UKH

At last, some half decent journalism:

https://www.ft.com/content/9680c20f-7b71-4f65-9bec-0e9554a8e0a7

(free to read)

Excerpts:

"Health leaders had entered the crisis confidently. On March 17 top NHS officials told the Commons Health Select Committee there was “adequate supply” of PPE to “keep staff safe in the months ahead”. They acknowledged some “local distribution problems” but insisted two existing stockpiles — one for a pandemic, the other for a “no deal” Brexit — were sufficient.....

......Behind the scenes, some hospital procurement chiefs moved unilaterally to protect their staff and began “parallel sourcing”, having lost confidence in the Health Department’s central procurement operation. The result has been confusion, according to one person with a ringside view of the process: “The NHS central team don’t know what the NHS hospitals are doing. The [Cabinet Office] team don’t know what the NHS are doing and the army — brought in to help with logistics — are pulling their hair out.”

According to one prominent procurement manager, a major stumbling block has been a lack of agility and expertise in NHS Supply Chain Co-ordination Ltd, a company owned by the Department of Health which manages the procurement of goods for the NHS. It had no experience of directly sourcing PPE overseas, and was accustomed to securing it through UK-based intermediaries, the manager said."

Also:

https://www.ft.com/content/c462d350-f1ab-4013-86c5-e5d9dc88df97

"When the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), which advises the government, met on January 28, the UK was just three days away from its first confirmed case of coronavirus. Minutes of the meeting, seen by the Financial Times, show experts believed that sophisticated PPE in the form of FFP3 respirators would be reserved for intensive-care situations and “aerosol-generating procedures” in hospitals, and surgical face masks for normal ward settings. The minutes record Nervtag’s conclusion that “the current PPE recommendations for pandemic flu are acceptable for use should there be evidence of sustained community transmission of covid 19"

  Separately, a government spokesman said "The first additional orders of PPE was placed on 30 January via NHS Supply Chain’s ‘just-in-time contracts’. BAU orders of PPE were ramped up around the same date."

Good to see that many of the lies generated by the Tufton Street propaganda machine are being dismissed. 

The FT was never a usual source of news for me. Since the virus started I've definitely delved into it more. 

I like the comment.

""We should have been getting the sourcing directors for Primark and M&S, say, in a room and saying ‘here’s the problem, there’s a phone, go and sort it out’. But that hasn’t happened.”""

If we think its bad here, just think what its like in the USA......

I think it was seen as a good opportinity to get on with Brexit, and that is where the main attention was directed.

The article is weak in one area, it does not highlight the regulatory requirments on PPE. My limited knowledge on this is that PPE is graded according to its intended use. Depending on the grade you have to have it appoved by a " notified body".This is understandable, you do not want rubbish( like that 150 chinese ventilators that were supplied to a Birminham hosptial which were then scrapped them as they were useless).

So its all well and good saying that Uk manufacturers were ignored. But it does not mean the PPE was capable of being manufactured to the right standard for use in the right environment. Little Joe's textile garment place in the " backstreets of counterfeit jeans capital Preston" was probably not good enough.

But hang on a minute, I thought we don't have PPE because Boris hates our beloved NHS and wants to sell it to the Americans?

I have a friend who is very experienced in the procurement of raw materials from China and onward sale to West Africa. I asked him if he has any masks because my wife wants to buy some. Here is his reply:

"How many Masks does your wife want? I have approx. 26,000 left but they are Type 2, which is the surgical grade and have been vetted by the Chinese Ministry as fit for purpose.  They come in cartons of 2,000.  I think Direct Care have them available on EBAY so you can get an idea of the costs. I think the going price is £ 0.70 per mask but remember these are approved for surgical use where as what is being sold in Boots etc is for civilian use ( Type 1 ) and to be honest is no real protection at all.

These masks can also be reused at least 3 / 4 times by steam cleaning them. At night boil a kettle of water and run them over the escaping steam. The cheap masks fall  apart when doing this, these type 2 masks are more robust.

