Coronavirus (COVID-19): Personal Protective Equipment (PPE) - action plan

Section One: Definitions and Scope

Aims and Objectives

1. This Action Plan sets out the Scottish Government's progress to date and planned next steps through the winter and beyond. It outlines how the Scottish Government is working with private, not-for-profit, voluntary and public sector organisations to ensure everyone can get the PPE they need and support Scotland's manufacturers to help us create long-term, resilient PPE supply.

Definition of PPE for the Purposes of this Action Plan

2. This Action Plan is about PPE used in the context of the current Covid-19 pandemic. It focusses on specific products that are used to protect an individual or a person being cared for from being infected by Covid-19. PPE falls broadly into two categories: preventative (masks, aprons and gloves); and that for Aerosol Generating Procedure (AGP) treatment (FFP3 masks, visors and gowns). PPE for the purposes of this plan therefore includes the following items:

• FFP3 respirator masks;
• FFP2 masks, where used;
• Type IIR surgical masks;
• Gloves;
• Eye protection;
• Plastic aprons;
• New PPE categories such as non-sterile 'Covid' gowns, which are referred to as AGP (Aerosol Generating Procedure) non-sterile gowns; and
• Hand sanitiser (not strictly speaking PPE, but an essential commodity to keep people safe)

3. It does not specifically cover other items of PPE that might be used routinely in other settings (e.g. by Police Scotland or the Scottish Fire and Rescue Service for their business as usual activities), which should continue to be used as normal.

4. This Action Plan does not cover face coverings. There is separate Scottish Government advice on face coverings which addresses their use^[1].

Scope of Action Plan, and Roles and Responsibilities of Key Partners in Delivery

Scope

5. While hospitals, primary care and social care settings are where a significant proportion of PPE is being used in the current Covid-19 pandemic, the scope of this plan is not limited to these sectors. Instead, it is important that we consider the need for PPE across all settings including in the public, private, voluntary and not-for-profit sectors, as well as for people who provide unpaid care.

6. In non-health or social care settings, PPE is only required where a need has been identified by a risk assessment under the relevant guidance^[2]. Other mitigation measures such as handwashing, social distancing and cleaning will always be required.

Roles and Responsibilities

Role of Scottish Government

7. The Scottish Government's direct responsibilities in connection to Covid-19 PPE include:

• Supporting Ministerial decision-making;
• Working with stakeholders;
• Setting policy direction;
• Seeking to support a joined-up and seamless approach across the multiple areas of interest;
• National procurement policy;
• Engagement with the other UK nations and beyond;
• Pandemic stockpiling (via partners); and
• Managing the current contract with a third-party supplier, which is making PPE available for purchase to those delivering essential services outside health and adult social care.

8. The Scottish Government does not itself directly buy PPE, unless required to do so for its own employees.

9. The Scottish Government is responsible for the national pandemic stockpile. This is delivered via a Service Level Agreement (SLA) with NSS National Procurement to provide a stock holding service. Prior to Covid-19 the purchase was carried out by the UK Department for Health and Social Care with a Scottish allocation. The SLA with NSS National Procurement now includes the sourcing and purchase of PPE as well as its storage.

Role of NSS National Procurement

10. The NHS in Scotland benefits from a single national procurement service, the National Procurement function within NHS National Services Scotland. NSS National Procurement works closely with Health Board procurement teams across Scotland to ensure we can achieve a 'Once for Scotland' approach and harness the power of a joint procurement approach. It also means suppliers have a main point of contact, and clear, specific requirements based on needs right across the system, which can help them understand and respond better to what the NHS needs.

11. NSS National Procurement's usual role is to provide a stock and supply service for NHS PPE supplies. During the Covid-19 response NSS National Procurement broadened its work to start to supply Primary Care services (GPs, Optometrists, Dentists and Community Pharmacists), who are more usually responsible for their own PPE purchasing. For social care support, whether provision is in the public, independent, voluntary or not-for-profit sectors, the supply of PPE remains primarily the responsibility of social care providers themselves. However, given the immense pressure on normal supply chains due to Covid-19, NSS National Procurement has been providing back-up and emergency PPE from the national stock when social care supply chains have been unable to supply, to ensure that staff, social care Personal Assistants and unpaid carers have what they need.

Role of Centres of Procurement Expertise

12. Public Sector Centres of Procurement Expertise exist across a number of key parts of the public sector. These include NSS National Procurement but also Scotland Excel (for local Government), Advanced Procurement for Universities & Colleges (APUC) and SPPD (for Central Government Organisations). Each work with and collaborate with Scottish Government and each other, and carry out a leadership role within their sectors. They will have a key role in continuing to support their relevant sectors to have access to the PPE they need.

Role of Employers, Employees and Unions

13. Employers are responsible for sourcing, providing and paying for PPE for their staff.

14. Across all workplaces, employers and managers need to ensure they understand and appropriately communicate relevant guidance; that risk assessments are undertaken where necessary; and that, if appropriate, staff are properly provided with the appropriate level of PPE for the job they undertake. Further advice for health, social care and other workplaces can be found on the Health Protection Scotland website^[3] and sector-specific guidance for a range of workplaces can be found on the gov.scot website^[4].

15. Individuals, HR Departments and Unions have important roles to play in ensuring that they are aware of the guidance and in reporting any issues arising. There is a clear need to ensure that there are mechanisms in place at all levels to allow issues to be raised, and resolved; and for issues which may point to wider concerns to be made known to the Scottish Government and the PPE Strategy and Governance Board, which brings together PPE demand and supply expertise from within Scottish Government Directorates and the public sector.

16. Workers have a number of statutory safety rights in addition to the statutory minimum obligations. These include but are not limited to: access to specific PPE of appropriate quality where required, and the right of safety reps to inspect relevant workplaces to ensure that planned PPE distribution, where required, is effective. Employers may have specific Fair Work and safety obligations under contracts for commissioned services. The evidence we have heard from trade unions is that engagement and reporting over the course of the pandemic has worked well in some settings but less well in some others. Our shared goal is for two parallel outcomes to be delivered in support of this Action Plan: firstly, effective workforce participation and (wherever relevant) trade union participation; and secondly good quality data on the use of PPE and any issues arising.

Role of Public Sector Bodies

17. In the public sector as with the private and third/voluntary/not-for-profit sectors, individual public bodies are responsible for sourcing, providing and paying for PPE for their staff. In doing so they must comply with public sector procurement legislation. Examples of public bodies are Local Authorities, national bodies such as Police Scotland and the Scottish Fire & Rescue Service, Executive Agencies such as Transport Scotland and Non Departmental Public Bodies such as the Scottish Environment Protection Agency or Highlands & Islands Enterprise.

18. Local government and arms-length public bodies determine their own PPE buying requirements and enquiries about PPE purchase and use within such bodies should be directed to the body in question. Public bodies are subject to audit and therefore accountable for the decisions they make, as well as for planning and preparing to mitigate and manage risks^[5]. In some emergencies other functions of the Civil Contingencies Act 2004 will apply however the additional work that has been done to ensure that there is already adequate stock supply should mean in most cases this is not required.