The Welsh Government and NHS Wales Shared Services Partnership (Shared Services) procured and supplied Personal Protective Equipment (PPE) for frontline staff in very challenging circumstances. They put good arrangements in place to manage risks which helped to avoid some of the problems reported in England. However, Shared Services did not publish contract award notices for all its PPE contracts within the required 30 days of them being let.
The challenge facing the NHS and social care at the start of the pandemic was stark. The stockpile developed for a flu pandemic was inadequate for a coronavirus. Global supply chains had fragmented as countries competed for scarce supplies and some imposed export controls.
Before the pandemic, NHS Wales would typically spend around £8 million annually on PPE. During 2020-21 the total amount expected to be spent on PPE for Wales is over £300 million. While this is a big increase, we estimate the Welsh Government has received £880 million through the Barnett formula as a result of spending on PPE in England.
Public services across Wales worked in an increasingly collaborative way to understand what PPE was needed and a range of bodies were involved in sourcing PPE globally. Shared Services has taken on an expanded role in securing PPE for the wider NHS, including independent contractors in primary care (GPs, dentists, pharmacies and optometrists) and the whole social care sector, including private providers.
Shared Services had issued 630 million items of PPE as of 8 February 2021. Shared Services data shows that, nationally, stocks did not run out. Stocks of some items – visors, certain face masks and surgical gowns - fell below two days at points in April 2020. At times, Wales drew on mutual aid from other countries but ultimately gave out significantly more than it received. The health and care system is now in a much better position, with buffer stocks of most items and orders due on key items where stocks are below the current target of 24 weeks of supply.
Staff surveys by the Royal College of Nursing and British Medical Association suggest confidence in the supply of PPE grew shortly after the start of the pandemic, and there are still some concerns. While we cannot be sure how representative these views are, some frontline staff have reported experiencing shortages of PPE. In some cases, staff concerns relate to the fact that they want a higher level of PPE than required under the guidance.
Shared Services balanced the urgent need of getting PPE to frontline staff with the need to manage significant financial governance risks. These risks included dealing with new suppliers, having to make large advance payments and fraudulent and poor-quality equipment being offered. An expert financial governance group looked at riskier contracts. Unlike the position in England, our report finds no evidence of priority being given to potential suppliers depending on who referred them.
Due diligence checks could not always be carried out to the level they would outside of a pandemic due to time pressures. However, for each contract we reviewed, evidence shows key due diligence checks were undertaken.
Shared Services did not meet requirements under emergency procurement rules to publish its contract award notices within 30 days. Shared Services told us that its staff needed to prioritise sourcing PPE and that there were other administrative reasons for delays.
Recommendations in the report centre around:
- Preparedness for future pandemics
- Developing a clear procurement strategy for PPE – including the size and nature of the stockpile, plans for the domestic PPE market, and considering wider factors such as sustainable development and modern slavery
- Transparency on contract awards and availability of PPE stock