I will never purchase masks / PPE again, the amount of rogues involved in buying and selling PPE and the appalling behaviour of the NHS Central purchasing makes selling to Nigeria like a walk in the park.  I actually shipped 50,000 masks to a customer in Ghana rather than deal with these people."

It looks like a decent article, though I've only skim read it between phone calls.

There does seem to be an elephant in the room.... back in Jan/Feb even early March, nobody expected the UK to be one of the worlds worst affected countries.

Vetted by the Chinese Ministry is irrelevant.

It does not mean compliance with EU CE rules etc." Robust" is not a word recognised in these rules.

This just illustrates how little people understand the requirments.

To illustrate, and I am sure it is far more complicated than this.

In the EU, medical devices are split into one of four classes — I, IIa, IIb and III — with Class III devices being the most stringently assessed. 

For sales on the European market, all products are required to hold a CE mark. 

Although surgical face masks are considered a Class I medical device, they still have to undertake several tests to be certified. 

These include how efficiently the masks filter out bacteria — with the devices also needing to be breathable, splash-resistant and complete a microbial cleanliness test. 

Good to see the stealth privatisation is working well then...

https://unitetheunion.org/news-events/news/2020/april/government-cuts-to-nh...

I thought one of the more trenchant sections was this - 'On March 7, the guidance was revised, advising that workers on Covid wards needed only plastic aprons, surgical mask and eye protection based on a "risk assessment" within one metre of a patient' . . . Prof Macdonald said the level of protection would be "unacceptable in any other occupational setting . . . it seems as though the government has been tailoring its advice to the availability of the PPE".'

The scandal within the scandal.

.... and if the government wasn't obsessing with just one topic, maybe we wouldn't be?

There is that possibility. On the other  hand there is really no point in having somebody who is not exposed to COVID in full blown top of the grade PPE kit. So it would be sensible to review the guidelines to make sure PPE is not being wasted in going to the wrong people.

Not easy to figure out with all the conflicting information, some of it driven by other interests.

So there may or may not be a "scandal".

In my view this is not the issue. After all those facilities are just warehouse boxes with drivers. There are plenty in the UK and I am sure Amazon, Ocado etc and others can do it really well.It should be automated.

The real issue is UK manufacturing capability for medical PPE equipment. I have yet to see any earth shattering articles from the press outlining our capabilities in this area and why we are having to rely on China, Turkey etc.( we know the reaosns but it would be good to see some well researched articles on it).

From my limited knowledge we retain our chemical  and biological warfare suits manufacturing here.

I read in France that Macron realises that 3M were allowed to close their factory  3 years ago and smashed up all their equipment making gowns, masks etc. It would be interesting to figure out what has happened here. Macron has realised now that this was a mistake. I bet there is some equal soul searching here.( and in other European countries as well).

I have an interest in textiles so try and follow this stuff.

The problem appears to have been a human factors and systems one. Focusing on the warehousing and the drivers rather misses the point, that the various managerial and organisational elements were a mess. 

In the event of a world pandemic you want the manufacturing here. That is the bit you cannot sort out quickly...... it is not at low cost. 

Logistics / purchasing etc easier to resolve once their failings have been tested.

No shit Sherlock. This wound up most NHS staff on the wards and on the road.  They were watching PPE dwindle and PPE guidance being watered down on almost a daily basis to match what was available.

In light of the fact that its  been pretty much proven that the strategic reserves of PPE were more or less completely inadequate (possibly let be run down to save on costs, i don't know). I think its naive at best to think your government is going to keep inefficient/un-costeffective factories running (whether it be by subsidies or nationalisation) considering that runs pretty much against everything the tory's hold dear and frankly not something that's likely on a Labour spending radar.

How do you find this out? Would you take the chance?

"They'll probably be alright, won't they? They don't look like they've got the virus."

As a construction manager I have to pester guys on using masks, etc. In the run up to lockdown they disappeared over a weekend shift. The final box I locked in my desk to stop people taking for hoarding. It got broken into over the last weekend shift and the lot gone. 

