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Doctor with PPE edited

The Government's PPE failure

Thomas Martin
December 29, 2020

2020 has not ended the way we all hoped. Coronavirus cases are rising, and hospital admissions are mirroring April levels. Thomas Martin gives his experience of the Government's handling of procurement for PPE during the first peak of the coronavirus pandemic, and offers a series of recommendations to strengthen the UK's resilience and prevent a repeat of the PPE crisis in the months ahead.

With the emergence of a new, much more transmissible strain of Covid-19 forcing the UK back into stringent lockdown measures, the time is right to examine some of the mistakes that were made in the early stages of the pandemic and understand the lessons we can learn as we look to a hard few months ahead.

In particular, the Government's handling of procurement for personal protective equipment (PPE) during the first peak has come under increased and sustained  parliamentary and media scrutiny.

Many of us remember the scenes from last Easter of doctors, medical staff and care home workers exposed to Covid due to a lack of proper protective equipment – and even being forced to make their own out of bin bags and other household items – as supply chains broke down in the face of border closures, export controls and unprecedented global demand.

The pressure the Government faced in trying to source and secure PPE at the onset of the pandemic was immense. The sheer volume of procurement activity during this time – with 8,600 contracts being awarded by the Department of Health and Social Care during the first lockdown period (in comparison to 174 contracts during the same period a year earlier) meant it was likely that some mistakes would be made. Some providers would not be able to deliver, and  inefficient contracts would no doubt be awarded for equipment that could have been sourced more quickly and cheaply from elsewhere.

However, it has since emerged through both media scrutiny and a National Audit Office (NAO) report that there were more fundamental problems with the way in which the Government sought to procure PPE in the early stages of the pandemic. The NAO has uncovered examples of PPE contracts being awarded through opaque processes to organisations with no history of PPE manufacture, expertise or supply, and who were ultimately unable to fulfil orders.

In some cases, non-compliant and sub-standard products were provided that increased the risks to wearers rather than mitigated them. Examples have also emerged of companies or individuals who were well-connected politically being awarded contracts to supply PPE, despite not having any relevant experience or apparent ability to deliver.

As the UK's largest distributor of health and safety equipment, with its own UKAS accredited product assurance laboratory, a 400,000 square feet National Distribution Centre and a sourcing team based permanently in China, my company Arco was at the forefront of the response. When the pandemic was declared in the UK, we played a key role navigating the global supply chain restrictions to supply the NHS directly. At the height of the first peak, over 291 NHS Trusts placed orders directly with us, with an average of 108 orders per day. We sourced and distributed over 140 million face masks, 18 million gloves and over 50,000 coveralls and 500,000 hygiene products for the NHS, ambulance services, local authorities and other public bodies.

Our experience on the front line of the response has given us a unique insight into the mistakes that were made as NHS Supply Chain's procurement structures collapsed under the pressures of the spiralling healthcare crisis. To manage demand, the NHS set up an entirely new set of processes – and drafted in military planners, Cabinet Office officials and external consultants to co-ordinate them. However, setting up completely new structures at the onset of the crisis meant suppliers lacked information and clarity about who they should be working with. Supply Chain Coordination Limited, the management function of NHS Supply Chain, seemed unable to play its part.

The Government set up an online portal so suppliers could register their interest. However, the portal did not require suppliers to provide information about their experience or record in sourcing PPE, neither was proof of ability to meet obligations under the PPE Regulations required. This meant it was swamped with speculative offers, crowding out numerous reputable and established suppliers from a highly developed sector.

Often, those making procurement decisions had no experience in PPE purchasing, no understanding of the PPE market, nor the right level of technical understanding around compliance and quality assurance to make a decision on whether the PPE they were ordering met the right standards.

These mistakes had real life impacts. We are aware of a consortium of local authorities which procured face masks for use in social care settings, despite being shown evidence that they were non-compliant and would not offer the necessary protection. Another local authority purchased non-compliant gowns from Turkey which had been approved by a notified body that did not have the correct accreditation for such equipment.

I believe that Arco's experience and capabilities, together with our contribution to the pandemic response, gives us a moral responsibility to offer our views on what went wrong and what lessons we can learn for the future. To this end, we have published a position paper, 'Personal Protective Equipment and the Government's Response to the Covid-19 Pandemic', which sets out a series of recommendations on steps that can be taken to strengthen the UK's resilience and prevent a repeat of the PPE crisis in the months ahead. Our standing at the forefront of one of the UK's beacon global sectors also gives us the right to comment.

Our recommendations include a suggestion that the Government consult on whether PPE suppliers should be formally registered to be allowed to supply Category II and III products. This would ensure only suppliers capable of providing compliant products would be able to bid for contracts. In addition, the Department for Health and Social Care should conduct a thorough review and stress test of its purchasing framework from the perspective of both procurer and supplier. To make sure that only companies which can realistically fullfil orders of PPE to the right quality and standard are able to bid, the purchasing portal should be strengthened to include a more detailed pre-qualifying questionnaire to weed out non-serious offers. Procurement leads at NHS Trusts, local authorities and social care providers should be trained and up-skilled in PPE standards.

We are also calling for more transparency from the Government. Ministers should clarify how the PPE stockpile was risk assessed at the start of the crisis, and ensure that the evidence behind its assumptions about future need is made public so it can be tested and challenged. The Government should also set a roadmap for the full reimplementation of the PPE Regulations – which were scaled back during the crisis – to reduce the likelihood of poorer quality products entering the market.

It is only by understanding what went wrong, that preparations can be made for the future. I hope the insights in our position paper offer a valuable perspective. We have produced our recommendations in the hope that key lessons in the pandemic response can be identified, remedied, and future risks mitigated – in the spirit of the national public health effort to bring an end to the pandemic.

The UK has a world class safety sector. It should have been better deployed, but it can still make a massive difference as we plan for the future.

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Thomas Martin is Non-Executive Chairman of Arco, the UK’s leading safety products and services company.
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