Doctors working in the riskiest areas of the UK’s hospitals with Covid-19 patients are finding it harder to get protective kit, despite ministerial pledges to solve the problem, research reveals.
The Royal College of Physicians has condemned the apparently worsening availability of personal protective equipment (PPE) as “truly terrible” and warned that frontline staff’s lives are at risk as a result.
Among doctors performing aerosol-generating procedures (AGP), in which patients with the disease release droplets from their mouth, 37% cannot always access a visor to wear while 31% have not been able to obtain a full-length surgical gown. Both are key elements of the full PPE NHS staff are advised to wear when participating in an AGP, such as a patient being intubated before being ventilated.
A survey undertaken by the college, to which 2,129 hospital doctors responded last week, found medics are finding it harder generally access to any sort of PPE. Just over a quarter (27%) said they could not get the kit they needed to keep them safe while treating people with Covid-19, up from 22% who said the same when the RCP conducted the same survey at the start of April.
“We’re living through the darkest times the NHS has ever faced and this survey shows the reality of the situation facing hospital doctors at the moment”, said Prof Andrew Goddard, the college’s president.
“The lack of PPE remains their biggest concern and it is truly terrible that supply has worsened over the past three weeks rather than improved.”
In remarks that lay bare leading doctors’ frustration with ministers’ repeated emphasis on the hugely increased amounts of PPE that have reached the frontline in recent weeks, Goddard added: “Healthcare workers couldn’t care less how many billion pieces of PPE have been ordered or supplied. If it isn’t there when they need it, they are in harm’s way.”
Dr Matthew Roycroft, the joint chair of the RCP’s trainees committee, hinted that some doctors may decide to withhold treatment amid the PPE shortage. “Without the right PPE my colleagues and I may find ourselves with the most awful of conundrums on our hands – having to choose between protecting our own lives or protecting those of the patients we treat.”
Hospital bosses said the college’s findings underlined the need for any future inquiry into the UK’s handling of the pandemic to include the action taken on PPE.
Chris Hopson, the chief executive of NHS Providers, which represents health service trusts in England, said: “Trust leaders have told us that, in general, after a difficult start, with the exception of visors and gowns, they now have the PPE they need.
“It will be important – when the time comes for a public inquiry – to examine why the pandemic stockpile was not configured for an epidemic like the one we face today and didn’t have enough gowns and visors.”
Niall Dickson, his counterpart at the NHS Confederation, said that while the self-selecting nature of the survey meant its findings should be treated with caution, shortages were continuing in some areas, though overall the picture is improving. Priority should now be given to getting PPE to GP surgeries, care homes and community-based health services, Dickson added.
Meanwhile, 61% of family doctors are no longer seeing a patient unless they have adequate PPE, according to a separate survey, of 675 self-selecting Gps by the medical website Pulse, while 74% said they fear for their health and their life, it emerged.
Although many GP appointments are now being conducted by telephone or video link, some patients are still coming into surgeries for a face-to-face consultation.
Many GPs have trouble getting hold of face masks, visors or goggles and gowns. Only a third said they had enough masks, for example.
Pulse also found that among GPs who responded:
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52% feel unsafe because of PPE shortages.
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26% have seen Covid-positive patients without proper PPE.
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One in five GPs have had Covid-19 or assume they have.
The Department of Health and Social Care said: “We are working night and day to ensure our frontline health and social care staff have the equipment they need to tackle this virus, and have delivered over a billion items of PPE since the outbreak began.
“Lord [Paul] Deighton is leading the national effort to increase domestic production scaling up existing manufacturing whilst tapping into new resources. In addition, there is a significant international strategy to ensure that we have the PPE we need.”