I think this coupled with the Sunday Times reporting of various government preparedness statements shows that they were completely unprepared for the scale of the crisis and got a hell of a shock in mid-March, despite all the warnings from Italy, the WHO and from within the U.K. scientific community. They have been backpedaling ever since.

You may as well have everyone in full blown PPE in that case which is clearly ridiculous. Do office staff in the NHS need it etc etc. 
 

the practise  of red and green zones is that not part of the control system?

Like these?

"But the decision to take COVID-19 off the HCID list was not made by politicians. It was made by Public Health England and their equivalents in the rest of the UK, with the Advisory Committee on Dangerous Pathogens in agreement. The guidelines on PPE use by health workers may have been “weakened”, but the guidelines are set by Public Health England, not politicians. And the procurement of face masks, gloves and gowns is not the personal responsibility of Boris Johnson or Matt Hancock, but of officials in the NHS and Public Health England."

No, more the like the sudden proliferation of people stating on social media that procurement was the sole responsibility of NHS Trusts. 

Use of the words “personally responsible” make the whole paragraph utterly meaningless. They are accountable and have a huge influence over policy, that is the purpose of government.

I don't think the scale of the failure of PHE and also the procurement executive has yet been grasped. PHE has a number of objectives, but the overarching one is to anticipate and prepare for public health crises such as we are now experiencing. 5,000 scientific and technical staff have had f*ck all to do but prepare for this moment for the last 8 years; what a cushty little number that must have been.

The constant delegation to these arms length agencies has been a recurring theme of governments of all persuasions over the last 20 years, and what's not been to like? Plenty of bureaucrats and physicians at the end of their careers get great little numbers to see out their declining years and set them up for pensions, and  Hancock and the government can claim credit for Nightingale beds and testing getting up to speed, and blame someone else for not having enough PPE or a coherent strategy when it all goes t*ts up.  

The NHS and its management are gob-smackingly inefficient and corrupt - needless to say this does not extend or benefit the frontline staff, who do extraordinary things in a trying environment.  There should be a reckoning once the dust has settled. Maybe in 4 years time...

The aim  of any analysis is surely to understand the problem in order to improve things in the future . Both the FT and the IEA quote identify the NHS and PHE as the actual problem: they didn't know the information that they should have known, they therefore gave bad advice to their political masters, and they were unable to execute the orders that they were given.

There is certainly a case for saying the politicians should have undertaken fundamental reform of the whole system. In that sense, they are accountable, so let's do it.....

PS. I can give you a hand. You'd be better off going down the "It's all the fault of the Lansley reforms" line. "Without them there'd have been mountains of PPE".

That's optamistic.

How long did it take Hillsborough disaster to come to some sort of conclusion?

And then we're in the process of Grenfell Tower. This pandemic planning will not see the light of day, in an enquiry room for decades.

Blow me down, we're agreeing again.

You sound like an advocate of Cummins and Tony Blair all in one.......  

The Private Eye podcast is good today on the whole PPE thing.  By the way, who was in charge for the Lansley reforms?  PS, I can give you a clue, he's not going to get the blame for the PPE shortage.

Go on then, why not go completely over the top? FFS!

Yes of course it is, and does it ensure you don't get red people in green? Does it shite?

Are you quoting the Institute of Economic Affairs as a reliable source? Last week they published an article that did not seem to realise that NHS Supply Chain Co-ordination Ltd existed. What was I saying about Tufton Street.

  No. Only that you were saying that the FT refuted it's claims when it basically supported them. If you can't see that, so be it.

 NHS Supply Chain, the NHS and PHE all ultimately report to the DofH and the secretary of state. Why you think that undermines the points being made God alone knows.Anyway, the FT made the points I wanted to and I am sure most people will understand it. I'm out.

Still on "smash it up" as your solution to every problem I see. 

It's the best source of objective news comment by far.

