The government’s failure to deliver vital PPE to health and care workers left staff afraid for their safety
30% of healthcare workers felt they had insufficient PPE, writes Olivia Blake MP. | PA Images
To avoid repeating last year's mistakes DHSC must listen to doctors, nurses and carers, ensuring they have confidence in the systems and processes designed to guarantee their safety.
‘Trying to find equipment to keep my staff safe, so that they could look after the patients that we needed to deliver care to, was absolutely the most frightening thing that I have had to do as a nurse’ – that was what Dr Emily McWhirter, a senior nurse and representative of the Royal College of Nursing, told the Public Accounts Committee (PAC) in her evidence on PPE procurement during the early days of the covid-19 crisis.
The position of the Department for Health and Social Care is that – to their knowledge – no NHS service or care provider ran out of PPE. It’s an official narrative that clashes with the experience of the medical professionals who gave testimony in PAC’s evidence sessions.. It also contradicts findings from the British Medical Association, The Royal College of Nursing, the Royal College of Physicians and Unison.
Their surveys suggest that 30% of healthcare workers felt they had insufficient PPE. 51% of nurses reported being asked to reuse single-use items. For black and ethnic minority health and care workers, the disparities were stark – 33% of BAME doctors felt they did not have the PPE necessary to do the job safely, compared to 14% of white doctors, and only 49% of BAME nurses reported being properly fit-tested for a respirator mask, compared with 74% of white nurses.
Health and care workers, many of whom are on zero-hours, low paid contracts, were forced into contexts they felt were unsafe
Our PAC report highlights these disparities, the failures of the Department in getting PPE to frontline health and care workers, but also how the inability to provide quality supplies consistently created a fearful atmosphere in hospitals and care settings. Deliveries of sub-standard, unusable stock – sometimes with old expiry dates covered over with new dates because they were past their time – undermined confidence in supply chains and left staff afraid for their safety.
And that’s if equipment even arrived. In our evidence session, senior NHS workers recounted having to call for help outside their setting when – only hours from running out entirely – the emergency hotlines for PPE told them they couldn’t help with diminished stocks.
The situation for the care sector was even worse. While official figures show that DHSC provided 80% of the estimated need in the health service, care providers were given only 10%. Although global demand for PPE rocketed at the same time as supply crashed, decision makers at the Department bafflingly assumed that the care sector could rely on its usual supply chains to make up the short fall. The situation was only taken seriously after the mortality rate in care homes tragically soared.
The PPE procurement debacle had real human consequences. Health and care workers, many of whom are on zero-hours, low paid contracts, were forced into contexts they felt were unsafe, and where they had no confidence in the procedures used to check and guarantee the quality of protective equipment.
The lessons are clear. DHSC thought it could cope because it had bought PPE to deal with a potential flu pandemic, but this was nothing like the stock levels it would need to deal with covid-19. It needs to provide a regular audit of existing stockpiles, and that those supplies are in date and that they are stored in locations that enable speedy delivery. The distribution of those supplies should be aimed at not just the NHS, but the health and social care sector in its entirety.
The procurement process also needs refining and making more transparent. The government created a new parallel supply chain, but within that its method of prioritising “credible” offers of help – which relied on recommendations from parliamentarians and government officials – was badly conceived. MPs, for example, lacked the experience to judge what constitutes a credible offer, and the notion of “credibility” was itself never defined.
Throughout the crisis, NHS and care workers have worked tirelessly in the firing line of the virus. Ministers need to attend to the experiences of frontline staff – especially BAME staff – and incorporate them into the process of determining need.
We can’t repeat last year’s mistakes. To avoid them means backing our doctors, nurses and carers, taking what they say seriously, and ensuring they have confidence in the systems and processes designed to guarantee their safety.
Olivia Blake is the Labour MP for Sheffield Hallam and a member of the Public Accounts Committee.