A specific risk assessment for is needed for pregnant employees. Making sure a pregnant employee follows the covid secure rules is the key and doing so even more e.g. increased handwashing, face mask in communal areas, not moving around the school at busy times, carrying hand sanitiser. Anything you can think of really.
The best guidance is the Q & A from The Royal College of Obstetrics and Gynaecology which in summary is:-
Coronavirus infection and pregnancy – The Royal College of Obstetrics and Gynaecology (RCOG)
Q. What is the main advice for pregnant women?
There is no evidence that pregnant women are more likely to get seriously ill from coronavirus but pregnant women have been included in the list of people at moderate risk (clinically vulnerable) as a precaution. The government guidance for the clinically vulnerable remains in place and you should ensure you continue to follow the latest government guidance.
Pregnant women should follow the latest government guidance on staying alert and safe (social distancing) and avoid anyone who has symptoms suggestive of coronavirus. If you are in your third trimester (more than 28 weeks’ pregnant) you should be particularly attentive to social distancing.
So, a pregnant employee is in the clinically vulnerable category and needs to follow the latest government guidance on staying alert and safe, as well as observing social distancing. An employee over 28 weeks pregnant should be ‘particularly attentive to social distancing.’
Staying alert and safe (social distancing)
7. Clinically vulnerable people
If you have any of the following health conditions, you may be clinically vulnerable, meaning you could be at higher risk of severe illness from coronavirus. If you are clinically vulnerable you:
- can go outside as much as you like but you can still try to keep your overall social interactions low
- can visit businesses, such as supermarkets, pubs and shops, whilst keeping 2 metres away from others wherever possible or 1 metre plus other precautions
- should continue to wash your hands carefully and more frequently than usual and that you maintain thorough cleaning of frequently touched areas in your home and/or workspace
The latest school guidance is here:-
Guidance for full opening: schools – Updated 28 August 2020
Staff who are pregnant
Pregnant women are in the ‘clinically vulnerable’ category and are generally advised to follow the above advice, which applies to all staff in schools. Employers should conduct a risk assessment for pregnant women in line with the Management of Health and Safety at Work Regulations 1999 (MHSW).
The Royal College of Obstetrics and Gynaecology (RCOG) has published occupational health advice for employers and pregnant women. This document includes advice for women from 28 weeks gestation or with underlying health conditions who may be at greater risk. We advise employers and pregnant women to follow this advice and to continue to monitor for future updates to it.
The school guidance refers to the Royal College of Obstetrics and Gynaecology (RCOG) guidance, which talks about all employers following the recommendations in Section 3 (below). However, these are specific for pregnant healthcare workers, not pregnant workers in schools. The Additional Statement at the start of the RCOG guidance states that, when performing mandatory risk assessments for their pregnant employees, in addition to Section 3, employers should use other sector-specific advice published on the UK government, Working safely during Coronavirus (COVID-19) and NHS Employer websites,.
COVID-19 virus infection and pregnancy – RCOG
Additional Statement
A note on this guidance:
RCOG/RCM/FOM Occupational health advice for employers and pregnant women during the COVID-19 pandemic was written for implementation at the peak of the pandemic when clinically vulnerable individuals were advised to stringently apply social distancing measures and extremely vulnerable individuals were advised to shield.
While national policy has shifted since then and now varies regionally, the government has maintained the precautionary measure that pregnant women are classed as ‘vulnerable’. Therefore, although this guidance is no longer current for the UK as a whole, it remains useful for pregnant workers who are still advised to stringently adhere to any active national guidance on social distancing. Furthermore, our clinical advice around pregnant women and the risk and potential implications of being severely affected by COVID-19, particularly affecting those who are at 28 weeks’ gestation or above, still stands.
Specific guidance on how and where pregnant women can safely work should be advised on an individual basis, following employer-led workplace and individual risk assessments. The RCOG recommends that employers use the clinical advice in the RCOG/RCM/FOM Occupational Health Guidance (see section 3 of this guidance ‘Recommendations for pregnant healthcare workers’) when performing mandatory risk assessments for their pregnant employees, along with other sector-specific advice published on the UK government, Working safely during Coronavirus (COVID-19) and NHS Employer websites. The RCOG, RCM and Faculty of Occupational Medicine continue to act as clinical advisors on these documents published by government agencies.