The FT's star writer today tweeted a nice comment, which I'll paraphrase."No one knows what the government should be doing next to cope with the crisis, or is willing to stick their neck out and tell us. But everyone is damned certain they know what should have been done a month ago"

It's 7-12 weeks ago that I'm more interested in, apart from a bit of muddled communication, I've got no real issue with April, February and the first half of March on the other hand.

Can anyone explain to me why PPE cannot be laundered and re-used?

Obviously I understand why you'd dispose of surgical scrubs etc, but couldn't the PPE of a nurse working on a ward (for example) be washed at 60 degrees (which I believe kills Corona) and re-issued? I'm probably being simplistic but I've never understood why it all appears to need to be disposable.

Because it would have been found to be cheaper and probably more hygenic to make it it all disposable.

The quote of an idiot ^^^

This is very true. We have limited our search to ffp which is the European standard. There are other equivalents which could be used. For example the USA changed it's advice and allowed import of K95 standard masks to broaden the supply chain. It's not a given that these are unsafe since in my experience many standards are often copy and paste document of US or EU standards. Obviously it's a tough call to declare equivalence and even if it was a technical upgrade you'd probably still take flack for downgrading ppe. 

Sounds about right. I've had experience of NHS supply and they are utter incompetents unable to comprehend how the private sector operates. Organisation within the NHS is appalling at almost every level which causes excessive stress to those working with patients.

It's very easy to blame the government but personally I blame the organisation for being so stratified by class. Good ideas don't move up from the bottom because only the over promoted rich kids are allowed to think. The problem is that someone who excells medically does not always make a good manager.

Personally I've never felt as talked down to because of class perception in my life as when I worked in a hospital. Must be awful to have to turn up there to work every day. 

What happened in early March with UK health care worker's PPE provision was quite clear cut. Guidance changed from mandatory wearing of FFP3 respirators for possible CV19 contact to surgical masks for confirmed contact with CV19 patients. FFP3 is designated 'respirator' because it provides respiratory protection. A surgical mask is termed 'mask' because it provides protection only from gross contaminants not inhaled particles. This is why no HSE guidance on RPE includes surgical masks, they do not reach the requirement necessary to class as respiratory protective equipment.

https://www.healthyworkinglives.scot/resources/rpe-selector-tool/Pages/defa...

This was a huge downgrade in PPE provided. The first of many over the following weeks.

Honest to gods this sort of statement /nonsense drives me nuts - do you have any proper evidence or analysis of them being gobsmackingly ineffecient in the bigger picture? You can' always find a one off example that looks crazy but they work in a context where following rules is very important and keeps you out of court when 'common sense' actually doesn't work and people suffer great harm as a result.  They also work in a framework where they don't design their own organisation - it's set by government and open to frequent tinkering to suit agenda and dogma,

If there's really going to be a re-org after this (and there probably should be) I'd like it to be be done in properly, with a proper remit and transparent results and processes, and by an independent group rather than by Dominic Cummings or whoever knocking up a new plan inspired by something he saw on youtube , or by some clown pandering to the Daily Mail

We probably all have friends or know people who work in the NHS so you hear  anecdotes so its difficult to weigh it all up. Myy wifes best friend etc etc  is a nurse in operating theaters etc and about 2/3 months before Covid hit the hospital moved to using reusable instead of disposable ppe.

As she says herself...she has no anxiety or concerns as a result, and the hospital as been fine.

But clearly there were hospitals who had not moved to reusables.( probably the ones with PPE issues).

Also I assume that there are certain areas where disposables are the only option ( ambulances etc)

So it is a complicated picture.

Was it really downgrading or clarification of what people should actually be using so it was clear cut where the priorities lie ( to the ambulance crews as per Stichtplate).

Some PPE is graded as an equivalent to Medical Devices and has far higher testing standards imposed on it. USA equivalence is probably not good enough to meet those standards, so you cannot copy and paste.. Nor should Stichtplate in his role have to accept second best.

