1/16 Clear some trusts will now run out of gowns. Explanation below - why, what’s been done to prevent this and what next? We are not the government or NHS England, we are the voice of frontline trusts. More info here: nhsproviders.org/news-blogs/pre…
2/16 Why is the NHS running out of gowns? Greatest risk of running out of stock in a pandemic is usually if the pandemic stock reserve runs out before the items ordered once the pandemic started begin to arrive consistently and reliably. This is what has happened with gowns
3/16 National leaders tell us that, at the moment, and with the exception of visors, gowns are the only item in the pandemic stock reserve that they are concerned will run out in this way. Aprons, fluid repellent masks, gloves, FFP2/3 masks etc currently look fine
4/16 Our dialogue with national leaders, and the views of the trust CEOs working alongside those leaders, is that no stone has been left unturned since the pandemic started to secure the right stocks of gowns but...
5/16...for the reasons set out in this article - theguardian.com/commentisfree/… - the gowns that were ordered weeks ago and should have already arrived are currently only arriving in fits and starts
6/16 What has been done to solve the growing shortage of gowns? National and local NHS leaders have worked well together in a six part approach 1. Carefully allocate remaining stock to trusts most in danger of running out. 2. Trusts carefully manage stocks
7/16 3. Mutual aid - trusts with a bit of stock to spare helping their neighbours 4. Get fantastic support from police, fire, vets, local councils who’ve provided their stock. 5. Use coveralls (gowns with hoods).
8/16 6. Do everything possible to get new stock e.g. emergency last minute deals and asking other near neighbouring countries for help. National leaders say latter shows we have been in better position than others
9/16 First five steps have worked well for last week but we have now reached the point where national stock of fully fluid repellent gowns and coveralls exhausted. So some trusts will run out of this type of gown/coverall in next 24-48 hours. What next?
10/16 Trust leaders and @NHSProviders asked national leaders, on several phone call meetings last week, to prepare a clear public plan should a trust run out of gowns so everyone knew what was happening and what next steps would be, especially frontline staff...
11/16...No-one wants to be in this position and has done everything to avoid it. But much better to have a public plan than pretend problem doesn’t exist or ignore it. National leaders developed this plan at pace and effectively
12/16 Trusts will continue to try and do six steps in approach outlined above. But if they run out of gowns they will then follow the agreed plan. This is best summarised as “provide the highest level of protection possible with the equipment available.”
13/16 For example the new guidance published tonight says to use disposable, non-fluid repellent gowns or coveralls with a disposable plastic apron for high-risk settings and aerosol generating procedures with forearm washing once gown or coverall removed.
14/16 This is clearly not ideal but is the best available option given the circumstances. National leaders tell us that a number of other European nations have had to do the same given the global shortages of gowns. Hopefully this temporary supply disruption will be short-lived
15/16 In the meantime, trust leaders will do everything they can to ensure every member of frontline staff has the highest possible level of protection equipment, where such equipment is required.
16/16 An obvious question for any Coronavirus public inquiry is why there were insufficient stocks of gowns (and visors) in national reserve. We understand this is connected to what type of pandemic (e.g. winter flu vs Coronavirus type pandemic) reserve was configured for
