Forty-Second Report - COVID-19: Government procurement and supply of Personal Protective Equipment

Select Committee

Public Accounts Committee HC 928 10 February 2021

Report Status Government responded

Conclusions & Recommendations 29 items (11 recs)

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Government Response (AI assessment · 29 of 29 classified)

Accepted 14

Acknowledged 6

Deferred 1

Not Addressed 8

Government response

Treasury minutes: Government response to the Committee of Public Accounts on the Forty-second report from Session 2019-21 · published 3 Sep 2021

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Recommendations & Conclusions

8 results

2 Recommendation Not Addressed

While government had plans and a stockpile of PPE, this proved inadequate for the COVID-19...

Recommendation

While government had plans and a stockpile of PPE, this proved inadequate for the COVID-19 pandemic. The Department had a strategy for managing an influenza pandemic, which included a stockpile of PPE owned and managed by Public Health England. In … Read more While government had plans and a stockpile of PPE, this proved inadequate for the COVID-19 pandemic. The Department had a strategy for managing an influenza pandemic, which included a stockpile of PPE owned and managed by Public Health England. In March 2020, NHS England & NHS Improvement gave public assurances to the Health and Social Care Committee that the stockpile would be sufficient to manage the pandemic, but this confidence was misplaced since the stockpile held no more than two-weeks’ worth of most types of PPE. Furthermore, it did not hold all of the planned PPE, such as visors and gowns, and some of the PPE it did hold had expired or did not meet current safety standards. Government and its contractors also struggled to distribute the stockpiled PPE quickly. In response to these problems the Department created a parallel supply chain to buy and distribute PPE. However, because of the time lag between ordering PPE and it being available, this could barely satisfy local organisations’ requirements. Frontline staff in health and social care experienced shortages of PPE, with surveys by staff representative organisations showing that at least 30% of participating care workers, doctors and nurses reported having insufficient PPE, even in high-risk settings. Provider organisations attempted to buy PPE at short notice, in an overheated market, and COVID-19: Government procurement and supply of Personal Protective Equipment 7 found they needed to pay hugely inflated prices to suppliers they were unfamiliar with. The PPE from central government was sometimes not usable and providers told us that emergency helplines referred them to suppliers which did not have PPE. Recommendation: The Department must improve its approach to managing and distributing stocks of PPE to ensure the correct equipment gets to those who need it, when they need it. The Department should write to us by July 2021 to confirm that: • Stockpiles hold everything required as specified in the Depa Show less

Government Response Summary

The government response did not address the recommendation about improving PPE management and distribution, instead discussing an unrelated HMRC conclusion.

HM Treasury

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3 Recommendation Not Addressed

The high-priority lane was not designed well enough to be a wholly effective way of...

Recommendation

The high-priority lane was not designed well enough to be a wholly effective way of sifting credible leads to supply PPE. Government’s PPE buying team, within the parallel supply chain, received over 15,000 offers to supply PPE. This cross- government … Read more The high-priority lane was not designed well enough to be a wholly effective way of sifting credible leads to supply PPE. Government’s PPE buying team, within the parallel supply chain, received over 15,000 offers to supply PPE. This cross- government PPE buying team set up a high-priority lane to separately assess and process high-priority leads that it considered more credible, which sat alongside an ordinary lane to process other leads. Leads that were considered more credible were those from government officials, ministers’ offices, MPs and members of the House of Lords but it is not clear why this assumption was made. The priority lane did not include organisations with expertise in the health and social care sector that had existing relationships with suppliers through their members or directly and were well-placed to assess the credibility of potential PPE suppliers, such as the British Medical Association. Around one in ten suppliers that came through the high-priority lane were awarded a contract compared with one in a hundred for the ordinary lane. There were no written rules to support those making referrals in deciding which leads to put forward. Some of those making referrals that were considered high priority, such as MPs, passed on leads on the basis that others would assess their suitability rather than vouching for the credibility of those offers. The same eight-stage process for assessing and processing offers was applied to both lanes, but the Cabinet Office and the Department accepted that leads that went through the high-priority lane were handled better. Recommendation: The Cabinet Office and the Department should by July 2021 publish the lessons it has learnt from the procurement of PPE during the pandemic for future emergencies and disseminate these lessons to the wider government commercial function. This should include guidance for determining what is considered a credible offer and how this is communicated to potential suppliers. Show less

Government Response Summary

The government response refers to a PAC conclusion about the Home Office breaching its Net Cash Requirement, which is entirely irrelevant and does not address the recommendation on publishing lessons learned from PPE procurement.