Yes, fair enough, though I do have a masters degree in health service management and I do run 2 business that supply services to the NHS, so If I sometimes come across a bit bitter that may be a reason for it!  And I don't mean corrupt in the sense that mafiosa types are on the take (though I'm sure there is some of that), it's that the style of management - top down, risk averse, insular, complacent - inevitably leads to poor decision making and outcomes.

To me it is self evident that PHE has failed to deliver what it declares is its raison d'etre - to anticipate and prepare for threats to public health. And the centralised procurement company failed to procure PPE; according to that FT article they are not used to dealing with suppliers, their procurement is through middlemen… who add what value to the process exactly? When my DiL was responsible for buying knitwear for M & S, that involved deciding what was needed, getting on planes, meeting designers, factory managers, shipping agents, and putting the whole supply chain together - isn't that what procurement should be about? 

Exactly the same in the Trust where I work! Operating procedures rewritten overnight when  clinical staff are very aware of research based evidence rather than the protocols being advised in house...

I'd keep a written record of what changed when and how it goes against clinical evidence.

It's not just the NHS. Any public body or private company taking on public sector contracts seems to end up using procurement companies that charge massively over the RRP:

"What's that, you want 10,000 note books? Well you can buy one for £1.65 in WH Smiths, so we can supply them at £2.70 each "

I was listening to the news on the radio yesterday.  They were talking about the "exit strategy" and people going to back to work post-lockdown, and how employers are worried about the implications of getting social distancing, ppe etc., wrong and being prosecuted of H&S breaches, even potentially for corporate manslaughter in the event someone catches the virus and dies.

It seemed so strange to hear that kind of talk from seems like another world now - where it isn't acceptable to simply rig your risk assessment to come to the conclusion that what you need is whatever you already happen to have lying about, and where if an employer can't provide people with a reasonably safe environment to work in it isn't an acceptable solution to just give them a round of applause instead.

I think the lead nurse for infection prevention is doing exactly that.

Typical NHS....clinical leads talking sense, senior managers being defensive and the Board taking assurance from them whilst knowing little about it or how to scrutinise....

Ahh, but as UKC has amply demonstrated, there’s plenty out there convinced healthcare staff aren’t at any risk cos they listened to a 10 minute program on radio four. Even though the NHS isn’t compiling definitive data.
 

We now have at least 7 paramedics dead from CV19 (not official figures, 6 in the media, 1 unreported but a friend of a friend). I checked the register this morning and and there are 28000 paramedics registered in the U.K. The 1:4000 death rate this indicates is significantly higher than the 1:19000 deaths amongst working age population.

Up until 3 weeks ago, no one on our station had ever heard of ambulance staff dying of non-blood born infectious disease. But hey, this is what we all signed up for. Apparently.

I was in the forces before the NHS....very true there. Crap ill fitting gear and no extra supply.

"Right......out on patrol...."

'.....but this snatch is crap and that road's full of IED's'

"...don't fu***ng start with me son and fu***ng move it now"!

https://mobile.twitter.com/BBCHughPym/status/1257614912328740864

Deputy Chief Medical Officer for England acknowledges there was a change of policy on virus testing in March partly because there was not enough capacity. Dr Jenny Harries told the Commons Health Select Committee that “if we had unlimited capacity we would have done differently”.

On March 26, all she said was it was "not an appropriate mechanism as we go forward”. 

Seems to fit the 'change the goalposts' theme with government response. 

Personally I found the kevlar vest "fitted for but not with" ceramic plates much lighter and comfier...

Equivalence does not mean sourcing inferior product, indeed I have encountered many products which exceed our EU standards, even these standards vary regionally. I'm not talking about second best at all, the PPE must be of an acceptable standard. The attitude of 'probably not good enough' is precisely what must be dispelled, there are plenty of US standards regarding chemical safety which are far safer than what the EU deems acceptable levels of risk.

Testing regimes may vary and it wouldn't be for NHS staff to decide what is equivalent it would be for a standards agency to do so. However you prove my point rather well, that the quite false cry of 'downgrading' and 'putting lives at risk' would be made by people who don't let facts get in the way of a good moan.

