Recommendations & Conclusions
8 items
2
Recommendation
Forty-Second Report - COVID-19: Governm…
Not Addressed
While government had plans and a stockpile of PPE, this proved inadequate for the COVID-19 pandemic. The Department had a strategy for managing an influenza pandemic, which included a stockpile of PPE owned and managed by Public Health England. In March 2020, NHS England & NHS Improvement gave public assurances …
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While government had plans and a stockpile of PPE, this proved inadequate for the COVID-19 pandemic. The Department had a strategy for managing an influenza pandemic, which included a stockpile of PPE owned and managed by Public Health England. In March 2020, NHS England & NHS Improvement gave public assurances to the Health and Social Care Committee that the stockpile would be sufficient to manage the pandemic, but this confidence was misplaced since the stockpile held no more than two-weeks’ worth of most types of PPE. Furthermore, it did not hold all of the planned PPE, such as visors and gowns, and some of the PPE it did hold had expired or did not meet current safety standards. Government and its contractors also struggled to distribute the stockpiled PPE quickly. In response to these problems the Department created a parallel supply chain to buy and distribute PPE. However, because of the time lag between ordering PPE and it being available, this could barely satisfy local organisations’ requirements. Frontline staff in health and social care experienced shortages of PPE, with surveys by staff representative organisations showing that at least 30% of participating care workers, doctors and nurses reported having insufficient PPE, even in high-risk settings. Provider organisations attempted to buy PPE at short notice, in an overheated market, and COVID-19: Government procurement and supply of Personal Protective Equipment 7 found they needed to pay hugely inflated prices to suppliers they were unfamiliar with. The PPE from central government was sometimes not usable and providers told us that emergency helplines referred them to suppliers which did not have PPE. Recommendation: The Department must improve its approach to managing and distributing stocks of PPE to ensure the correct equipment gets to those who need it, when they need it. The Department should write to us by July 2021 to confirm that: • Stockpiles hold everything required as specified in the Depa
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Government response AI summary
The government response did not address the recommendation about improving PPE management and distribution, instead discussing an unrelated HMRC conclusion.
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HM Treasury
3
Recommendation
Forty-Second Report - COVID-19: Governm…
Not Addressed
The high-priority lane was not designed well enough to be a wholly effective way of sifting credible leads to supply PPE. Government’s PPE buying team, within the parallel supply chain, received over 15,000 offers to supply PPE. This cross- government PPE buying team set up a high-priority lane to separately …
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The high-priority lane was not designed well enough to be a wholly effective way of sifting credible leads to supply PPE. Government’s PPE buying team, within the parallel supply chain, received over 15,000 offers to supply PPE. This cross- government PPE buying team set up a high-priority lane to separately assess and process high-priority leads that it considered more credible, which sat alongside an ordinary lane to process other leads. Leads that were considered more credible were those from government officials, ministers’ offices, MPs and members of the House of Lords but it is not clear why this assumption was made. The priority lane did not include organisations with expertise in the health and social care sector that had existing relationships with suppliers through their members or directly and were well-placed to assess the credibility of potential PPE suppliers, such as the British Medical Association. Around one in ten suppliers that came through the high-priority lane were awarded a contract compared with one in a hundred for the ordinary lane. There were no written rules to support those making referrals in deciding which leads to put forward. Some of those making referrals that were considered high priority, such as MPs, passed on leads on the basis that others would assess their suitability rather than vouching for the credibility of those offers. The same eight-stage process for assessing and processing offers was applied to both lanes, but the Cabinet Office and the Department accepted that leads that went through the high-priority lane were handled better. Recommendation: The Cabinet Office and the Department should by July 2021 publish the lessons it has learnt from the procurement of PPE during the pandemic for future emergencies and disseminate these lessons to the wider government commercial function. This should include guidance for determining what is considered a credible offer and how this is communicated to potential suppliers.
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Government response AI summary
The government response refers to a PAC conclusion about the Home Office breaching its Net Cash Requirement, which is entirely irrelevant and does not address the recommendation on publishing lessons learned from PPE procurement.
