GOVERNMENT GREEN LIGHT FOR REUSABLE PPE GOWNS COULD SAVE NHS £1BN+ A YEAR

TSA welcomes DHSC decision after months of lobbying, but warns it’s a ‘slow burner’

 

After months of lobbying by the Textile Services Association (TSA), the Department of Health and Social Care has confirmed that reusable gowns are now part of its official PPE strategy.   The TSA has long argued that reusable gowns make economic sense – they can be laundered and reused up to 75 times and the difference in cost is, as the DHSC itself says, ‘modest’.  At the same time reusable PPE gowns are far better for the environment.  While disposable gowns are creating, each year, an estimated 45 million tonnes of clinical waste that needs to be burnt, reusable ones are the far more sustainable option as they can be recycled at end of life.

“Everyone we spoke to in the cabinet office, civil service and government agreed with our argument, but they didn’t take it anywhere,” says David Stevens, CEO of the TSA.  In early October, the DHSC published its Personal Protective Equipment (PPE) Strategy, in which it mentions reusable PPE on several occasions.  However, as Stevens points out, they didn’t exactly shout it from the hilltops – and the policy of sourcing and using disposables has continued, despite recent media furore about the contracts involved.

Now, however, Stevens has had the policy on reusable PPE gowns confirmed at the highest level.  “A spokesperson from NHSI England acknowledged that we are pushing at an open door – the problem is, there still doesn’t seem to be much progress. On the plus side, the DHSC says it wants to see an increase in reusable gowns and talks about developing a comprehensive business model, with commercial laundries central to delivering the strategy.  It’s also working with the UK textile industry and universities on developing the use of new materials, such as graphene.

Stevens adds, “While the news that the DHSC is so supportive of reusable PPE gowns is very welcome, it comes with a health warning: this is a slow burner and, going by past experience, could take a long time to come to fruition.  That’s why the TSA is going to keep on pushing.” 

The TSA is now having regular calls with the NHS Improvement team to drive the use of reusable PPE gowns further up the agenda.  Currently, as part of the DHSC official PPE strategy, NHS England is piloting the use of reusable gowns with twenty providers, with sixty more waiting to join the pilot, working alongside laundry suppliers to increase the proportion of reusable gowns in the system and reduce waste of single use gowns.

Meanwhile, the TSA has published a short guide on multi-use PPE gowns, detailing how the reusable gowns could be made in the UK (currently most disposable PPE comes from overseas) and cleaned in commercial laundries to ensure they are safe for reuse.  The Guide, ‘The Case for Reusable Gowns… there’s a better way’, explains the difference between disposable and reusable gowns, and gives stark statistics – including the potential saving to the NHS of £1.2bn per year.  The Guide is available to download from here

If you wish to discuss the above or if you would like any further information, please do not hesitate to contact us on  020 3151 5600 or at tsa@tsa-uk.org.

Could ‘clean’ healthcare uniforms be COVID-19 carriers?

TSA backs calls for research into textiles and infection control; ‘PHE should revise 2007 guidelines’

The Textile Services Association (TSA) is backing urgent calls for research into the ability of infectious diseases, including COVID-19, to survive on linen and clothing, even after it is washed in a domestic setting.  It’s especially concerning because many nurses and care home workers wash their uniforms at home – and there is evidence that some infection outbreaks in healthcare settings have been caused by inadequately managed washing equipment.  The TSA is also calling for Public Health England to revise guidelines the Association believes are outdated.

Currently Public Health England recommends uniforms are washed in commercial laundries, but it is not compulsory.  Furthermore, it says that domestic washing should be adequate.  However, this is based on reviews published in 2007 – and experts are saying that, especially in the light of the COVID-19 pandemic, it’s high time for proper research that will give accurate guidance on the matter. There is also increasing consensus within the research community that the infrastructure, processes and quality standards in a commercial laundry mean they are much better equipped to deal with all the risks associated with infectious textiles than is possible in a household or on-premises laundry setting.

“It can’t be right to base guidance on reviews that were done 13 years ago,” says David Stevens, CEO of the Textile Services Association.  The TSA is currently conducting a survey of care home owners to find out about their current practices.  The Association is also working with the DHSC, who have agreed to review the infection control procedures around laundry.  “They have said they would welcome a revised guidance document that can be issued to the care home sector,” says Stevens.

“When it comes to best practice for health workers who are laundering their uniforms at home, the PHE guidance is onerous,” Stevens adds.  “It says that workers should transport the uniform in a disposable plastic bag, and wash at the highest temperature it can tolerate, in a separate half load, and it should be ironed or tumble dried.   It’s a lot to ask of a tired worker just home from a stressful shift.”

Previous research by Dr Katie Laird of De Montfort University (DMU) found that healthcare workers were not always adhering to these policies when laundering at home, underlining the risk of inadequate decontamination.  It showed 44% of workers were laundering their uniforms at temperatures below 60°C, and 40% laundered them with other clothing items.

