Fit testing of masks – Dental Protection position statement

As a result of changes to practice aimed at reducing the risk of transmission of COVID-19 and protecting staff, respiratory protective equipment (RPE) (eg FFP2, FFP3 facemasks) is now essential PPE for certain dental procedures and the fit-testing of these masks is a legal requirement. The Health and Safety Executive website provides guidance on fit-testing along with checklists for reference. 

The legal requirement for fit-testing means that the fit-testing must be carried out by a competent person. This person does not need to be a healthcare professional and fit-testing may be undertaken by an external provider. Competence in fit-testing can be confirmed by completing accredited training under the Fit2Fit RPE Fit Test Providers Accreditation scheme; we are aware that members are currently undertaking training to enable them to carry out the fit-testing themselves and address the shortage of fit-testers within the professional community.

What are the requirements?

A fit-test should be carried out before staff wear RPE for the first time or when there is a change to the circumstances of the wearer that could alter the fit. Qualitative fit-testing is reliant upon the wearer’s subjective assessment of any leakage through the face seal. 

Once the practice team have had their masks fit-tested and received training in the correct use of the model of respirator mask provided by the practice, each team member has a personal responsibility to wear the correct RPE and that the fit is checked in accordance with their training. 

Fit-checking of a mask must be undertaken each time a new mask is fitted. This can be done by the clinician themselves but where other appropriately trained staff are asked to check the fit, this should be done in a way that complies with current social distancing guidance.

Unable to wear fit-test RPE?
Information for members who are unable to wear a fit-tested RPE can be found in our UK specific COVID-19 FAQ here.

What about indemnity arrangements?

The fitting, testing, and then the correct use of protective equipment is a health and safety requirement and members should at all times seek assurance from their commercial insurance providers that their public/employer liability policies extend to cover this. 

We also understand that some members have been commissioned to fit-test masks for staff/colleagues in other local practices and clinical settings.

NHS England and Improvement has confirmed that individuals trained to undertake fit-testing through the Public Health England funded courses arranged by HEE are to be engaged under an honorary agreement for these activities, which will cover any liabilities arising through that agreement. Members undertaking this training and work should therefore seek confirmation they will be offered an honorary contract to undertake this work.

Further clarification is being sought in relation to indemnity for those who undertook training prior to the PHE funded courses being established but are undertaking this work to support local practices.

In the event that both your business insurer providers and NHS Resolution have been approached and have confirmed that the circumstances of a particular claim fall out-with public/employer liability or Government Clinical Negligence Schemes, members who undertake qualitative fit-testing can request assistance from Dental Protection for matters arising from this where:

1. they have successfully completed training by an accredited provider,
2. are competent to undertake this work, and
3. the fit-testing is being provided for colleagues working in the same practice or
4. the fit-tester is providing fit testing services in practices other than their own so long as they are not undertaken on a commercial basis. This applies to individual practice principal members and to non-principal Dental Protection members who have been asked to undertake the role of fit-tester.

Where members are looking to provide this service on a commercial basis to other parties or practices, they would need to ensure they have appropriate commercial insurance to cover this work.

KEY POINTS

• Face fit-testing is a legal requirement for anyone who wears a close-fitting mask. The law requires employers to ensure that all RPE at work is adequate and suitable for the wearer, task and environment. To conform and provide evidence, a fit test is required and should be conducted by a competent person. This requirement now applies in dental environments as a direct result of the COVID crisis.
• The provision and correct use of protective equipment is a health and safety requirement. Members should therefore seek assurance from their commercial insurance providers that their public/employer liability policies extend to cover this, before undertaking fit-testing within the practice.
• Members who are trained and competent to carry out fit-testing and are doing this for work colleagues in their own practice, or in another practice on a voluntary (unpaid) basis , can seek assistance and support from Dental Protection in the event that the circumstances of a claim mean that it falls outside of your employer /public liability insurance or the CNSC indemnity arrangements.

Employer /public liability and state indemnity all relate to liability in relation to claims for compensation. Members can be reassured that they can request assistance in relation to any non-claims support, for example a complaint being made to the GDC, arising from this work.