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HM Treasury
4
Recommendation
Forty-Second Report - COVID-19: Governm…
Not Addressed
The Department’s focus on supporting hospitals meant assistance to social care providers was neglected. The pandemic has shown the tragic impact of delaying much needed social care reform and treating the sector as the NHS’s poor relation. This is an issue this Committee has raised concerns about before when we …
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The Department’s focus on supporting hospitals meant assistance to social care providers was neglected. The pandemic has shown the tragic impact of delaying much needed social care reform and treating the sector as the NHS’s poor relation. This is an issue this Committee has raised concerns about before when we examined 8 COVID-19: Government procurement and supply of Personal Protective Equipment the Department’s approach to readying the NHS and social care for the COVID-19 peak, and in our earlier examinations of the interface between health and social care and on the adult social care workforce. The Department provided NHS trusts with 1.9 billion items of PPE between March 2020 and July 2020, equivalent to 80% of their estimated need. In contrast, it provided the adult social care sector with 331 million items of PPE, equivalent to10% of its estimated need. Social care representatives told us their usual suppliers could not provide PPE, in part because some of it was diverted to the NHS, and consequently some providers ran out of PPE. Some 25,000 patients were discharged to care homes from hospitals, some without being tested for COVID-19, even after it became clear that people could transmit the virus without having symptoms. This contributed significantly to the deaths in care homes during the first wave. Social care was only taken seriously after the high mortality rate in care homes became apparent. Key workers outside of health and social care, including transport and supermarket workers, security guards and taxi drivers, were not provided with PPE, yet doing so could have prevented them becoming ill or passing on the virus. Recommendation: The Department should write to the Committee by the end of April 2021 to explain how it will revise its emergency response plans so that they include who will be supported, how and when. This must give appropriate weight to all sectors of health and social care, as well as occupations outside these sectors which are also
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Government response AI summary
The government response states that HM Treasury breached its Capital Annually Managed Expenditure total by £32 million, which does not address the recommendation for the Department to explain how it will revise its emergency response plans for various sectors.
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HM Treasury
1
Conclusion
Forty-Second Report - COVID-19: Governm…
Not Addressed
On the basis of two reports by the Comptroller and Auditor General, we took evidence from the Cabinet Office, Department of Health & Social Care (the Department) and Public Health England about government procurement during the COVID-19 pandemic and the supply of personal protective equipment (PPE).1 As part of our …
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On the basis of two reports by the Comptroller and Auditor General, we took evidence from the Cabinet Office, Department of Health & Social Care (the Department) and Public Health England about government procurement during the COVID-19 pandemic and the supply of personal protective equipment (PPE).1 As part of our inquiry, we also took evidence from Care England, the British Medical Council, the Royal College of Nursing, and UNISON.
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Government response AI summary
The government response addresses a different PAC conclusion regarding the Department for Business, Energy & Industrial Strategy's expenditure, and does not engage with the substance of this introductory conclusion about the inquiry's scope.
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HM Treasury
10
Conclusion
Forty-Second Report - COVID-19: Governm…
Not Addressed
The British Medical Association and the Royal College of Nursing told us that their organisations did not have access to the high-priority lane, even though they were being contacted by, and therefore would have been able to put forward, credible leads based on the knowledge of their members. The British …
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The British Medical Association and the Royal College of Nursing told us that their organisations did not have access to the high-priority lane, even though they were being contacted by, and therefore would have been able to put forward, credible leads based on the knowledge of their members. The British Medical Association also noted that suppliers which had contacted them, including suppliers trusted by doctors, tried the normal channels of reaching out to the Government but had “hit a brick wall”. Care England told us that it had similarly shared the details of potential suppliers but there had been no follow-through. The Department was unable to confirm whether the British Medical Association had access to the high-priority lane and committed to checking this.16 12 Qq 117–118, 134, 144, 272; C&AG’s Report The supply of personal protective equipment (PPE) during the COVID-19 pandemic, paras 10, 2.2, Figure 6 13 Qq 89, 149, 179, 191 14 Qq 179–188 15 Qq 179, 180, 182, 186; 191–192; C&AG’s Report Investigation into government procurement during the COVID-19 pandemic, paras 3.12–3.14, Figure 6 16 Qq 46–47; Qq 181–184 14 COVID-19: Government procurement and supply of Personal Protective Equipment Volumes of PPE procured
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Government response AI summary
The government response explicitly addresses a recommendation about publishing lessons learned from procurement, which does not address the committee's conclusion about medical associations' lack of access to the high-priority PPE lane.
