Frontline staff hit out at PPE report
AN OFFICIAL report praising how Wales “responded well” to source Personal Protective Equipment (PPE) during the Covid crisis has come under fire from frontline workers.
A new report by the Auditor General for Wales repeats the commonly used line from the Welsh Government that Wales never ran out of PPE at the height of the first wave in March and April last year.
But critics suggest this fails to take into account the lived reality of Wales’ brave frontline workers, some of whom had to go to work without even the most basic protective equipment.
They say that while it may be true that Wales always had some supplies of PPE in a warehouse, this means little to those risking their lives because of a lack of supply.
Last April, Aberdare nurse Gareth Roberts died with Covid. Following his death, health officials said they would investigate after family friends claimed
he had been sent to look after Covid patients with “a paper mask, plastic gloves and a pinny”.
Responding to the new report Janette Leonard, a family friend of Mr Roberts who crowdfunded for his family after he died, said: “I don’t suppose they did run out but proper PPE suitable for a raging virus was never, ever supplied.”
Last March, the chairman of the British Medical Association’s (BMA’s) Welsh Council said some GPs were opting to wear goggles bought from DIY stores because the eye masks that had been delivered to surgeries were inadequate.
We have spoken to care home workers and professional bodies all of whom feel that the report fails to acknowledge the fact that a great many workers were left undefended by the lack of PPE.
Nicky Hughes is an associate director of nursing at nursing union RCN Wales.
She pointed to surveys of members in April last year.
These included:
■ Over half of nursing staff in Wales felt pressured during the pandemic in April 2020 to care for a patient without adequate PPE;
■ 49% of those working in high-risk areas reported they had been asked to reuse items of PPE that were marked single use by the manufacturers; and
■ 59% said they had concerns about PPE but only 18% for the concerns have been fully addressed.
“Members were telling us that the lack of PPE was classed as a burden of immense stress and anxiety for stuff members and the patients they would be caring for,” she said. “April was the real crunch time.”
Ms Hughes believe that the report is fair in acknowledging the immense challenge faced by NHS shared services and the fact they did worked hard to make up the shortfalls.
When asked if she though the report underplayed how many staff went without PPE initially she said: “Yes definitely. Getting the PPE from wherever it was to that nurse on the frontline [was an issue].
“Our members were telling us that they didn’t always feel that they had the PPE that they needed. This is about people not being able to put their hands on the PPE that they needed.
“In those early days we had a lot of people raising concerns. They were ringing our helpline for advice.
“We work very closely with Welsh government and are very vocal.”
She also felt the report failed to highlight how inappropriate the back-up stocks in place before the pandemic were.
She added: “The other thing I feel It needs to go further in highlighting is that the pandemic stocks were not adequate. They were inappropriate. And we need to plan now how we are going to stop something like that happening again in Wales.”
This was echoed by Dr David Bailey, BMA Cymru’s council chair.
He said the Welsh Government and NHS Wales Shared Services “eventually provided a good level of PPE” – but that they needed to learn lessons.
“These lessons include better communication between health boards, Welsh Government and NHS shared services to ensure a rapid and effective response,” he said.
“For example, the disconnect between Welsh Government reports of PPE supplies and frontline staff reporting a lack of.
“Additionally, future modelling and a full evaluation of the UK-wide and global response to a health crisis such as this will help to ensure staff in all healthcare settings are properly protected”
The sector which most suffered from a lack of PPE was in Wales’ care homes.
Care home bosses across Wales have recounted the challenges posed by the limited availability of personal protective equipment in the early weeks of the pandemic.
Ceri Roberts, MD of Cariad Care Homes, has described the supplies her two care homes in Gwynedd were receiving a year ago as “laughable”.
She said the amount of the PPE delivered to the homes fell a long way short of demand, questioning the assertion that the Welsh Government had sufficient supplies.
“If it was the case that the Welsh Government was not short of PPE then this was not reflected in what was being made available to social care providers,” said Ms Roberts, who runs the Bodawen home in Porthmadog and Plasgwyn in Criccieth.
