PPE : SUPPLY & USE OF

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Publications approval reference: 001559

To:
Chief executives of all NHS trusts and foundation trusts
CCG Accountable Officers
GP practices and Primary Care Networks
Providers of community health services
Homecare providers
Independent sector providers
Copy to:
Local authority chief executives and directors of adult social care
Chairs of Local Resilience Forums
NHS Regional Directors
20 March 2020
Dear colleague

GUIDANCE ON SUPPLY AND USE OF PPE
We are setting out, in a single document, everything that you need to know on the supply and use of Personal Protective Equipment (PPE).
1. Supplies you will be receiving

We have now moved to providing substantial extra deliveries and support will be available 24 hours a day, 7 days a week. Services across the NHS are urgently being sent stocks of PPE to help them manage cases and potential cases of COVID19 and keep staff safe. See section 6 for details of equipment being sent. • On Thursday 2.6 million face masks and 10,000 hand sanitisers went to trusts in London. • On Friday 150 hospital trusts will have extra PPE kit delivered. Over the weekend every other hospital trust will receive a further special delivery of PPE. • Every GP practice, dental practice and community pharmacy has now had a PPE delivery. • All care homes, hospices, and home care providers will have a PPE delivery, and these began earlier this week.

To meet your needs, we are putting on substantial extra deliveries. We will aim to deliver these in usual working hours but, given the volume of deliveries, please ensure your organisation is prepared to receive some deliveries at evenings and weekends.
You can access NHS Supply Chain’s Delivery Schedule here: https://www.supplychain.nhs.uk/covid19/delivery-schedules/

2. Reporting supply disruption The supply distribution helpline can answer PPE calls and emails 24/7 via the supply disruption helpline on 0800 915 9964 or email supplydisruptionservice@nhsbsa.nhs.uk to help with queries. Emails will be answered within one hour.
Trusts should raise non-PPE orders with NHS Supply Chain in the usual way.

3. Securing additional supplies from manufacturers

COVID-19 is generating unprecedented global demand on the supply chain, combined with a manufacturing slowdown in affected countries, especially China which manufactures a large amount of PPE.

Government, NHS Supply Chain, and the NHS are doing everything to work with industry to secure additional supplies and manufacture further PPE.

4. Shelf life of PPE items

The NHS’s stockpiled PPE is checked as part of the stock management process operated through the NHS Supply Chain. This means rotating stock to make sure that items which have been there the longest are issued first.
Some products may appear to have out-of-date ‘use by/expiration’ dates or have relabelled ‘use by/expiration’ dates. Please be assured products being issued have passed stringent tests that demonstrate they are safe. The PPE is exposed to extreme conditions for prolonged periods, to see how the product deteriorates. All that are not up to standard are destroyed and not distributed to trusts.
We have been working with independent test facilities and the Health and Safety Executive (HSE) who, after being provided with scientific evidence, were content with our assessment that these are safe to use by NHS staff.

5. Correct use of PPE

NHS England and NHS Improvement collates all advice to clinical staff, including safe

systems of working including the of use PPE, online here:
https://www.england.nhs.uk/coronavirus/
The full COVID-19 guidance collection is available at https://www.gov.uk/government/collections/coronavirus-covid-19-list-of-guidance

6. Putting on PPE and fit test training

Public Health England (PHE) recommended PPE ensemble for healthcare workers within a metre of a patient with possible or confirmed COVID-19 is: • Fluid repellent facemask • Apron • Gloves • Eye protection if there is a risk of splashing

The recommended PPE ensemble to be used for aerosol generating procedures on patients with possible or confirmed COVID-19 is: • FFP3 respirator • Long sleeved disposable gown • Gloves • Eye protection (disposable goggles or full-face visor)

Some healthcare workers will not have worn items like FFP3 respirators before. To protect their safety, we are asking trusts to ensure that all relevant staff have received the necessary fit test training.
PHE has engaged with RPA (an independent Respiratory Protective Equipment (RPE) fit testing company) who are running fit-test training sessions via webinars to help staff who will be training to use Qualitative or Quantitive fit test methods for FFP3 respirators for the first time or those seeking refresher training to ensure they are able to train FFP3 users safely. Booking on to these courses is via RPA’s helpline on 07947 968972 and 07947 968922. This training is free.
The linked Public Health England poster is intended as a guide for staff about how to put on PPE, including FFP3 respirators.
A YouTube video is also available here: https://youtu.be/kKz_vNGsNhc

7. Disposing of PPE correctly

All PPE that is used when encountering confirmed cases of COVID-19 is single-use only and should be changed immediately after each patient and/or following completion of a procedure or task.
PPE should be disposed of after use into the correct waste stream i.e. healthcare/clinical waste (this will require disposal via orange or yellow bag waste). There might be further local guidance depending on the impact of the disease.
Please ensure the Public Health England poster on the removal of PPE for full guidance on doing this safely is shared with staff.
A YouTube video is also available here: https://youtu.be/oUo5O1JmLH0
Full list of resources around PPE use
• COVID-19 Guidance for infection prevention and control guidance • Coronavirus guidance for clinicians • Posters and videos on donning and doffing of PPE

Kind regards

Professor Keith Willett NHS Strategic Incident Director NHS England and NHS Improvement