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HM Treasury
14
Conclusion
Forty-Second Report - COVID-19: Governm…
Not Addressed
Not all of the PPE the Department bought can be used. The Department told us that only 0.5% of the 18 billion items of PPE it had received and checked so far had failed to meet clinical safety standards and therefore could not be used at all. However, this figure …
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Not all of the PPE the Department bought can be used. The Department told us that only 0.5% of the 18 billion items of PPE it had received and checked so far had failed to meet clinical safety standards and therefore could not be used at all. However, this figure 17 C&AG’s Report The supply of personal protective equipment (PPE) during the COVID-19 pandemic, para 2.26; Qq 193–196, 232, 267–269 18 Qq 193–197, 270–271; C&AG’s Report The supply of personal protective equipment (PPE) during the COVID-19 pandemic, paras 4.5, 4.10 19 Qq 194–197, 248, 267–268 20 Letter from Department of Health & Social Care, 15 January 2021 COVID-19: Government procurement and supply of Personal Protective Equipment 15 is not complete, both because the calculation does not include PPE which the Department hopes to use for different purposes to that for which it was intended, and because much PPE is yet to be received or tested. The Department accepted that this figure would change as it finished its process of checking. The NAO report found that the Department had identified 195 million items of PPE that were unusable or potentially unsuitable, which would be around 1% of the items received to date.21 The Department explained that this included a wider group of products, including those which could not be used for their intended purpose but could be used in other ways.22 In its letter after our evidence session, the Department stated that its updated estimate was that 1.3% of the items bought were not fit for the original intended purpose and that 0.4% were not fit for any purpose. The letter did not provide information on the number of items tested to date.23
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Government response AI summary
The government response explicitly addressed PAC recommendation 7a, concerning a detailed breakdown of unusable PPE, rather than the provided committee conclusion about the Department's figures on unusable PPE.
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HM Treasury
19
Conclusion
Forty-Second Report - COVID-19: Governm…
Not Addressed
The Department told us that it had not been complacent over the stockpiles, but that COVID-19 was a novel virus and it learned more about it over time. Unlike influenza, COVID-19 can be passed on by people who are not showing symptoms of the illness. The Department explained that this …
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The Department told us that it had not been complacent over the stockpiles, but that COVID-19 was a novel virus and it learned more about it over time. Unlike influenza, COVID-19 can be passed on by people who are not showing symptoms of the illness. The Department explained that this meant government needed to provide PPE to a much larger group of people to stop the spread of the virus. It also said that while there were vaccines and antiviral medication available for managing influenza, this was not the case with COVID19, and that government did not have the gowns needed for managing COVID-19 because its infection control policy had been to use aprons rather than gowns.29 The experience of frontline organisations
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Government response AI summary
The government response addressed a different PAC recommendation (PAC recommendation 2) concerning PPE management and distribution, rather than the provided conclusion about the Department's perspective on stockpiles and the nature of COVID-19.
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HM Treasury
24
Conclusion
Forty-Second Report - COVID-19: Governm…
Not Addressed
Witnesses from organisations representing staff working in health and social care told us that providers received unusable PPE from central government. The Royal College of Nursing told us of instances where it had received masks on which the elastic was rotten, goggles which took significant amounts of time to assemble …
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Witnesses from organisations representing staff working in health and social care told us that providers received unusable PPE from central government. The Royal College of Nursing told us of instances where it had received masks on which the elastic was rotten, goggles which took significant amounts of time to assemble and were later recalled for being unsafe, and of opening a box of gowns to find insects inside. It also told us that it had received stock with stickers with dates showing the products had passed their expiry dates, and new stickers replacing these, with no explanation of any process to assure that the equipment was still safe. It noted that frontline staff were faced with unfamiliar-looking PPE and lacked confidence whether it was safe, and they were sometimes very frightened as a result. UNISON agreed that similar experiences were causing distress and anxiety to frontline workers.40 In its letter to us after our evidence session, the Department stated that it had recalled and quarantined 40 million items of faulty PPE.41
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Government response AI summary
The government response explicitly addressed PAC recommendation 7a, concerning a detailed breakdown of unusable PPE, rather than the provided committee conclusion about witnesses' experiences with unusable PPE.
Read full response →
HM Treasury