Specialist nurses must be involved in decisions around what is bought, used and ‘clinically acceptable’ when it comes to the provision of personal protective equipment (PPE), an inquiry has been told.
Royal College of Nursing (RCN) professional lead for infection prevention and control and nursing sustainability lead Rose Gallagher today provided further evidence to the UK Covid-19 Inquiry – this time focusing on the procurement of key healthcare related equipment and supplies.
Drawing on thousands of concerns raised with the RCN in the early stages of the pandemic, Ms Gallagher stressed nurses must not be excluded from national procurement decisions in any future event, and that ‘innovation’ in respiratory PPE was required.
PPE ‘not fit for purpose’
In March 2020 alone, the RCN had received more than 3,500 queries relating to PPE, including 1,300 around a lack of access and 700 about a general shortage or a lack of specific items.
As well as a lack of supply, concerns had also been raised around the quality of the equipment given to nursing staff.
‘We had many concerns from members around material degrading, but particularly the nose bands,’ said Ms Gallagher.
‘Members reported some really quite distressing incidents of respiratory irritation where they were inhaling the fibres from these degraded masks.’
She said this had led to serious concerns that the PPE received by nursing staff ‘was not fit for purpose and potentially causing them harm’.
Ms Gallagher told the inquiry there was an urgent need for ‘innovation in respiratory protective equipment to avoid the issues that we’ve seen time and time again through the pandemic’.
‘That PPE has to be developed so that it’s not just acceptable for staff, but also acceptable for patients,’ she said.
‘Critical’ that nurses are involved in procurement
Examples where specialist nurses and other clinicians had not been involved in national discussions and decisions around the procurement of PPE were also highlighted during the inquiry meeting today.
In any future incident, Ms Gallagher stressed it was ‘absolutely imperative that frontline healthcare workers are involved’.
This was part in reason because nurses can ‘look at the needs of our colleagues’, including around different face shapes, different sizes and religious and cultural needs, she explained.
‘It’s absolutely critical that [nurses] are involved in decisions about what is bought [and] what is clinically acceptable in practice,’ said Ms Gallagher.
She added: ‘I’d like to reinforce the need for the clinical voice and specialist nurses to be part of all decision making relating to the procurement of PPE, but also that that process is transparent and formalised to avoid variation at a time of escalation.’
Ms Gallagher explained that specialist procurement nurses were under ‘extreme pressure’ during the pandemic, and felt ‘significant responsibility for ensuring that the correct and acceptable PPE was distributed to their colleagues in practice’.
But she said that this had been made more difficult by having several routes in place that they had to use to report concerns about the PPE being given.
‘This was very, very personal to procurement nurses. They took the time on top of everything else they were doing to report issues, but they had to be reported through multiple routes,’ said Ms Gallagher.
‘It took an extraordinary amount of time to do that, and on top of that, they rarely heard anything back.
‘So, in terms of learning for the inquiry, what we and specialist procurement nurses would like to see in the future is a one stop reporting system where the information is taken out, so you only have to report that particular issue through one particular portal.’
In November, Ms Gallagher had told the inquiry about the need for infection prevention and control guidance to reflect a variety of health and care environments to better protect nurses.
And in the summer of 2023, she also told the inquiry that those representing the nursing profession were ‘shut out’ of key decision-making during the pandemic.
At the weekend, Nursing in Practice attended an event hosted by the RCN to mark five years since Covid-19 was declared a pandemic.
The event heard reflections from the national chief nursing officers about the crisis, and concerns from the RCN’s chief executive and general secretary about the risk of the profession being seen as ‘dispensable’.