“We had to wait to receive PPE from the local authority. Once they did start arriving the amount we received was laughable.
“You didn’t know what was going to be delivered, or when. You might receive a couple of boxes of gloves, which would last only a very short time due to how frequently our care practitioners had to change them.
“The situation created added pressures for us, during a period of time that was already extremely challenging.”
Ms Roberts’ frustrations over the situation were compounded by being unable to purchase PPE online from two major suppliers as they were only delivering to care homes in England.
This was a key difference between England and Wales. The UK Government sent all of the English supplies of PPE to wholesalers who were able to quickly distribute it to homes. In Wales the Welsh Government opted to send it directly, which at times led to long delays.
Another care home boss who has been frustrated is Glyn Williams, owner of the Gwyddfor Care Home in Boddern on Anglesey.
“I can’t say how much PPE there may have been in Wales a year ago but we certainly didn’t see much of it,” said Mr Williams.
“I have considered the amount of PPE provided by the Welsh Government to be inadequate.
“Some of the equipment we have received has been of poor quality and cannot be sanitised.”
Mario Kreft, the chair of Care Forum Wales, added: “In the early days of the pandemic there was a desperate shortage of the PPE available to care homes so it comes as a real surprise to hear that the Wales Audit Office say that supplies never ran out in Wales.
“It’s clear that the Wales Audit Office did not consult the sector in any depth before compiling the report as they would have no doubt reached different conclusions.
“They have clearly asked for the views of the Welsh Local Government Association and wrongly assumed that covered social care.”
Mr Kreft was very keen to point out that since last spring, supplies have been far more reliable and they have now got adequate PPE.
Plaid Cymru health Spokesperson Rhun ap Iorwerth said the planning was “woefully inadequate”.
“Things have clearly settled down now in terms of PPE supply, and that’s good to see, but we all remember the many examples of PPE shortage in the early months of the pandemic with frontline staff fearing for their own safety and that of the people they were caring for.
“Last April the Royal College of Nursing found 54% of its members surveyed ‘felt pressured’ to care for
patients ‘without adequate protection’.
“It is evident that pandemic planning by UK and Welsh Government was woefully inadequate.”
The Audit Wales report says the Welsh Government and NHS Shared Services responded well in challenging circumstances to source Personal Protective Equipment
It says that “working collaboratively, NHS Shared Services and other public services overcame early challenges to provide health and care bodies with the required PPE without running out of stock at a national level”.
We contacted the Auditor General’s Office, who drew attention to the parts of the report which said the focus on the national efforts to supply health and social care in Wales. They added: “The report emphasises that we have not reviewed arrangements for local procurement of PPE by NHS and local government bodies, nor the logistical arrangements in place locally to distribute PPE directly to frontline staff.
“We have, however, reflected evidence collected by professional bodies about the views of front-line staff.”
On the accusations of not taking into account the examples of staff working without any PPE a spokeswoman added: “Paragraphs 1.43 onwards in our report include more detail about the findings from surveys by the British Medical Association and the Royal College of Nursing and on some wider matters relevant to the points you have raised.
“As part of that commentary, we felt that it was important to reference data from other sources relating to cases and deaths among health and care workers (data collected by the Office for National Statistics and the Health and Safety Executive).
“However, we emphasised that there are various limitations noted with the data in both cases and care needs to be taken when interpreting the findings.
“We do not have hard evidence that any of these cases or deaths were caused by occupational exposure, or more specifically by a shortage of suitable PPE.
“We did not examine these issues and any possible root causes in more detail as part of our work. Indeed, it is not our role to examine the cause of deaths.
“As we say in the report, the Welsh Government has emphasised to us that NHS Wales has well-established processes to ensure that staff and patient deaths are appropriately reported, fully investigated and where appropriate referred to the coroner, and that it is from these processes that it and NHS Wales will gain evidence on any potential systemic failures, including in the supply or use of PPE, that have resulted in work-related deaths from Covid19.”