A GP member contacted the MDU advice line after seeing an adult male patient of the practice, who had presented with an ingrown toenail. During this initial consultation the patient declined to wear a face mask, stating he was exempt.
The GP had a discussion with the patient but was unable to ascertain why he felt he was exempt from the requirement to wear a face mask. Nonetheless, the GP assessed the patient’s toenail and advised that removing it would be the appropriate treatment, and that the procedure would take around thirty minutes.
The GP told the patient that the procedure could be carried out at the practice at a later date and attempted to discuss the possibility of the patient wearing a face mask for the procedure, but the patient was dissatisfied with this and left the practice abruptly.
The GP sought MDU advice on what further steps he and his colleagues should consider. The MDU adviser explained that if urgent treatment is needed, a doctor should do whatever is necessary, regardless of whether a patient is able or willing to wear a face mask.
The MDU adviser and the member agreed that removing the patient’s ingrown toenail was a non-urgent matter, so the adviser suggested the member and his colleagues take time to reflect on and explore all possible avenues for treatment, both within the practice and any other services available locally. The adviser suggested looking into the availability of NHS podiatry services locally and seeking information about how those services are provided, in terms of the extent of protective measures in place within the service.
The adviser also provided information about government requirements in the member's region of the UK around face mask exemptions. They suggested the member might consider inviting the patient to call the practice to discuss his concerns about wearing a face mask and, bearing that in mind, how best to deal with the issue of his ingrown toenail.
The member contacted her local NHS podiatry service, who explained they had acrylic protective screens in place that would allow the patient to have his procedure carried out there without needing to wear a face mask. They would be able to carry out the procedure, but the patient would have to wait longer to have it done than he would if it were carried out within the GP practice.
The patient responded to the member’s request that they talk on the phone to explore possible options for treatment. They discussed the patient’s objections to wearing a face mask, with the patient clarifying he simply preferred not to wear a facemask if at all possible as he found it uncomfortable.
The GP explained the details of the measures in place in the local NHS podiatry service and the timescales involved in being referred there to have the procedure performed. After a discussion, the patient agreed to be referred to the local podiatry service where he was able to have the procedure carried out without needing to wear a face mask.
This page was correct at publication on 02/07/2021. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.