UK doctors threaten to stop treating COVID-19 patients over PPE

Furious doctors have warned they might be forced to stop treating patients as ministers admitted tonight that a crucial consignment of personal protective equipment has failed to arrive from Turkey.

Medical associations have warned that their members face difficult choices about exposing themselves and other patients to risk of infection, with fears that supplies of critical items are running low in hospitals.

Education Secretary Gavin Williamson said he ‘hoped’ the 84 tonnes of kit from Turkey would now be in the UK tomorrow, despite it having been announced with fanfare by Cabinet colleague Robert Jenrick last night.

But appearing alongside Mr Williamson at the daily Downing Street briefing, deputy chief medical officer Jenny Harries complained that critics are not being ‘adult’ about the problems with PPE.

She urged people to reflect on what had been ‘achieved’ in maintaining levels of equipment amid global pressures, and insisted the UK was an ‘international exemplar in preparedness’.

Dr Harries also played down concerns about revised guidance that some pieces of protective kit should be re-used, urging health workers to ‘implement’ the rules as effectively as possible.

The comments could inflame tensions with medical staff with the NHS Confederation joining the groups backing staff who refuse to treat patients unless they have adequate PPE, such as gowns, goggles and masks.

The Royal College of Surgeons, the Royal College of Nurses and Midwives, and the British Medical Association have also raised serious concerns.

The row comes as Britain recorded 596 coronavirus-related deaths today, bringing the national death toll to 16,060. Some 43 NHS workers are official confirmed as having lost their lives so far, although the true toll is believed to be higher.

Mr Williamson confirmed that the expected shipment from Turkey has been held up – although the cause is not clear. ‘We hope to see that coming into the country tomorrow,’ he said.

As the government scrambles to get a grip on the spiralling PPE situation, Health Secretary Matt Hancock has appointed former Olympics chief Lord Deighton as a ‘personal protective tsar’ to shore up supplies.

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Michael Gove admitted today that some PPE was sent to China during its initial outbreak – although he stressed it was not from core pandemic stockpiles and the UK had received ‘far more’ back from Beijing since then.

Even before the news on the delayed shipment, the BMA said last night it will support doctors who refuse to work without adequate PPE.

 Dr Chaand Nagpul, BMA council chair, said: ‘There are limits to the level of risk staff can be expected to expose themselves and their patients to. In the most extreme circumstances, if adequate protective measures are not in place, doctors can refuse to put themselves at risk of becoming infected, and inform their management to make alternative arrangements’.

Prof Neil Mortensen from the Royal College of Surgeons has told his colleagues not to risk their health if good PPE could not be used when treating coronavirus patients.

He said: ‘We are deeply disturbed by this latest change to personal protective equipment guidance, which was issued without consulting medical bodies.

‘After weeks of working with PHE and our sister medical royal colleges to get PPE guidance right, this risks confusion and variation in practice across the country.’

But Dr Harries said: ‘I think we have had, if I might say from my own professional perspective, we could perhaps have a more adult, and more detailed conversation about PPE supplies.

‘For example, quite rightly, the conversation at the moment is very much focused on gown supplies. Earlier, in earlier weeks, I’m very aware of consideration of eye-wear for example, in goggles and masks.’

Dr Harries called the pandemic a ‘huge pull on services which we have never seen before’.

She continued: ‘We have managed actually despite signalling many potential shortfalls to continue to supply going forward, and even as I stand here, I know with the gown position, for example, that even though when orders go in overseas, supplies may be very different what is received to what we think we’re going to get.

‘We perhaps need to, rather than lumping all of the PPE together, which is not a homogeneous mix at all, we just need to think carefully through what has been achieved and the challenges which are acknowledged ahead.’

Asked if she would be comfortable treating Covid-19 patients by re-using single-use PPE, Dr Harries said: ‘If I happened to be working on the frontline today I have a responsibility to look after patients to the best of my ability, to protect my colleagues and my staff and to manage my practice safely.

‘All of those in the current climate will mean that I need to understand the agreed guidance on PPE .. and to implement that whenever I can.’

She said it was ‘very easy to make a throwaway comment about single-use PPE’ but the situation was ‘actually quite complex’.

Dr Harries added: ‘It is the fact we are in a global shortage … we all need to use this PPE carefully.

‘Some sessional use is entirely appropriate. For example wearing a gown for sessional use with a disposable plastic apron on top of it is an entirely appropriate use of PPE.

‘In that example you can see there is one element of what some people may call re-use and one element of what some may call single use.’

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When asked why the Government has not responded to manufacturers willing to produce PPE, Mr Williamson said that they will be contacted in the next 24 hours.

The Education Secretary said that a billion extra PPE have been brought into the country while the Government was doing ‘immense work’ in trying to find British suppliers. He encouraged those suppliers who have been in contact with the Government and have ‘slipped through the net’ to get in touch again.

He added: ‘We recognise this is a national endeavour and we are so incredibly grateful for so many people who are willing to step forward to make a real difference, and we certainly don’t want to miss out on those opportunities.’

The press conference comes amid intensifying fears that underfunding during a prolonged period of austerity has left the NHS inadequately prepared in terms of PPE for a pandemic.

Mr Hancock appointed Lord Deighton, chief planner from the London 2012 Olympics, as ‘PPE tsar’ after the Government issued guidance stating that medics would have to re-use PPE supplies.

Lord Deighton, 64, who is personally known to Boris Johnson from the Olympics, will be charged of the ‘end-to-end process of design through to manufacture’ including streamlining approvals’, sources claim.

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