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4 Recommendation Not Addressed

The Department’s focus on supporting hospitals meant assistance to social care providers was neglected.

Recommendation

The Department’s focus on supporting hospitals meant assistance to social care providers was neglected. The pandemic has shown the tragic impact of delaying much needed social care reform and treating the sector as the NHS’s poor relation. This is an … Read more The Department’s focus on supporting hospitals meant assistance to social care providers was neglected. The pandemic has shown the tragic impact of delaying much needed social care reform and treating the sector as the NHS’s poor relation. This is an issue this Committee has raised concerns about before when we examined 8 COVID-19: Government procurement and supply of Personal Protective Equipment the Department’s approach to readying the NHS and social care for the COVID-19 peak, and in our earlier examinations of the interface between health and social care and on the adult social care workforce. The Department provided NHS trusts with 1.9 billion items of PPE between March 2020 and July 2020, equivalent to 80% of their estimated need. In contrast, it provided the adult social care sector with 331 million items of PPE, equivalent to10% of its estimated need. Social care representatives told us their usual suppliers could not provide PPE, in part because some of it was diverted to the NHS, and consequently some providers ran out of PPE. Some 25,000 patients were discharged to care homes from hospitals, some without being tested for COVID-19, even after it became clear that people could transmit the virus without having symptoms. This contributed significantly to the deaths in care homes during the first wave. Social care was only taken seriously after the high mortality rate in care homes became apparent. Key workers outside of health and social care, including transport and supermarket workers, security guards and taxi drivers, were not provided with PPE, yet doing so could have prevented them becoming ill or passing on the virus. Recommendation: The Department should write to the Committee by the end of April 2021 to explain how it will revise its emergency response plans so that they include who will be supported, how and when. This must give appropriate weight to all sectors of health and social care, as well as occupations outside these sectors which are also Show less

Government Response Summary

The government response states that HM Treasury breached its Capital Annually Managed Expenditure total by £32 million, which does not address the recommendation for the Department to explain how it will revise its emergency response plans for various sectors.

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1 Conclusion Not Addressed

On the basis of two reports by the Comptroller and Auditor General, we took evidence...

Conclusion

On the basis of two reports by the Comptroller and Auditor General, we took evidence from the Cabinet Office, Department of Health & Social Care (the Department) and Public Health England about government procurement during the COVID-19 pandemic and the … Read more

Government Response Summary

The government response addresses a different PAC conclusion regarding the Department for Business, Energy & Industrial Strategy's expenditure, and does not engage with the substance of this introductory conclusion about the inquiry's scope.

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10 Conclusion Not Addressed

The British Medical Association and the Royal College of Nursing told us that their organisations...

Conclusion

The British Medical Association and the Royal College of Nursing told us that their organisations did not have access to the high-priority lane, even though they were being contacted by, and therefore would have been able to put forward, credible … Read more

Government Response Summary

The government response explicitly addresses a recommendation about publishing lessons learned from procurement, which does not address the committee's conclusion about medical associations' lack of access to the high-priority PPE lane.

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14 Conclusion Not Addressed

Not all of the PPE the Department bought can be used.

Conclusion

Not all of the PPE the Department bought can be used. The Department told us that only 0.5% of the 18 billion items of PPE it had received and checked so far had failed to meet clinical safety standards and … Read more

Government Response Summary

The government response explicitly addressed PAC recommendation 7a, concerning a detailed breakdown of unusable PPE, rather than the provided committee conclusion about the Department's figures on unusable PPE.

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19 Conclusion Not Addressed

The Department told us that it had not been complacent over the stockpiles, but that...

Conclusion

The Department told us that it had not been complacent over the stockpiles, but that COVID-19 was a novel virus and it learned more about it over time. Unlike influenza, COVID-19 can be passed on by people who are not … Read more

Government Response Summary

The government response addressed a different PAC recommendation (PAC recommendation 2) concerning PPE management and distribution, rather than the provided conclusion about the Department's perspective on stockpiles and the nature of COVID-19.

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24 Conclusion Not Addressed

Witnesses from organisations representing staff working in health and social care told us that providers...

Conclusion

Witnesses from organisations representing staff working in health and social care told us that providers received unusable PPE from central government. The Royal College of Nursing told us of instances where it had received masks on which the elastic was … Read more

Government Response Summary

The government response explicitly addressed PAC recommendation 7a, concerning a detailed breakdown of unusable PPE, rather than the provided committee conclusion about witnesses' experiences with unusable PPE.

HM Treasury

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