I think you're equating two separate issues.

You're correct that CE marking is the lowest common denominator, and the equivalence of international standards (e.g. FFP3 in comparison to N99 in the US) is a matter for the various standards agencies.

The other issue would seem to be managers with no knowledge of protective equipment writing guidance to staff on the basis of what's left in the cupboard under the sink, rather than what is actually required to give adequate protection.

Wow, not for NHS staff to say? You’d better drop a line to the HART chaps I was talking to at Croxteth station last week who’d been very actively testing kit to decide if it was fit for purpose. And where exactly is this ‘false cry’ of downgrading kit? 

Your recent stream of inaccurate and ill informed posts have made it quite plain that you’re not going to let a lack of acquaintance with the facts stop you shooting your mouth off and denigrating others. 

Probably by that "independent" group that you happen to agree with. Independent groups are farcical and have boldy led us into this mess because they. The group needs to be set up with specific aims or its remit simply widens to the point of being ineffectual. They are just another reason for governments to fail to action change.

Unfortunately what we really need is fresh ideas about how to integrate and manage the health service with a serious look to the German model where private companies were seamlessly mobilised for national action by pre-made plans. This isn't a call for privatisation or nationalisation but we have failed to allow both sectors to work in tandem for years and thus neither understands how the other works or is willing to learn from the other.

Inventive ideas rarely come from the frontline of any organisation, or from those long in the tooth from years of dedicated service in a committee. We need someone truly dynamic in charge of the process, unfortunately the UK has few people who fit this bill because from starting university onwards career progression hinges on your ability to bullshit, the Germans don't tolerate that approach.

Next your going to tell me that NHS staff wrote the ffp3 standard. They didn't a standards agency did. Testing kit isn't writing a standard, or assessing compliance or equivalence. You pretending to me that you write standards as well now? Judging by your previous demonstration that you cannot read a post one might think that you're incapable of even reading a standards document and very capable of shooting your mouth off and denigrating others. 

The standards downgraded were from attending suspected CV19 in level 3 PPE (FFP3, tyvek suit, double gloves, goggles, overshoes) to attending confirmed CV19 in level 2 PPE (surgical mask, flimsy pinny, single gloves). Nothing to do with technical standards as anyone with even a passing acquaintance with the current PPE scandal would be aware, let alone a highly trained medical expert such as you keep hinting you are.

I’m sorry, you’ve given me a few good laughs but you’re obviously either some sort of medical Walter Mitty or perhaps plainly simple?

It's a shame you haven't really grasped the thrust of the arguement. You're hung up on the issue you want to see. The argument I put forward was in support of sourcing more respiratory protection by broadening the supply chain with ffp3 equivalent PPE by looking to other technical standards not to masks.

I fully agree that your sourcing chain is shite and that your lions are led by donkeys, I've spent enough time working in hospitals to know that theres a whole level of management who do f*ck all, are generally obstructive, and get paid a fair whack.

And no it wasn't a medical role.

Maybe try reading the full post before you eat the crayon. Peace

No one on the actual frontline is quibbling about standards or designations. We aren't concerned about KN95, N95 or FFP2 respirators (they aren't 'masks' as you keep calling them). We are concerned because we're being told respirators aren't required. Your argument is the equivalent of insisting that the real problem for passengers on the Titanic was that they couldn't decide what type of  lifeboat they wanted. 

You know nothing of PPE supply chains. You know nothing of allocation and distribution of PPE. You are operating on pure speculation. There are very good reasons not to buy from unknown distributors from unknown manufacturers. The market is full of fake kit and useless kit, which is one of the reasons our HART teams have been so busy conducting portacount testing.

I'd already gathered that by how impressed you were with autonomic patient simulators on the other thread. They're crap. 

