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

Section Three: Readiness for Winter 2020-21 and Beyond

1. As we enter the winter period 2020-21, it is essential that we both reduce the risk of a major second wave of Covid-19 through the wider mitigation measures we are now taking across Scotland, and also plan appropriately for surges, which would include an increased need for PPE. Our winter planning also needs to address the possibility that a high level of Covid-19 cases could occur at the same time as a seasonal flu outbreak. The additional impact of a potentially no-deal or low-deal trade deal with the EU will also need to be considered.

2. Where we are now is very different to the position in the spring, when the pandemic first emerged. Across health and social care and beyond we now have in place:

• Detailed planning and modelling to ensure we get early warning of potential issues;
• Significantly increased stocks, particularly within NSS National Procurement;
• A number of proactive working groups covering health and social care who meet regularly to discuss any current issues, and work to find solutions to resolve these in a timely way;
• A high capacity of PPE production in Scotland to remove reliance on uncertain overseas capacity with long delivery times; and
• Joint working within Scotland through our new governance and joint working arrangements, and joint planning arrangements on a four-nations basis.

Planning for the future and getting early warning of potential issues

3. We are continuing to carry out detailed modelling work to understand the impact of different scenarios on PPE demand over the winter period. This will allow users of PPE in Scotland to receive adequate supplies whatever conditions we encounter over the winter period. We are keeping modelling under constant review as scenarios develop, and adapting our plans on the basis of the reasonable worst case scenario to ensure PPE will be available. Modelling covers a wide range of health and social care providers, from acute hospitals to community pharmacy to unpaid carers.

4. Supply is regularly measured against demand to understand how many weeks of stock are being held and should any issues be noted, action is taken to address them. This process is now automated and feeds directly from NSS National Procurement stock systems, to allow quick and up to date information on demand and supply to be available seven days a week.

5. Actual consumption of PPE for health and social care is monitored on a regular basis, and this will be further improved by the implementation of a new stock management system by National Procurement over the coming months. Whilst social care PPE is sourced partly through social care Hubs and partly through existing supply chains, modelling for social care has been undertaken to show full demand, to enable the proportion that NSS National Procurement is responsible for providing to be easily adjusted. NSS will continue to review stock levels and consumption as well as predicted demand. They are able to place additional orders as required to meet forecast demand and ensuring effective distribution networks are in place.

6. Workshops to test and strengthen PPE availability in all parts of the supply chain are ongoing with NSS National Procurement, Scottish Government Health Resilience team and wider stakeholder groups. These exercises will help us work out any mitigating actions needed and how processes could be adapted to meet the changes in demand.

7. To ensure supply chain resilience, the Scottish Government is working with NSS National Procurement to understand distribution routes across health and social care. This work will help us spot and stop problems before they happen. Distribution routes have expanded and strengthened significantly since March 2020, with regular distribution of PPE to local hubs for social care and direct deliveries now being piloted for primary care. NSS have contingency plans in place as part of their business as usual continuity resilience, and this is being further tested to cover additional Covid-19 demand as well as winter pressures.

Building up stocks

8. NSS National Procurement is building strong stocks of PPE in light of these potential risks. By the end of October 2020, they are on course to have at least four months' supply for each of the key PPE commodities, based on the current average usage. Levels of stock are based on current modelling assumptions and consumption (which will continue to be stress tested and revised as indicated above). These will ensure a substantial buffer remains in place ahead of the end of the EU Exit transition end period. Substantial additional warehouse space is being secured to enable the effective storage and distribution of stocks.

9. To provide additional assurance, and in preparation for the end of the EU Exit transition period, NSS National Procurement are building a broader stock of critical well as engaging with key suppliers to encourage suppliers' own supply chain resilience measures.

Working groups

10. There have been a number of working groups set up to manage PPE, discuss opportunities and review current assumptions of demand modelling work for expected PPE usage. These groups include:

• Single Point of Contact Group with representation from health boards, NSS, SG and other external stakeholders
• Social Care PPE Steering Group
• Primary Care PPE working Group
• Clinical PPE Advisory Panel
• Collaborative Procurement Leads Working Group

11. These groups cover PPE for health and social care as well as wider essential public services. It allows issues or concerns to be fed back and action to be taken to resolve concerns before they lead to potential operational difficulties.

Scottish Supply

12. Boosting Scottish manufacturing sector will be vital to ensure that an adequate and appropriate supply of domestically produced PPE is available and accessible. The work we have done and continue to do to provide this will allow us to make PPE available quickly if required. This gives us resilience and sustainability in case there is a rapid escalation in demand brought on by a resurgence of Covid-19 alongside seasonal influenza. Section four sets out in more detail our procurement and manufacturing approaches.

13. In addition to these measures, we continue to collaborate with other UK nations to better understand supply and demand and opportunities that are available to meet peaks in demand and become less reliant on supplies from abroad.

14. We will also consider the implications of EU Exit in the overall supply chain where goods are imported, or where elements of raw materials are imported for Scottish Manufacturers.