaccinations to protect those at higher risk of severe COVID-19. Additionally, COVID-19 treatments are available for specific groups of people with coronavirus who are thought to be at greater clinical risk.

Health care workers have also been eligible for COVID-19 vaccination as advised by the JCVI^[45].

Risk of exposure to COVID-19 in health settings is mitigated by the fact that use of facemasks will still take place as clinically required, alongside other infection prevention and control measures.

2. Evidence / Date – Related to Healthcare Settings

Staff in Healthcare settings:

Females account for 78.8% of people employed in NHS Scotland, although this varies between job families, 48.9% of staff in ambulance support services are female compared with 90.0% of staff in nursing and midwifery^[46].

Patients/ service users in healthcare settings:

Figure 4. A graph showing respondents to a health survey sent out to those registered to a GP. The graph shows the breakdown of sex from 130,352 people who responded, with 43% being male and 57% female. It is important to acknowledge only 24% of those sent the survey replied, it does however give a rough insight into patients/ service users in Scotland.

Visitors to Healthcare settings:

According to 2011 census data^[48], Scotland’s population was 5,295,000 with 2,728,000 women and 2,567,400 men. Currently there is a lack of data around demographic breakdown of visitors to healthcare settings however, we have used census data in line with the assumption that most people will visit or use healthcare services at some point in the year.

3. Impact Summary – Related to Healthcare Settings

Does the withdrawal of the extended use of facemask guidance in healthcare settings have a positive or negative impact on people as result of their sex?

It is important to emphasise that the use of face masks will still be in place in healthcare settings if they are required clinically or as a result of outbreak/ incident management. The NHS as an employer is responsible for each member of staff’s health and safety. This includes having to complete risk assessments and refer to Occupational Health where necessary. Upon assessment any reasonable adjustments must be made which includes the routine use of face masks.

It is evident that there can be both positive and negative impacts in relation to withdrawing the enhanced facemask guidance in healthcare settings.

Women largely making up the healthcare workforce, places them at a disproportionate risk of catching COVID-19 and other respiratory infections.

A positive impact is noted for women experiencing menopause. Anecdotal evidence tells us that women can face difficulties as a result of the routine wearing of a fluid resistant face mask. PPE can exacerbate heat stress which can worsen several of the menopause symptoms, including hot flushes. The removal of this guidance could have a positive impact on women experiencing menopause at all stages.