Maybe try a little humility and engage in a discussion rather than making wild claims. Speaking of which; care to retract your claim that all SF medics are fully qualified NHS trained paramedics? How about your claim that crew other than paramedics or doctors operate within UK HEMS? What about your claim that they are better trained than NHS paramedics? Any answer to my question as to what exactly these 'advanced techniques' these unqualified medics were using to deal with stuff like cardiac tamponade?

There is a big difference between knowing your shit and knowing you're full of shit.

That's a hell of a jump from level 3 to level 2, any sane person would expect at least one more level between fully suited and booted to a thin plastic smock. What's level 1 PPE, attend in just your under crackers? 

I just tried to find out what level 1 PPE consists of but a search of our organisation's intranet came up blank. Maybe it's a confident smile and a quick blast of Lynx Africa? What I did find was a complete list of the PPE requirement updates regarding corona starting with MERS which had an R0 of 0.5. Recommended PPE for a suspected MERS patient- FFP3 mask, gloves, eye protection, fluid repellent long sleeved gown and plastic apron. (28/8/18)

Covid 19 had a transmission rate 4 to 5 times higher before lockdown reduced that to an R0 of around 1. PPE for a patient with confirmed Covid 19. Surgical mask, gloves, sleeveless apron.

The first Covid 19 update (31/1/20) indicated HART personnel with specialist kit would attend confirmed cases. Unconfirmed cases would be attended in level 3 PPE with crew assessment supported on scene by either a Senior Paramedic Team Leader, Advanced Paramedic or a Sector Manager. 

By March, Newly Qualified Paramedics (under one years service) in our area were being sent in on their own to assess confirmed Covid 19 wearing this...

https://www.liverpoolecho.co.uk/news/liverpool-news/pictured-flimsy-apron-m...

Eye protection covers a wide range of sins. What standard on eye protection?

We've been issued with everything from home made visors to school chemistry lab type glasses to close fitting industrial goggles. There doesn't appear to be a standard.

You might be on to something with Lynx Africa, if it keeps covid 19 away as well as it does women the world is saved. 

And by the end of March and early April when too many Paramedics were sick or Stood Down, because of Covid 19, then EMT's were sent in on their own to assess confirmed Covid 19 wearing the same kit.

Didn't know that was happening. Round this way we've got urgent care running where one of the crew is a student paramedic who started their second year in February. Band 3 of course. Quite shocking that they could earn more stacking shelves at Aldi.

While you and your colleagues obviously know what you’re talking about when it comes to paramedics and the PPE provision for them in your areas I wouldn’t trust a word that the Liverpool Echo prints.

If they said it was daytime I’d have to go outside to check.

Isn't this what we should have done early on?

https://www.bbc.co.uk/news/uk-scotland-52595134

It just seems scarcely credible that we didn't.

Yep. I was with a PTS crew member last week. First job full-on RTC car vs bike. All the toys were used. Every credit to PTS putting on big boy pants but that was the least demanding job of the night.

As I see it there are just not that many U.K.  textile companies capable of doing that and it also says non - surgical gowns.hope fully it’s a five year contract at a good price.Most textile companies have had to move to top end mfg. this is not top end. So good price is critical. 

"There does seem to be an elephant in the room.... back in Jan/Feb even early March, nobody expected the UK to be one of the worlds worst affected countries".{ an above comment in reply to your Opening Statement}

This is exactly what the Conservative government will excuse itself with and I'm afarid to  say this is to fall hook line and sinker for the distortion that it  is.

The impression is that it could not be controlled- an uncontrollable, highly infectious disease-  when in fact, a government on top of the issue, practising early lockdown, an early detection programme { especially at airports} and a testing programme could have controlled the outbreak much more.

It is symptomatic of the initial attitude towards the disease, ignoring its deadliness in other countries and the experiences  in Spain of mass deaths in residential homes,{even I read about that at the time, in the newspaper} --- that position flowed on into  decisions about PPE. It is a sequential conclusion of a  distracted, maverick , erratic approach in the first place in January, February and early March.

And that boils down to leadership. But, of course we carry on in unity through to the end of this crisis.

I think the fact that we are one of the world's worst affected, and there are big global variations, does make clear it can be better controlled with good government and leadership.

