An ambulance worker puts on a protective mask outside the Royal London Hospital in April
The National Audit Office found the government had to pay very high prices for PPE such as face masks and gowns for medical staff © Justin Setterfield/Getty Images

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The UK government’s belated efforts to secure personal protective equipment for health workers during the Covid-19 pandemic led to huge extra costs to the taxpayer, according to a report from parliament’s spending watchdog.

The National Audit Office found that England had inadequate levels of PPE going into the crisis, and in ramping up supply after March the government paid “very high prices due to unusual market conditions”. 

The government would have saved £10bn on this essential gear if it had been acquired in 2019, the NAO said.

Meg Hillier MP, Labour chair of the House of Commons public accounts committee, said the “government was far too slow to recognise how precarious the position was. When the penny finally dropped DHSC [Department of Health and Social Care] had to scramble to buy what was left as prices went through the roof”.

Between February and July, the health department spent £12.5bn on 32bn items of PPE — but this would have cost just £2.5bn at 2019 prices. Prices were already rising fast when the government started to accelerate purchases of stock from March, when the extent of the pandemic was becoming apparent, given the global surge in demand and restrictions on exports. The cost of body bags for example increased 1,310 per cent from 2019 to 2020.

Gareth Davies, head of the NAO, said: “Once it recognised the gravity of the situation, [the government] worked hard to source PPE, but most of these orders were not received in time for the first wave of the pandemic and many frontline workers reported shortages. The price of PPE increased dramatically, and that alone has cost the taxpayer around £10bn.”

He added that there were “important lessons for government to learn as it continues to tackle the pandemic”.

The investigation into the government’s frantic race to secure sufficient personal protective equipment also revealed that frontline health and social care workers were often lacking essential equipment.

Of the 32bn items of PPE ordered between February and July, only 2.6bn items were delivered, according to the NAO. “Demand for PPE was so high in April and May that stock levels were negligible for most types of PPE,” it said.

The NAO found that the government’s stockpiles of PPE were intended for an influenza pandemic — or to prepare for shortages caused by Brexit — and so did not hold all the equipment needed for Covid-19 such as gowns. 

“Government initially considered it was well-placed for managing the supply of PPE in a pandemic, with tested plans and a stockpile in place,” said the report.

“But neither the stockpiles nor the usual PPE-buying and distribution arrangements could cope with the extraordinary demand created by the Covid-19 pandemic. As a result, government structures were overwhelmed in March 2020.”

When they were provided with protective kit, the NAO found, some items failed to meet required standards. Across two contracts, for example, orders totalling £214m were made for 75m respirator face masks which the NHS has not been able to use for their original purpose. The health department told the NAO that 195m items were potentially unsuitable.

Health minister Jo Churchill said: “During this unprecedented pandemic all the NHS providers audited ‘were always able to get what they needed in time’ thanks to the Herculean effort of government, NHS, armed forces, civil servants and industry who delivered around 5bn items of PPE to the front line at record speed.”

Government officials said that due diligence and robust systems were put in place for the award of government contracts and all offers followed an eight-stage process for assessment and implementation. The vast majority of the PPE met the required clinical safety standards, they added.

The report lays out the rush to find sources of PPE for NHS and care workers, as well as staff in key industries, as the virus spread during the spring.

The health department ordered 14.6bn items of PPE by the end of May worth £7bn — the first time there had been sufficient supplies to meet one day’s demand across the NHS. The department said in September that it was on course to stockpile four months’ supply of PPE by November 2020.

Adult social care providers have complained throughout the pandemic that they were not adequately supported by the government, and were very close to running out of PPE.

The health department told the NAO that it took different approaches to supporting social care and NHS trusts during the pandemic. The social care sector received 331m items of PPE from the government between March and July — just a tenth of their estimated need — compared with 1.9bn items sent to NHS trusts — four-fifths of estimated need.

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