Some NHS trusts are going to run out of fully protective gowns within the next 24 to 48 hours, with thousands of doctors and nurses voicing concerns about inadequate supplies of personal protective equipment (PPE).
NHS Providers, which represents hospital trusts, says supplies of long-sleeved disposable fluid repellent gowns have been exhausted despite remaining stock being carefully allocated to the hospitals most in danger of running out.
On Friday, Public Health England changed its guidance – asking doctors and nurses to work without full-length gowns and to reuse items – but the updated stance has drawn criticism from several healthcare bodies.
The British Medical Association has warned that doctors and nurses should not be asked to put their lives on the line to save others, and said PHE’s decision was a further admission of the dire situation that some doctors and healthcare workers continue to find themselves in because of government failings.
Dr Rob Harwood, who chairs the BMA’s consultants committee, said: If it’s being proposed that staff reuse equipment, this must be demonstrably driven by science and the best evidence – rather than availability – and it absolutely cannot compromise the protection of healthcare workers.
The Royal College of Nursing echoed these concerns and claimed it was not consulted about the change in guidance, adding it was unacceptable if PPE was not provided in a healthcare setting.
At least 50 NHS workers have now died after contracting coronavirus.
According to a BMA survey, approximately one third of doctors working in high-risk areas said they were sometimes pressurised to work without adequate protection.
Meanwhile, 50% of doctors who work in high-risk areas said there were shortages of long-sleeved disposable gowns and disposable goggles – or no supply at all. In the survey, 56% said the same regarding full-face visors.
One of the doctors surveyed said current levels of PPE left them feeling as though they were being thrown to the wolves, with BMA council chairman Dr Chaand Nagpaul warning: Too many doctors and healthcare staff have already lost their lives. We cannot afford to risk losing any more.
A separate survey by the Royal College of Nursing revealed that 50% of nursing staff have also felt pressure to work without appropriate PPE during the coronavirus crisis.
Of the 14,000 respondents, 12% said they had relied on face or eye protection that they had bought themselves or made at home, while just 54% said they believed they had an adequate supply of alcohol hand gel.
Just over half of those working in high-risk areas said they had been asked to reuse items of PPE that were marked as single use by manufacturers.
The Royal College of Nursing has previously urged its members to refuse to treat patients as a last resort if adequate PPE cannot be provided.
Public Health England’s new guidance says PPE should be reused until conformation of adequate resupply is in place, and that some compromise is needed to optimise the supply of PPE in times of extreme shortages.
A previous recommendation that stipulated long-sleeved disposable fluid repellent gowns should be worn when treating COVID-19 patients was reversed.
If these gowns are not available, clinical staff are now being advised to wear disposable, non-fluid repellent gowns or coveralls or washable surgical gowns with aprons, and to wash their forearms afterwards.
Saffron Cordery, the deputy chief executive of NHS Providers, has said it is hoped the disruption was short-lived, and that gowns would start arriving consistently and reliably rather than in the current fits and starts.
National leaders have told NHS Providers that the supply of aprons, fluid repellent masks, gloves and face masks currently look fine.
The Welsh government has said that it currently does not anticipate any disruption to its PPE supplies.