Personal protective equipment - future supply: consultation analysis

Executive Summary

The Covid-19 pandemic brought unprecedented challenges to Personal Protective Equipment (PPE) supply in Scotland. In June 2021 an Audit Scotland report stated that a new, long term approach to PPE supply was required, for business as usual PPE needs, and in preparation for future pandemics. The Scottish Government is now working with partners such as the NHS to ensure Scotland is fully prepared for any future pandemic situation through the PPE Supply Implementation Project.

A public consultation on the future supply of pandemic PPE ran between 25 January and 22 March 2022 and received 164 responses. It included 19 closed and 10 open questions exploring lessons learned from the Covid-19 pandemic and the broad principles of the proposed new arrangements.

Lessons learned

There was widespread agreement with each of the seven lessons outlined in the consultation. The consensus was that: collaboration and communication between the Scottish Government and stakeholders are an integral part of PPE supply (96% agreed); primary care and adult social care require a long term, sustainable PPE supply strategy (96%); surge capacity should be incorporated to future PPE supply and stockpiling arrangements (96%); progress made during the Covid-19 pandemic must be built upon to support new, domestic supply chains and data modelling (93%); cross public sector collaboration with the NHS on PPE supply issues should be considered (92%); a reformed stockpiling and buying approach for pandemic PPE is required (91%); and the strategy should consider how private and third sector organisations can prepare for pandemics (91%).

Open comments from respondents largely reinforced or added to these lessons. However, a few additional lessons were identified including issues around more equitable access to supplies across different sectors; inflated PPE prices; and minimising waste.

Support for the proposed stockpile

There was broad support for Scotland having its own pandemic PPE stockpile: 80% were in favour. Respondents commented on the importance of Scotland having its own stockpile to ensure it has adequate access to PPE based on its own needs as distinct from the rest of the UK.

Access to the stockpile

Questions about which organisations or sectors should have access to the stockpile elicited some mixed views. However, a prevalent theme was that it should be available to all workers in essential services that have close contact with the general public including health and social care workers and other important sectors such as retail and transport.

Scottish Government support for the private and third sectors

Respondents expressed differing opinions around access for private and third sector providers in free text comments, but there was strong support for the Scottish Government having a role in supporting private businesses providing an essential public service and the third sector (79%). Respondents felt this could include allowing access to the stockpile, ensuring these sectors have equitable access to supplies, and/or taking steps to ensure that organisations pay a fair price for PPE.

Costs

Another important issue was the extent to which organisations with access to the stockpile should contribute to its costs. Comments were relatively evenly split between those who felt organisations should pay towards the costs of the stockpile and those who argued that the Scottish Government should fund it, either for all organisations or for certain sectors.

There were some differences in opinion as to whether private and third sector organisations should pay for PPE. Many argued that, if organisations are expected to contribute to the costs, their share should be proportionate to their size based on factors such as the number of staff, service users or the amount of PPE used.

Almost two thirds (64%) agreed that mechanisms should be found to split the cost of pandemic PPE between the organisations using the stockpile. A recharge system, where the Scottish Government would charge or invoice organisations for all or a share of the cost of the PPE they have used, was the most common suggestion.

Collaborative approach

Just under half (45%) indicated their organisation would be willing to take part in a collaborative buying approach for pandemic PPE with the NHS,10% said they would not and 45% had no view. Willingness was highest among Health and Social Care Partnerships, other public sector bodies and local authorities. Over three quarters (77%) felt this would support Scottish manufacturing, and 79% agreed it would improve Scotland's resilience in a future pandemic.

In open comments, achieving best value and advantages in storage and distribution were potential benefits of collaboration identified by respondents. One challenge in establishing a collaborative approach appears to be a perception among some respondents outside the NHS that they may not receive equal treatment in any collaborative arrangement.

Sector-specific arrangements

Respondents were invited to comment on the proposed arrangements for their sector. Fifty-nine per cent of respondents agreed with the proposed arrangements in their sector. In free text responses, there were some favourable comments, but the most common response was a request for more details about the proposals.

Conclusions

The range of views identified in the consultation provide a useful evidence base for the Scottish Government in developing plans for a pandemic PPE stockpile. It is unlikely that the proposals will fully satisfy all stakeholders, given the variation in the opinions expressed, and the responses indicate that some of the finer details of the proposals need to be clarified. There is, however, clear support for the proposals to ensure adequate PPE arrangements for Scotland in any future pandemic.