Northern Ireland’s health service had less than one week’s supply of most items of personal protective equipment (PPE) for most of March 2020, according to a report published on Tuesday by the North’s audit office.
The report by the auditor general, Kieran Donnelly, examined the challenges faced by the health and social care sector in sourcing and securing PPE from the outbreak of the Covid-19 pandemic until July 2021.
It also found “clear evidence” of PPE shortages in the health and social care (HSC) and independent care (ICS) sectors “well into April 2020”, particularly in regard to FFP3 respirator masks.
Mr Donnelly made a number of recommendations and said the report demonstrated a need for “improved contingency and emergency planning to avoid a repetition of any supply shortages.”
He concluded “there should have been less reliance on uncompetitive procurement processes, better controls for managing potential conflicts of interest, and more comprehensive documenting of decisions over high cost procurements.
“It is also important that there is greater clarity over longer-term procurement and funding arrangements for PPE provision to the independent care sector,” he said.
Demand
The report showed the “dramatic rise” in demand for PPE due to Covid-19. The total number of items required by both sectors increased by 429 per cent; 6.3 million items were used by HSC providers in 2019 compared to 33 million items between March 2020 and May 2021.
The Business Services Organisation's Procurement and Logistics Service (BSO PaLS) – an arms-length body of the North's Department of Health, which purchased equipment for the HSC sector – purchased nearly £400 million of PPE was purchased between January 2020 and April 2021, compared with £3 million in 2019.
As supply pressures eased the total number of core PPE items delivered to healthcare providers increased from 17 million in March 2020 to an average of 32 million items every four weeks between late April 2020 and May 2021.
As was the case in the rest of the UK, there was “heavy use” of Direct Award Contracts (DACs) – contracts let without competition – to purchase items, with £371 million of PPE purchased through DACs by April 2021.
High costs
The report also noted the high costs incurred by the HSC early in the pandemic, with average pre-Covid prices increasing by 957 per cent for gowns and 1,314 per cent for type IIR masks.
In one case a supplier who received a £0.88 million prepayment failed to deliver an order for 2.5 million type IIR masks.
“BSO PaLS had identified this supplier as high risk prior to contract signature, and has commenced legal action to try and recover this amount,” the report said.
The auditor general said the report reflected the “enormous challenges” facing the health service, particularly at the outset of the Covid-19 pandemic, and the “immense pressure” facing the health service to identify new sources of PPE and secure orders amid rising global demand.
“Although there were clearly initial supply shortages, over 2,000 potential leads were investigated, and 45 new suppliers engaged between January 2020 and April 2021, from whom over 600 million core PPE items have been ordered.
“It is clear that the unprecedented response to Covid-19 has extended to all parts of our health service, including those working in procurement, and I would like to pay tribute to their efforts,” Mr Donnelly said.
