Covid-19 update: 7 May

Deputy chief medical officer for England, Jonathan Van-Tam, told Monday’s press briefing that there were continuing challenges on PPE. ‘It is an absolute priority to continue pushing on this to get it right in the long run,’ he said.

As part of a revised approach, the Department has written to procurement directors and chief finance officers asking trusts to stop placing their own major orders for supplies.

‘The global demand for PPE and other supplies is unprecedented,’ the letter said. ‘Therefore, it is vital that the UK government procures items nationally, rather than individual NHS organisations compete with each other for the same supplies.’

Many trusts have had to supplement national ‘push’ deliveries from national procurement body NHS Supply Chain and the recently set-up parallel supply channel dedicated to PPE. And trusts have worked together to ensure supplies are moved around locally to avoid organisations running out of key equipment. Some trusts have also supported other local organisations including care homes, GP practices and housing associations.

According to the revised instructions, significant procurements already in progress should be flagged to a new group of trust procurement leads, who are working with the Department on this programme. The letter says that the national team will then help conclude the deal, reimburse the trust, and manage the products through national stocks.

Trusts have been told they can continue to work with new small, local suppliers or with goods that have been donated. However, where there is the potential for these deals to be scaled up to support wider demand, trusts should inform the centre.

NHS Providers chief executive Chris Hopson (pictured) said it was the right move to avoid different parts of the NHS ‘unwittingly competing against each other’. ‘It makes sense to co-ordinate procurement with trust procurement leads playing a key role in the process,’ he said. ‘This way we get the best of both worlds – the maximum number of people across the NHS seeking to purchase much needed equipment, but proper co-ordination between national and trust levels.’

The Health Care Supply Association also supported a more structured and collegiate approach, but pointed out that local sourcing outside of the national system, which it said had previously been encouraged, had been the only way most trusts had been able to source sufficient volumes of PPE.

‘Trusts will always need the flexibility and contingency to source locally, but this should reduce as confidence in the national system increases,’ it said. However, it warned that the current push system still required local reworking.

The government also launched its new test, track and trace programme, which started a pilot this week in the Isle of Wight. Residents in 80,000 households on the island will be asked to download an app which uses Bluetooth to log the distance between phones. If someone becomes unwell, they indicate this in the app and then anyone who has been in contact with this person will receive an alert, enabling them to isolate and get tested where appropriate.

For the whole country, an initial 18,000 people are being recruited to support the contact tracing initiative.

The government last week claimed it had met its end-of-April target to deliver 100,000 tests per day for the coronavirus – despite criticisms that the target had only been met by including  40,000 tests dispatched by post, which may not have been taken.

Test numbers dropped over subsequent days, with just under 70,000 tests undertaken on 5 May, according to the government’s briefing on Wednesday evening. The government has suggested that capacity currently exceeds demand, however prime minister Boris Johnson has already moved on setting a new target of 200,000 tests a day by the end of May.

Continuing earlier calls for an updated testing strategy, NHS Providers’ chief executive Chris Hopson said three significant issues still needed to be addressed on testing. Too many health and care staff with symptoms still couldn’t get access to rapid turnaround tests due to capacity constraints. Second, while testing would be crucial to identifying potential mass outbreaks in the next phase, NHS bodies were still unclear of their role in the test, track and trace strategy.

And third, greater clarity was needed over how testing could support the resumption of planned care. ‘Just testing a million frontline health and care staff once a week would require 142,000 tests a day, compared to the current 80,000 a day,’ he said. He added that there was a strong argument for decentralising responsibility for testing – an approach that had worked successfully in other countries.

Meanwhile, concerns continued about the spread of the coronavirus in care homes. According to the Office for National Statistics, there were 7,911 deaths in care homes from all causes in the week to 24 April. This figure was up on the week before while the number of deaths in hospitals for the same week (8,243) was a fall on the previous week. Some 35% of these care home deaths involved Covid-19.

Analysis by the Nuffield Trust suggests that care home deaths in the same week were approaching four times the usual number – suggesting greater levels of under-reporting of Covid-19 in these settings.