Specialist procurement nurses should be formally made part of all decision making on how personal protective equipment (PPE) is obtained, the RCN has told the UK COVID-19 Inquiry.
The voices of nursing staff using PPE on the frontline of COVID – particularly in the early months of the pandemic – were largely ignored, according to the RCN's Rose Gallagher MBE.
"We knew the value that nurses could bring to the selection of products. It was actually really upsetting... to find that the clinical voice was completely absent," Rose told the inquiry in her evidence on 18 March.
Rose – who was the RCN's Professional Lead for Infection Control during the pandemic – told the inquiry the procurement process should be transparent and formalised to avoid any variation in "a time of escalation", such as COVID. She called for PPE to be developed so it's acceptable for staff and patients, for staff to be fit-tested for PPE, and for the needs and experiences of black and minority ethnic staff in all health care settings to be taken into account, specifically in relation to the use of PPE.
Rose added that procurement nurses help eliminate waste by ensuring appropriate and high-quality equipment is purchased.
"It's absolutely critical that they're involved in decisions about what is clinically acceptable in practice," she said.
"We can also look at the needs of our colleagues that work with us, so they're very conscious of different face shapes, different sizes, religious and cultural needs, for example, bring that into the discussion."
The inquiry has been hearing testimony regarding the procurement and distribution of key health care equipment and supplies across the 4 nations of the UK, including PPE, ventilators and oxygen.
Rose told the inquiry how the RCN received an "unprecedented" 3,500 queries related to PPE as concerns ramped up in March 2020. Some members reported a general lack of access, while others were unable to get specific equipment, such as a fit-tested FFP3 respirator.
The RCN conducted 2 member surveys around the use and availability of PPE – in April and May 2020 – to gain a better understanding of the depth and scale of the problem members were reporting. Around 18,500 members responded in total.
Rose discussed some of our members' concerns from the surveys at the inquiry, including:
- being asked to re-use PPE designed for single use
- shortages of PPE, leading staff to put off going to the toilet or take breaks, knowing they would have to change their mask and risk depleting stocks
- inhaling fibres from degraded masks, leading to respiratory irritation
- concerns that Infection Prevention and Control (IPC) guidance was driving the supply of PPE, rather than by "what nursing staff on the front line felt that they needed"
- being asked to shave facial hair to be fit-tested, conflicting with religious beliefs
- a lack of eye protection, with concerns around potential infection through the conjunctiva.
These survey findings were shared with several health organisations including the Department of Health and Social Care, the UK Prime Minister, the Scottish Cabinet Secretary for Health and Sport, members of the Welsh Parliament, Audit Wales, the Health and Safety Executive, and NHS England and NHS Improvement.
Take the opportunity to have your say: share your experience of working throughout the COVID-19 pandemic with Every Story Matters. There's a separate listening exercise in Scotland where there is a nation-specific inquiry taking place.
