Rapid review of PPE guidance ordered by the centre

During the first NHS England and Improvement board meeting since the widespread outbreak of covid-19 in the UK, national medical director professor Stephen Powis said the report would be available within days.

The announcement was made in response to a question from NHSE vice chair David Roberts who said the availability and suitability of PPE was “clearly a cause of significant concern”.

PPE shortages and standards have drawn ire across the NHS; in a survey for HSJ 24 chief executives said they were most in need of FFP3 masks, while 21 said they needed visors. One chief said a “lack of clarity in PPE guidance is exacerbating the PPE shortages”, indicating that more is being used than may be necessary.

There are anecdotal reports that some staff are declining to treat patients in a range of circumstances without PPE, which may or may not all require PPE, depending on evidence and guidance.

Professor Powis said while the guidance had changed to reflect the severity of the virus, aligning with World Health Organisation guidelines, and indicating a lower PPE requirement, it still required work.

He said: “I realise how important it is for staff to feel confident that they are using PPE with guidance that is best in class and I think it’s really important that that guidance is of an international standard and in some areas it exceeds international standards where it’s appropriate.

“So to get confident that is indeed the case, the government’s chief’s scientific adviser, the chief medical officer and myself have in the last day asked for an independent rapid review to give us and the public confidence that we are indeed using guidance that is of that high standard.

“I expect that report to be available in the next day or two and I think that will be critical among a number of other things, such as the supply chain… to give everybody the confidence that we have the appropriate measures in place to protect our staff.

“It’s critical our staff feel confident.”

Professor Keith Willett, NHSE strategic incident commander for coronavirus, also outlined efforts made to deliver “tens of millions of gloves, millions of face masks and eye protection” and doing so on a “push model” which estimates PPE need for hospitals “delivering it whether they ask for it or not”.

Asked to contextualise the scale of the response to coronavirus, NHSE chief executive Sir Simon Stevens said: “I don’t think actually in the history of the NHS there has been anything quite like it.”

He compared the effort to that of London hospitals and emergency services during the second world war but added: “The reality is that this is now playing out across all services in all parts of the country.”

Nonetheless, Sir Simon also said there would be a “silver lining” for the NHS from some of the changes taking place.

He said: “Every country is confronted with this and is obviously putting great pressure on our frontline staff, who have also responded brilliantly, but it is also driving a lot of changes that, to me, turn out to be very desirable changes. So there will be a silver lining to this very difficult set of circumstances.”