PPE SCANDAL TOLD NOT TO
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URGEONS are being advised “not to risk their health” by working without adequate personal protective equipment (PPE) amid fears that hospitals could run out of supplies this weekend.
The Royal College of Surgeons of England (RCS) said it was “deeply disturbed” by changes to official guidance, which now states healthcare professionals could be asked to reuse items when treating Covid-19 patients.
NHS Providers said yesterday afternoon that the supply of clinical gowns was now “critical”, while unions leaders warned faith in Health Secretary Matt Hancock is “draining away” over the shortage in supplies.
On Friday evening, Public Health England (PHE) reversed its guidance which stipulated that long-sleeved disposable fluid repellent gowns should be worn.
If the gowns are not available, clinical staff are now advised to wear “disposable, non-fluid repellent gowns or coveralls” or “washable surgical gowns”, with aprons, and to wash their forearms afterwards.
The updated guidance states that the “reuse of PPE should be implemented until confirmation of adequate re-supply is in place”, and that “some compromise is needed to optimise the supply of PPE in times of extreme shortages”.
Professor Neil Mortensen, president-elect of the RCS, said the updated guidance implied that surgeons may not require adequate PPE, which he called “simply unacceptable”.
He said that like all doctors, surgeons are committed to their patients and “many will put themselves in the firing line” during the crisis.
But Prof Mortensen echoed advice from the Royal College of Nursing (RCN) that says nurses should refuse to treat patients “as a last resort” if not provided with adequate equipment.
“If fluid repellent gowns or coveralls are not available, then surgeons should not risk their health,” he said in a statement.
A Department of Health spokesman said on Friday: “New clinical advice has been issued today to make sure that if there are shortages in one area, frontline staff know what PPE to wear instead to minimise risk.”
The Government has been under fire for weeks over the distribution of PPE, with some frontline staff warning that they have had to work in situations where they feel unsafe.
At least 50 NHS workers have now died after contracting coronavirus.
A British Medical Association (BMA) survey of more than 6,000 doctors across the country said a significant amount of them remain without the protection they need to guard against Covid-19.
It echoed another survey of 14,000 medical staff by the RCN, which found half of nurses have felt pressure to work without appropriate protective equipment during the crisis.
Doctors and nurses should not be asked to “put their lives on the line” to save others, the BMA said after they were asked to reuse protective equipment.
Dr Rob Harwood, BMA consultants committee chairman, said it was “a further admission of the dire situation that some doctors and healthcare workers continue to find themselves in because of government failings”.
He said: “Telling staff to use aprons in the place of gowns directly contravenes both Public Health England’s previous guidance and that of the World Health Organisation.
“This is guidance that’s there to help keep healthcare workers and their patients out of harm’s way.
“If it’s being proposed that staff reuse equipment, this must be demonstrably driven by science and the best evidence – rather than availability – and it absolutely cannot compromise the protection of healthcare workers.”
Dr David Bailey, Chair BMA Welsh Council, said: “Whilst we have been assured by Welsh Government and Shared Services that there is currently enough PPE stock in Wales to cover demand, and that they are working hard to maintain levels, these are fluctuating. We continue to push for transparency and the publication of data at local and national levels and, by working with our members, are closely monitoring the situation on the ground. We simply cannot compromise on the safety of those working to protect us.”
The Royal College of Nursing chief executive Dame Donna Kinnair said the body was not consulted about the change, adding it was “unacceptable” if PPE was not provided in a healthcare setting.
She said: “Only sound scientific evidence or safety concerns should change the guidance.
“We have written to the HSE in the strongest terms to voice our concerns. Nursing staff need to be afforded proper protection full stop.”
Saffron Cordery, deputy chief executive of NHS Providers, which represents hospital trusts, said yesterday that the supply of clinical gowns was critical, calling it an “extremely worrying situation”.
“The absolute priority is for frontline staff to be able to feel safe and have access to the best possible PPE available,” she said in a statement.
“Trust and national leaders have been working around the clock to secure supplies of gowns, but the stock is just not yet available in the quantities needed.”
She said the new guidance on PPE usage to manage the shortage is endorsed by the World Health Organisation (WHO).
Local Government Secretary Robert Jenrick, giving the Government’s daily briefing at Downing Street yesterday, said “a very large consignment” of PPE – including 400,000 gowns – is due to arrive in the UK from Turkey today.
He said: “Today I can report that a very large consignment of PPE is due to arrive in the UK from Turkey, which amounts to 84 tonnes of PPE and will include for example, 400,000 gowns – so a very significant additional shipment.
“But demand is also very high. We are working with British manufacturers to ensure that they can make a contribution, and you’ve heard of some of the more prominent ones like Burberry and Barbour but there are many SMEs as well being involved in that, and my department is also involved in trying to ensure that the supplies that we have get out, not just to the NHS, critical though that is, but also to social care, often to smaller establishments like care homes, all across the country.
“There’s over 50,000 healthcare settings like that in the country, and we’re using local resilience forums, backed by almost 200 military planners to do the logistical task of taking the stocks that we do have, and getting them to the front line, but I completely accept that this is extremely challenging.”