A plan for PPE?

The UK government has now published its plan for Personal Protective Equipment) for frontline health workers.

The plan incorporates 3 strands for guidance, distribution and future supply.  It seems to follow the kind of line adopted by the Health Secretary when he urged doctors and nurses to treat PPE as a 'precious resource' and not to misuse it.  

This wasn't well-received by bodies representing the various strands of Health Care workers, not least the Royal College of Nurses. 

The plan instead restates the obvious.  

1) guidance: being clear who needs PPE and when, and who does not, based on UK clinical expertise and WHO standards. This will ensure workers on the frontline are able to do their jobs safely, while making sure PPE is only used when clinically necessary and isn’t wasted or stockpiled

2) distribution: making sure those who need PPE can get it and at the right time. The government will ensure those who need critical PPE receive it as quickly as possible by setting up a new national supply system

3) future supply: taking action to secure enough PPE to see us through the crisis. The actions are being taken to ensure we have enough critical PPE to last the UK through the coronavirus (COVID-19) pandemic, working alongside industry to boost future supply

Rather than presenting a plan, it is more a statement of reality. 

It says 

The UK was well prepared with a national stockpile of PPE which had been reserved for our preparations for an outbreak of pandemic influenza and no-deal Brexit.

If that was the case, then it begs the question of why so many nurses have been without them.

In England we held circa. 50,000 pallets of medicines and consumables (including PPE) to be able to respond to a future UK pandemic with the Devolved Administrations holding stockpiles separately for each of their nations. Circa. 25,000 of those pallets held PPE and hygiene products.

So what went wrong?

In all 761 million items of PPE have been distributed across the UK since 25th February.  Yet, the BMA found that many doctors and nurses were reporting shortages.

The problem is said to be logistics.  Which is why the government have brought the army in to help distribute supplies to the 58,000 healthcare settings including GPs, pharmacies and social care providers.

The problem also lies in the 'just in time' manufacturing, where huge stockpiles are not kept in warehouses.  

The new system has started by operating a ‘push’ model, with essential equipment being issued to NHS Trusts based on the expected number of COVID-19 patients. 

"Once the flow of PPE stabilises, we anticipate returning to a more systematic approach based on the demand signals from each Trust."The government say they have introduced a system that can rapidly respond to areas of need.  The new policy requires a lot of joined-up work between various agencies.

Thus, the plan appears to be to make the distribution more responsive to need by increased coordination of agencies involved.   The take-home message is "we have the supplies, but we need to get it distributed more efficiently."

Yet the story often peddled is that the shortages of PPE are worldwide and we have to compete for the kit on that market.

The third part of the plan is to identify sources of PPE and enhance the purchasing of supplies.

At least we now have a published plan.  It does more to tell us what went wrong that it does to give confidence that these problems are being corrected.

If preparation had been made in logistics, many of the shortages could have been avoided.  Let us hope the plan works.  It is not so much a plan as a response, but let's not quibble.