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GP practices and care homes at wrong end of Covid PPE ‘hierarchy’, inquiry told

GP practices and care homes at wrong end of Covid PPE ‘hierarchy’, inquiry told

A ‘hierarchy’ around personal protective equipment (PPE) in the early days of the pandemic left staff working in primary care, general practice and care homes with a lower standard of protection, the Scottish Covid-19 Inquiry has heard.

Norman Provan, associate director (employment relations) at Royal College of Nursing (RCN) Scotland, told the inquiry that ‘there appeared to be a hierarchy the further you got away from the very acute environments, in terms of both the availability and the type of PPE that was available’.

At a hearing last month, Graham Dunlop, junior counsel to the inquiry, asked Mr Provan: ‘In terms of the hierarchy, am I correct in understanding that the hierarchy was that ICU had the gold standard of PPE, and then as it filtered down the different wards in the hospital it wasn’t that gold standard, and then as it got further down to primary care, GPs and care homes it was of a lower standard again?’

Mr Provan answered: ‘Yes, I think that’s fair, particularly at the beginning when the big issue, of course, was securing the amount of PPE required. So, I know that in the community there was more frequent reuse of PPE and less of it.’

He added: ‘Care homes and small providers had their own method of purchasing PPE and of course every health system in the world was trying to get great amounts of PPE at quite short notice at the beginning of the pandemic, so for them it was particularly difficult to secure and increase their supply chain.’

Colin Poolman, director of RCN Scotland, also told the inquiry there was ‘huge difficulty in both procurement and the availability of PPE within the care home sector’.

He added: ‘It was an issue within the NHS as well, of course, but I would say it was more acute in the areas of independent and social care.’

However, Mr Provan commended the Scottish Government for the setting up of community hubs ‘which meant those environments like care homes which had difficulties securing their own PPE could phone and they would be supplied PPE from NHS stock’.

Also giving evidence, Eileen McKenna, associate director (nursing, policy and professional practice) for RCN Scotland, spoke of significant workforce issues going into the pandemic.

She said: ‘Pre-pandemic there were concerns around the number of vacant nursing posts across Scotland and prior to entering into the pandemic there was a growing crisis in the nursing workforce.

‘If nurses cannot provide the care that they feel or know the patients require because of staffing levels, that can have a detrimental impact on their own wellbeing.’

Mr Provan told the inquiry that, going forward, workforce planning ‘is an area that certainly requires to be looked at quite strongly’.

He also recommended closer collaboration between health boards and the care home sector, particularly regarding issues in relation to education, infection control assistance.

He said: ‘Many of the nursing homes don’t have the infrastructure that the NHS has in terms of diagnostics, cleaning, infection control provision, so I think there could be better collaboration between the health boards and local authorities in relation to the care homes and nursing homes in the area to import some of that expertise from the NHS into those environments.’

Also last month, the UK Covid Inquiry was told how ‘chronically under-resourced’ the care sector was to deal with the pandemic.


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