PPE: a problem yet to be fixed

by Keith Cooper

The BMA continues to take robust action on PPE after doctors reported continuing shortages and resulting severe stress and safety concerns

Location: UK
Published: Wednesday 10 June 2020

The struggle to obtain protective gear in hospitals and GP surgeries has faded from headline news in recent weeks.

However, it’s still a problem for many doctors on the front line, according to the latest and fifth BMA tracker survey. These trackers have kept tabs on supply issues since they first emerged.

The survey of 8,455 doctors, carried out at the end of last month, shows a continued trend in improvement in some areas. But that’s only part of the story. A significant proportion of doctors still report struggling to access basics: masks, gowns, and protective glasses. The supply problem now seems chronic and months of struggle is now hitting staff mental health.

‘The ongoing lack of NHS PPE [personal protective equipment] causes unnecessary anxiety,’ one male GP, aged over 55, said. ‘We have not received full PPE at the surgery’.

 Lack of access to PPE and ‘communication difficulties’ had led to short tempers and intolerance, another doctor describes. ‘Often you come on shift to find others at their wits’ end and instead of being the peacemaker, you end up feeling we’re all in the same boat, suck it up.’

Mask supply

In the latest survey, around one in five respondents reported shortages – or no supply at all – of FFP3 (filtering facepiece 3) masks when working in more risky areas where AGPs (aerosol-generating procedures) are carried out – a similar proportion to the late April tracker.

The supply of masks to doctors in other areas, including general practice, has also not improved. Access to disposable gowns and aprons has got better in AGP areas but worse for doctors in non-AGP areas, the results show.

These trends were reflected in doctors’ comments, several of which pointed to the early problems and improved access but also to residual anxieties brought on by shortages – and their apparent and sometimes devastating effect.

The lack of PPE causes unnecessary anxiety

Junior doctor

One doctor told of her husband’s admission to hospital with COVID-19 and pneumonia, after they were refused access to PPE.

‘With two young boys at home and both of us unwell, without family in the UK, I was very stressed,’ they added.

‘We had the support from our next-door neighbours and friends who offered help and we are very grateful.

‘Colleagues from the ward became unwell within days of the exposure and we had a sad fatality. One of the nurses died from COVID-19 infection,’ this doctor added.

‘This has been very difficult for me, my family and the team from the ward. Stress has affected my children as well, and my younger son developed anger from all of this.’

This latest survey also reflected previous findings that many doctors felt pressured to see patients without adequate protection. Almost one in three (28 per cent) of doctors said they had felt such pressure often or sometimes.

There has been a big national push on PPE, headed by the Conservative peer who ran the 2012 Olympics, Paul Deighton, a former investment banker. The Army was drafted in early on and a private delivery firm, Clipper Logistics, was contracted.

Poor fit

The BMA has called for ministers to take whatever action is necessary to scale up production in the UK. It has urged health secretary Matt Hancock to explore overseas suppliers and tap into EU joint-purchasing arrangements.

The association has flagged the struggles of female doctors to find masks that fit, leaving some with sores and ulcers after long shifts. ‘PPE is too often neither personal nor protective for women,’ BMA consultants committee deputy chair Helen Fidler has said.

Colleagues became unwell within days of the exposure

Consultant

With dental surgeries due to open in June – and demand for non-COVID care rising – the need to sort out the PPE supply chain fiasco is all the more pressing. Around four in 10 respondents to the survey reported a significant increase in demand for non-COVID patient care. More than half (52 per cent) were ‘not all confident’ or ‘not very confident’ that they would be able to manage patient demand as normal NHS services resumed .

Despite better access to PPE, the supply problem of protective gear looks likely to be around for some time.

BMA council deputy chair David Wrigley said that while PPE problems varied across the country the survey showed it remains a significant problem.

‘Despite all the Government promises on PPE supply it is unacceptable we see doctors anxious and worried about a lack of proper protection in their workplace. We need to hear from doctors about this and ask them to contact us via first point of contact.’ 

Guidance for BMA members

As well as taking robust campaigning action to secure a better supply of PPE, the BMA has also produced extensive guidance for members.

The BMA website has information on areas such as the PPE doctors should expect, guidance on usage, specific concerns about CPR, and for doctors who have beards for religious reasons.

To contact the BMA, call 0300 123 1233 or email