Recommendations & Conclusions
6 items
13
Conclusion
Forty-Second Report - COVID-19: Governm…
Acknowledged
The Department asserted that while it had deliberately secured a significant stockpile of PPE, it was not clear it had over-ordered as the stock would be needed for the ongoing COVID crisis. It admitted that it did not have full information about how much PPE had been provided by suppliers …
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The Department asserted that while it had deliberately secured a significant stockpile of PPE, it was not clear it had over-ordered as the stock would be needed for the ongoing COVID crisis. It admitted that it did not have full information about how much PPE had been provided by suppliers outside the parallel supply chain. Additional PPE was also used by staff who were not treating known COVID19 NHS patients but were supporting the ‘reopening of the NHS’. It also told us that the PPE it had ordered can be used to support primary care and social care and might also be needed for the programmes to test people for, and vaccinate people against, COVID-19. Not all of the PPE purchased had yet been delivered and the Department told us it would consider whether some of its PPE contracts could be reduced or cancelled. The Department also said that it was looking at sharing or selling some PPE with its partners.19 The Department wrote to us after our evidence session and told us that to date it had, for a multitude of reasons, cancelled or curtailed contracts to the value of around £400 million.20 Problems with the quality of some PPE procured
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Government response AI summary
The government describes its current PPE strategy, including purchasing based on modelled demand, increased UK manufacturing, a four-month stockpile, and a flexible logistics network. It will provide future information on stockpile management and is reviewing countermeasures for disease outbreaks, implicitly acknowledging the context of the …
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HM Treasury
21
Conclusion
Forty-Second Report - COVID-19: Governm…
Acknowledged
The Department explained that its formal reporting arrangements did not identify any provider organisation, in health or social care, as having run out of PPE completely. It monitored the risk that social care could run out within 48 hours. It told us the national supply disruption emergency helpline, which was …
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The Department explained that its formal reporting arrangements did not identify any provider organisation, in health or social care, as having run out of PPE completely. It monitored the risk that social care could run out within 48 hours. It told us the national supply disruption emergency helpline, which was available from mid-March, would supply immediately to any organisation which would run out within 24 hours.32 The Department told us it had put in place a process to understand the PPE available to local organisations. This included daily calls with NHS regional officers (who in turn were liaising with individual trusts), with local resilience forums and with government’s emergency helpline. We asked whether the Department triangulated this with information from the trade unions whose members may have reported a very different story about shortages. The Department noted it did have conversations with the Royal College of Nursing and the British Medical Association “at times”, but its main source of information on access to PPE was the process of daily calls.33 It acknowledged that its reporting mechanism for understanding how much PPE social care providers held was not all that it would have liked at the start of the pandemic but told us its data improved from around May.34
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Government response AI summary
The government agrees with the implied "recommendation" (despite the item being a conclusion), acknowledging frontline evidence and stating it has factored this into ongoing customer engagement, improving understanding of user needs, and increasing available PPE options.
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HM Treasury
25
Conclusion
Forty-Second Report - COVID-19: Governm…
Acknowledged
Staff representative organisations ran surveys in which frontline staff reported not having the PPE they needed. The British Medical Association, the Royal College of 37 Qq 11, 17, 37–38, 66–67, 121, 123 38 Qq 11–12, 17, 23–24, 37, 66, 123; House of Commons Public Accounts Committee, Readying the NHS and …
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Staff representative organisations ran surveys in which frontline staff reported not having the PPE they needed. The British Medical Association, the Royal College of 37 Qq 11, 17, 37–38, 66–67, 121, 123 38 Qq 11–12, 17, 23–24, 37, 66, 123; House of Commons Public Accounts Committee, Readying the NHS and social care for the COVID-19 peak, Session 2019–2021, HC 405, 29 July 2020, para 9 39 Qq 71–72 131, 194 40 Qq 14–16, 29–33, 39 41 Letter from Department of Health & Social Care, 15 January 2021 COVID-19: Government procurement and supply of Personal Protective Equipment 19 Nursing, the Royal College of Physicians and Unison ran surveys that showed at least 30% of participating doctors, nurses and care workers reported having insufficient PPE, even in high-risk settings.42 Among the survey findings was that 51% of nurses reported being asked to reuse single-use items of PPE in a high-risk setting; 33% of Black, Asian or other minority ethnic (BAME) doctors felt they did not have the PPE they needed, compared with 14% of white doctors; and 49% of BAME nurses reported being fit tested for a respirator mask compared with 74% of white nurses.43
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Government response AI summary
The government acknowledges the evidence from frontline workers presented in the NAO report regarding insufficient PPE and reuse of single-use items, while asserting that rapid action ensured trusts never stocked out.
