Staff groups enraged by Goddard’s plea to reduce “inappropriate” use of PPE

One of Britain’s leading specialists has implored NHS staff not to squander personal protective equipment (PPE) by using it “inappropriately” in case that leaves colleagues short of kit.

Prof Andrew Goddard, the president of the Royal College of Physicians, urged doctors and nurses to be more careful with which PPE they use so that hospitals do not “burn through” their supplies.

He voiced concern that staff are depleting stocks of “our most precious resource” by using the highest level of PPE unnecessarily in certain situations or changing it too often because they are so worried about their own health, he said.

This comes after the deaths of at least eight NHS doctors and five nurses after contracting coronavirus while working with infected patients in hospitals.

Goddard’s comments sparked a backlash from frontline staff. One doctors’ group accused him of blaming staff for the anxiety many feel over PPE shortages, while the Royal College of Nursing denied the lack of protective clothing had been caused by “frivolous” use.

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In an interview with the Guardian, Goddard said staff should follow newly revised UK guidance from NHS leaders on PPE “to the letter” and not use too much of it. The guidance, drawn up by Public Health England (PHE) with input from senior doctors, sets out in what medical settings NHS personnel should either use basic PPE – apron and gloves – or full PPE, which comprises full-length surgical gown, double gloves and either a visor or goggles to cover the eyes.

“We need to be sure that PPE is getting to the right places and being used in the right way. When people are using it inappropriately that’s taking it away from people who need to use it appropriately. Our PPE is a precious resource and we need to use it as wisely as we can,” Goddard said.

Asked in what situations staff were using it inappropriately, he said: “People wearing a higher level of PPE or changing it more than they need to. That can burn through your supply.

“I want people to follow the PHE PPE guidance to the letter when they can. That means not using full PPE in situations that don’t demand it, because that’s taking it away from people who need it. We should only change [PPE] when the guidance says they need to be changed.”

Some staff want to use a higher level of PPE or change it more often than the guidance recommends because, Goddard added, “for doctors and nurses on the ground [PPE] is the biggest worry they face at the moment. On the frontline, people just want to know that they are safe and that they have access to the right kit to keep them safe. Working in Covid wards is a scary situation and we need to make that as safe as we can for them, and getting access to PPE is really important.”

Staff groups voiced frustration at Goddard’s plea to reduce “inappropriate” use of PPE. “Nursing staff are desperate for enough equipment and the shortages are not caused by frivolous use,” said Rose Gallagher, the professional lead for infection prevention and control at the Royal College of Nursing, which represents most NHS nurses.

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“They’ve already been on the receiving end of changes in guidance and unsafe availability of masks, eye protection and other items. The only safe way forward is to produce millions more of the right quality and get them in the right hands without further delay.”

Dr Rinesh Parmar, chair of the Doctors’ Association UK, a network of grassroots medics, said: “NHS staff have faced uncertainty for weeks about both the availability and adequacy of personal protective equipment. [Earlier] guidance from PHE differed from World Health Organization standards, leading to concerns that UK staff were being exposed to higher risks than other healthcare workers around the world. The confusion created by PHE’s initial guidance has severely dented the confidence that NHS frontline staff have in its ability to keep staff safe.

“We need an open and learning culture in the NHS. Blaming staff for concerns about their safety created by unclear guidance will affect morale at a critical time where we need everyone in the NHS to pull together.

“The Doctors’ Association UK and Messly [a firm running an app to log shortages] are still hearing from frontline doctors via our NHSppe app that 43% of respondents have no access to any eye protection at all despite government reassurances that it was reaching the frontline.”

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