The most recent paper on the subject was published in August 2020 by Dr Laird and her colleague, Dr Lucy Owen from the Infectious Disease Research Group at DMU.  They point out the need for even more rigorous infection control, following the emergence of COVID-19, and underline the lack of empirical research into the role of textiles as potential fomites (infection carriers) in healthcare environments.  Furthermore, they reference a number of studies that indicate that microorganisms can survive on textiles for extended periods of time, and case studies that link outbreaks with inadequate washing processes and infrastructure in on-premise healthcare settings. This is important because it underlines the infection control benefits of the measures taken in a commercial laundry, compared to those in a domestic or on-premise setting.

The article, called The role of textiles as fomites in the healthcare environment: a review of the infection control risk, is available to download here

“Given what the experts are saying, surely we should be erring on the side of caution and ensuring that healthcare workers’ uniforms are washed in commercial laundries, with the appropriate hygiene certification,” says Stevens.  “We will be lobbying the government and PHE to fund research to establish the facts, or at the very least to revise the current guidelines.”

If you wish to discuss the above or if you would like any further information, please do not hesitate to contact us on  020 3151 5600 or at tsa@tsa-uk.org.

Hospitality Laundries Charge to the Rescue of the NHS and Care Homes

New hygiene certification means UK laundries can help healthcare sector through C-19 crisis

Over thirty hospitality laundries have already signed up to a new certification scheme that will allow them to help the UK’s health and social care system  manage the increasing amount of dirty linens and textiles that is being created by the Covid-19 pandemic.  The demand is expected to rise in the coming weeks considering the Government strategy to move from disposable to reusable PPE gowns.  Meanwhile, the Department of Health and Social Care is looking to use commercial laundries to ensure all adult social care facilities have access to hygienically cleaned and safe linens and textiles.

Textile Services Association (TSA), which represents the UK’s commercial laundries, has developed the scheme in consultation with NHSI (NHS Improvement) and other Government departments.  Called the Interim Healthcare Laundry Certification (IHLC), it gives laundries that normally serve the hospitality sector a fast track to the specialist standards of hygiene required by the NHS, care homes and other medical facilities.

“C-19 has created unprecedented levels of healthcare laundry, which requires specialist processing,” says David Stevens, CEO of the TSA.  “The increase was in the order of half a million PPE gowns every day at the peak of this pandemic.  Plus there are the uniforms, towels, bed linen and patients’ clothes.  To cope with that, the UK needs more specialist laundries.”

Under normal circumstances, laundries that want to service the healthcare sector need to achieve BS EN 14065 certification.  This is the standard that specifies the appropriate approach to managing bio-contamination risks and providing fit-for-purpose textiles with sufficient microbiological quality.  However, the urgent requirement for more laundry capacity, due to C-19, led to the creation of the new, fast track certification.

To achieve the Interim Healthcare Laundry Certification, laundries need to meet the requirements of the Department of Health’s technical memorandum HTM 01-04: Decontamination of Linen for Health and Social Care.  This provides a clear path for commercial laundries to prove they consistently decontaminate healthcare linen and manage related risks to patient safety.  The TSA has published a guidance document, Interim Healthcare Laundry Certification / Response to COVID-19, which gives full details on how laundries can meet these requirements.

“We want to ensure the laundry industry is ready to service the increasing needs of the healthcare sector,” says Stevens.  “We are delighted that so many laundries have already taken up the scheme, and we expect more to follow.”

There will be even more need for this support, with the massive increase in healthcare laundry requirements as the UK switches from disposable PPE gowns to reusable ones.  “It’s something we’ve been campaigning for over the last few months,” says Stevens.  “Reusable gowns are just as safe, they are much cheaper in the long run and they are better for the environment – disposable PPE is creating millions of tonnes of clinical waste.

“We’ve been working with the Cabinet Office and NHSI as they switch supply away from single use to these more robust and sustainable multi use products.  At the same time, we’ve been talking to the DHSC in the first steps towards a long-term partnership with the aim of bringing hygienically safe textile services to all the UK’s healthcare sectors, including adult social care facilities.  We now need to ensure that every healthcare facility in the country can have a certified laundry service.”

The hospitality laundry sector has been crushed by the C-19 lockdown, which saw virtually 100% of its business disappear overnight as hotels, restaurants and sports facilities closed.  “The good news for the UK is that there is plenty of capacity in the commercial laundry industry, so we can cope with the increased demand from the health sector,” says Stevens.  “The new interim certification will ensure these laundries are meeting the strict standards healthcare demands.”

The TSA’s guidance document, Interim Healthcare Laundry Certification / Response to COVID-19, is available to download here.

If you wish to discuss the above or if you would like any further information, please do not hesitate to contact us on  020 3151 5600 or at tsa@tsa-uk.org.