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HM Treasury
26
Conclusion
Forty-Second Report - COVID-19: Governm…
Acknowledged
We asked about the experience of BAME staff and whether this had been different to that of their white colleagues. The British Medical Association told us that its surveys showed between two and three times as many BAME doctors as white doctors felt pressured to work without adequate protection. It …
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We asked about the experience of BAME staff and whether this had been different to that of their white colleagues. The British Medical Association told us that its surveys showed between two and three times as many BAME doctors as white doctors felt pressured to work without adequate protection. It also told us that it called for BAME staff to be given risk assessments in early April, when it became clear that COVID-19 was having a disproportionately high impact on staff from BAME backgrounds. But information from its members suggested that risk assessments were not being carried out until the end of May. The Department said that, since the initial PPE shortages, it had worked hard to listen to the concerns of BAME colleagues and ensure that all staff have a risk assessment. It also explained that it had a respirator mask fit-testing project and worked hard to ensure it could provide PPE in a range of sizes, so that everybody could get the PPE they needed.44
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Government response AI summary
The government acknowledged the evidence regarding BAME staff experiences, stating it has factored this into its engagement program, continues to invite feedback, and is increasing PPE options to address diverse individual needs.
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HM Treasury
28
Conclusion
Forty-Second Report - COVID-19: Governm…
Acknowledged
Witnesses representing the health and social care sectors raised a number of concerns about the PPE guidance issued by government. The Department told us that it held conversations with the Royal Colleges (and with the NHS and public health services of the UK nations) about the PPE guidance issued.47 The …
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Witnesses representing the health and social care sectors raised a number of concerns about the PPE guidance issued by government. The Department told us that it held conversations with the Royal Colleges (and with the NHS and public health services of the UK nations) about the PPE guidance issued.47 The British Medical Association told us that, in March, the government guidance differed from the guidance of the World Health Organization: in particular government guidance did not recommend the use of eye protection in GP practices. Government did revise its guidance to recommend eye protection in early April. The NAO report stated that PPE guidance had been updated 30 times by 31 July, and the Royal College of Nursing highlighted that the frequency of changes was difficult for a provider organisation to manage and that the changes were 42 Qq 7–8, 11, 17, 49, 62, 142–143; C&AG’s Report The supply of personal protective equipment (PPE) during the COVID-19 pandemic, paras 18, 3.19–3.21, Figure 16 43 Q 49; Royal College of Nursing, Personal protective equipment: Use and availability during the COVID-19 pandemic (national survey results), 18 April 2020; C&AG’s Report The supply of personal protective equipment (PPE) during the COVID-19 pandemic, para 3.26 44 Qq 53–57, 260–261 45 C&AG’s Report The supply of personal protective equipment (PPE) during the COVID-19 pandemic, paras 3.22–3.23, Figure 17 46 Qq 53, 276 47 Q 142 20 COVID-19: Government procurement and supply of Personal Protective Equipment often issued late on a Friday with providers required to implement them from Monday. Care England and UNISON were concerned that the language of the guidance was not relevant for social care, and UNISON told us that government guidance permitting the re-use of masks led to many social care workers being required to wear the same mask for an entire 12-hour shift, which they felt was unsafe. The British Medical Association said it had concerns around the guidance for PPE use dur
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Government response AI summary
The government acknowledges the concerns about PPE guidance, stating it has factored the evidence into its engagement programme and continues to invite feedback from customer groups, aiming to improve understanding of user needs and increase available options.
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HM Treasury
29
Conclusion
Forty-Second Report - COVID-19: Governm…
Acknowledged
By the end of June, 44 Transport for London workers had lost their lives to COVID19. We asked representatives of health and social care staff organisations about the provision of PPE to non-healthcare key workers, such as taxi drivers, cleaners, transport, supermarket and security workers. The British Medical Association considered …
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By the end of June, 44 Transport for London workers had lost their lives to COVID19. We asked representatives of health and social care staff organisations about the provision of PPE to non-healthcare key workers, such as taxi drivers, cleaners, transport, supermarket and security workers. The British Medical Association considered that these workers deserved to be protected and noted that failing to protect them led to more hospitalisations and increased the pressure on the NHS. The Department told us it would consider providing PPE to a wider group of people, such as key workers, as part of its pandemic planning if the evidence suggested that this would be effective. It also noted it had provided PPE guidance for some groups of workers, such as police and prison officers, during the first wave of the pandemic, and provided PPE to the Home Office and the Ministry of Justice.49 48 Qq 20–21, 26, 69, 73–75, 82; C&AG’s Report The supply of personal protective equipment (PPE) during the COVID-19 pandemic, paras 17, 3.3–3.7, Figure 14 49 Qq 24, 79–80, 277–278 COVID-19: Government procurement and supply of Personal Protective Equipment 21
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Government response AI summary
The government states it is developing a framework to determine how to respond to PPE shortages across health, social care, and wider sectors, which could be adapted for future needs.
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HM Treasury