PPE procurement is not robust enough and the UK government must clarify its strategy for having a reliable supply in the face of a potential second wave of Covid-19, according to MPs.
In a report the Public Accounts Committee (PAC) said it was “extremely concerned” about shortages of personal protective equipment (PPE) faced by NHS and care workers during the pandemic. It has demanded that the Department for Health and Social Care (DHSC) clarifies within two months when it expects to have a predictable supply of PPE, as well detail on the roles and responsibilities for its procurement and distribution across NHS and social care settings.
In its report the PAC said the government claimed that although it never ran out of PPE, the pandemic was putting supply chains under unprecedented pressure. However, the committee said it was not convinced that “procurement is robust enough”.
It added the government needed a clearer understanding of what was needed and how to distribute it, particularly in the more fragmented care sector.
The report said: “Although the department says it is committed to building up stocks to meet longer-term demand, we were not convinced that it was treating the matter with sufficient urgency. In particular, the governance arrangements to procure and distribute PPE across health and social care remain unclear and uncertainty prevails around future provision of local PPE across the health and social care sectors.”
The government said the main challenge had been to distribute the right PPE to the right place on a timely basis, according to the PAC. While national purchasing was sufficient outside of crisis time, it had moved from supplying 240 trusts to trying to supply 50,000 customers across health and social care. It was not able cope with the surge in demand and so had to put new arrangements in place in a short time.
The PAC questioned the government on the way it procured PPE, especially the challenges faced by its reliance on international markets.
“The department told us that there are decisions to be made about the resilience of its supply chains,” said the report. “It noted that building up domestic production is one thing it can do to make supply chains more resilient. However, it conceded that in the current crisis, although domestic production will make a contribution, there is no imminent possibility that it will replace what it needs to buy on the international markets.”
The PAC also said the crisis could not be used as an excuse not to address long-standing issues, highlighted in previous committee reports, such as workforce shortages, coherent and aligned capital investment strategies, and tackling trust deficits.
It added that additional NHS funding, including writing off £13.4bn of loans, did not address underlying issues of NHS financial sustainability and increasingly poor performance against waiting times standards for A&E and cancer, and growing waiting lists for elective treatments.
The report included a raft of recommendations, including reviewing how the NHS would return to normal services after the Covid-19 peak, as well as providing a timetable for getting the 10 most financially distressed trusts back to financial balance.
The NHS should clearly communicate to the public the range and extent of health services that will be available, what patients can expect in terms of access and waiting times, and what it is doing to encourage patients to access services when they need to, the PAC recommended.
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