Hi,

Beyond Uk climbing I suspect that:  

Eventually that question of "how did we get here"{ which was skirted round when Parliament sat} , no doubt, will have to be eventually answered.

If you have the first steps essentially weak, any institutional weaknesses { that would anyway be revealed in a pandemic} become amplified.

My concern would be that of a governmental deflection tactic by focusing on those endemic  institutional weaknesses in order to underplay initial governmental weaknesses. watch out for that one!

There clearly is a standard. A large part of the stockpile for eyepro purchased in 2009 was found recently not to pass the standard it was supposed to. 

I think your talking above your paygrade about supply chain and procurement. Maybe time for you to wind your neck in. 

I'm talking from direct experience of what we've been issued over the last three months.

As for the rest of my knowledge on PPE, you're right, I'm absolutely talking above my pay grade. But not my wife's, who has worked in PPE for over twenty years, who's instrumental in sales and allocation of respiratory protection for a company big enough to be producing 100 million FFP3s per month and who sits on the board of the British safety industry federation. 

As I noted before. Huge difference between knowing your shit and knowing when you're full of shit.

I reckon both of you are talking at cross purposes.All that pands is saying is ( hope I have got this right) is the FFP3 is a European standard.The standards for that are not set by the NHS or the UK Gov, they are set by common agreement within Europe.It is just possible that somebody from Stichtplates wifes business sets on a standards commitee in either the Uk or Europe ( or even a trade body which sits on those ), and the same goes for the NHS.

It is highly debateable ( impossible)as to whether in a couple of months the UK Gov or the NHS could rewrite those standards ( as they apply European wide). They are the common denominator across Europe.

It is possible that the NHS have a higher local standard on top, if you like an FFP3 plus .

Its the same principle in other European standards.

No. He's made a whole heap of bollocks claims: unqualified medics working in HEMS, SF medics being NHS qualified paramedics, untrained medics using procedures only implemented by doctors, denied that NHS have been issued kit that has not met set standards and insisted that the NHS should widen standards from understood European frameworks to Global so procurement can be widened to new suppliers and manufacturers without understanding that the market is currently saturated with fakes and that the standards aren't the issue in the first place.

He doesn't work in any clinical role. He doesn't work in PPE procurement or manufacture. He doesn't work in standards. He's talking crap without even the basic understanding of the issues that could be gleaned from keeping up with reported news.

I have reread his posts in this particular chain and he does not anywhere comment on any of the points you mention ( unqualified medics etc etc.). Has he made these elsewhere?

His quotes from the "NHS frontline staff - Heroes?" thread:

 every special forces medic is a fully qualified NHS trained paramedic. 

They're little more qualified than your standard paramedics. The guys work with the HEMS teams. Edit: at least in trauma, which is what's relevant for their job. 

They are practiced in the really complicated procedures which are not conducted by ambulance based paramedics and require a doctor on scene to administer. Dealing with things like cardiac tamponade and other serious conditions outside of hospital. 

Helis don't carry baggage, every crew member is mission critical so you can't really say they're just along for the ride and they certainly don't fly the chopper. Title or not they do the job and I imagine many paramedics would say it takes a lot of work and only the best get into a HEMS team. 

The remit is quite straightforward - how best to manage/organise the NHS .  Obviously this is easy yo say but a monumental task.  I doubt there's been a better time to do this than now.

Well not necessarily - we have a lot of experience, and we probably have a pretty fair idea of what has worked and not worked in the past, and what we can learn from other countries.  Germany has much to teach but is not perfect .  

So you say

So a totally different thread to this, which is why the confusion.

Many assumptions about what I do/have done, however I've been lucky to have a fairly diverse career so far, no doubt yours is more illustrious though. I've shown you a sketch but it's not much to go off and you're wrong on a few points.  

You seem to me like you possess much anger.

'Hi there, I think you are a Cnut'

Biff! Bash!

'Oh, you seem to have some anger issues...'