3. Recommendations for pregnant healthcare workers
In the UK, significant protections in law for pregnant healthcare workers already exist. These must be followed in relation to COVID-19. NHS employers should do everything possible to maintain the health of their pregnant employees. The central aspect of this protection is based on risk assessment of each individual pregnant worker’s working environment and the role they play.
Acknowledging the evidence above and following discussion with the Government and UK Chief Medical Officers, the following recommendations should assist pregnant healthcare workers, line managers and occupational health teams in conducting this risk assessment.
Further information on keeping the healthcare workforce safe is available from the Faculty of Occupational Medicine, although this is not specific to healthcare workers who are currently pregnant.
3.1 Protection of all pregnant healthcare workers
Every pregnant worker should have a risk assessment with their manager, which may involve occupational health. Employers should modify the working environment to limit contact with suspected or confirmed COVID-19 patients to minimise the risk of infection as far as possible.
In the light of the limited evidence, pregnant women can only continue to work in direct patient-facing roles if they are under 28 weeks’ gestation and if this follows a risk assessment that recommends they can continue working, subject to modification of the working environment and deployment to suitable alternative duties. Pregnant women of any gestation should not be required to continue working if this is not supported by the risk assessment, as per the Management of Health and Safety at Work Regulations 1999 (MHSW). If a risk assessment indicates that a pregnant woman under 28 weeks’ gestation can continue to work in a patient facing role, and the woman chooses to do so, she should be supported by her employer.
Suitable alternative duties might include remote triage, telephone consultations, governance or administrative roles. This is in line with the national guidance that workers, including healthcare professionals, who are also identified by the government as vulnerable to COVID-19 should participate in their own risk assessment.
3.2 Choices for pregnant healthcare workers prior to 28 weeks’ gestation
Following a risk assessment with their employer and occupational health, pregnant women should only be supported to continue working if the risk assessment advises that it is safe for them to do so. This means that employers must remove any risks (that are greater in the workplace than to what they would be exposed to outside of the workplace), or else they should be offered suitable alternative work. Issues about pay and remuneration are beyond the remit of this guidance. If alternative work cannot be found, advice on suspension and pay should be sought from the relevant trade union and/or staff representative. There is some further guidance available from the BMA, RCM and Maternity Action.
Some working environments (e.g. operating theatres, respiratory wards and intensive care/high dependency units) carry a higher risk of exposure to the virus for all healthcare staff, including pregnant women, through the greater number of aerosol-generating procedures (AGPs) performed. These procedures are summarised in the PHE publication ‘Guidance on Infection Prevention and Control’. When caring for suspected or confirmed COVID-19 patients, all healthcare workers in these settings are recommended to use appropriate PPE. Where possible, pregnant women are advised to avoid working in these areas with patients with suspected or confirmed COVID-19 infection.
3.3 Healthcare workers after 28 weeks’ gestation or with underlying health conditions
For pregnant women from 28 weeks’ gestation, or with underlying health conditions such as heart or lung disease at any gestation, a more precautionary approach is advised. Women in this category should be recommended to stay at home. For many healthcare workers, this may present opportunities to work flexibly from home in a different capacity, for example by undertaking telephone or videoconference consultations, or taking on administrative duties.
All NHS employers should consider both how to redeploy these staff and how to maximise the potential for homeworking given current relaxation of NHS Information Governance requirements, wherever possible.
The RCM provides advice for pregnant healthcare workers who cannot be redeployed or work from home. Staff in this risk group who have chosen not to follow government advice and attend the workplace must not be deployed in roles where they are working with patients. Services may want to consider deploying these staff to support other activities such as education or training needs (e.g. in IPC or simulation).
These measures will allow many pregnant healthcare workers to choose to continue to make an active and valuable contribution to the huge challenge facing us, whether at home or in the workplace, until the commencement of their maternity leave.
Summary
There appears to be some confusion because the school guidance refers to guidance from the Royal College of Obstetricians and Gynaecologists that relates specifically to pregnant healthcare workers, rather than pregnant workers in schools. The key is carrying out a specific risk assessment for every pregnant employee.
