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Social care workers and NHS staffers in the community have said they are having even more trouble than their colleagues in hospital accessing the personal protective equipment (PPE) that they need.
As the NHS comes under strain during the coronavirus outbreak, with staffers either falling sick or self-isolating, so has the social care system. Nadia Whittome, the Labour MP for Nottingham East, has said she is returning to her previous job as a carer because "the care system is in serious danger of falling apart" during the crisis.
Laura Rearie, a former nurse, now runs CarePlus Scotland, which has a team of around 50 staffers giving care to highly dependent adults and children in Fife. She said she is unable to provide her employees with the equipment they need to stop them from falling ill or putting their clients at risk.
She told BuzzFeed News that Fife Council, whom she is contracted to supply care for, has also been trying to track down equipment, but it has been told that there is a shortage and that NHS frontline staff will be prioritised.
Her staff will only be given face masks if they are treating people who are known to have coronavirus symptoms. They are using aprons and gloves on all visits, but she has struggled to get hold of masks or hand sanitiser; instead, Rearie has said, they are carrying around flasks of hot and cold water, soap, and basins to use as makeshift handwashing stations. She worries that even soap is in increasingly short supply.
“To get this PPE is imperative,” she said. “If we don’t have any because we don’t have any cases yet — that’s bolting the door after the horse has gone.”
Rearie said she has resorted to trying to source homemade masks as there is no alternative available.
“Our PPE situation is pretty dire,” she said. “We’re doing what we can. We’re looking at someone sewing some for us. Anything is better than nothing.”
While medical staffers are being prioritised, carers are the ones who are often in closest contact with people, she said. GPs may visit the same clients, but “they’re going in to examine; we’re going in to clean up.
“We do need PPE, and it’s only a matter of time before the gloves and aprons supply runs out,” she added.
“We’re trying to work with Fife Council, but they’re having trouble sourcing those supplies, and we really need to get some help.”
Some of her clients include children with severe learning disabilities and tracheostomies, she said, for whom even a common cold can be dangerous. She added that some of her carers and their families also have circumstances that make them more vulnerable, including one who is undergoing treatment for breast cancer, one with a daughter with cerebral palsy, and one with a son with kidney problems.
“They’re not stepping back; they’ve been asked to step back because of personal situations, but they’re saying, ‘No, we’ve got this,’” she said.
Her team members come to her without qualifications and are classed as unskilled workers, but she said they are providing a vital service. “They need recognition,” she told BuzzFeed News. “They’re absolute angels — they’re providing a fantastic service and they do need a great big thank you from us.”
Jo Wall is a self-employed carer who has asthma. She has been provided with neither PPE nor information on what equipment she should be using to keep herself and her clients safe. She has managed to source her own latex gloves and disposable aprons but has been unable to purchase any masks.
“I haven't been provided any PPE; I've had to pay for mine off eBay,” she told BuzzFeed News. “It was more expensive than what I normally would pay. [I] got it within a week. I have no idea if it's correct, but as I've been a carer for 15 years I presumed it’s correct.
“I’ve been reading a lot off Gov.uk to get my information, but as I'm also at risk due to having asthma myself. I'm in a very vulnerable situation — and I have a daughter with severe asthma also.”
Wall told BuzzFeed News she wants more help gaining access to equipment and better guidance from the government on how she should be preventing transmission.
“I feel I’m risking my health going out to my vulnerable clients,” she said. “But they also need me, so it's a very difficult situation to be in — because if I don't work, I have no income ... and my husband has just been laid off also.”
After her husband lost his job in Frankie & Benny’s kitchen, Wall said she needs to continue to work.
“I have asthma and need to look after myself also,” she said. “I have no hand sanitiser as [it’s] all sold out, so I feel very vulnerable.”
But she will continue to work — not only because she needs the income, but because her “clients are very vulnerable and look forward to seeing [her] every day.”
It is not just carers who are struggling to access equipment; NHS staff working in the community also do not have the same supplies of PPE as their colleagues in hospital.
Dr Mark Porter is an NHS GP partner in the Cotswolds. His surgery has not been provided with any protective equipment, and he has had to source it himself.
He has managed to hold of a supply of 500 masks, but future supply is uncertain. And he has had to pay some on to the district nurse team — who had just 10 masks between them.
“[It’s] not great that we have to depend on the vagaries of [a] free market — price and supply — to obtain essential equipment,” he told BuzzFeed News.
“[I] don’t understand why GP surgeries are not on [the] same supply line as hospitals. We can typically manage with normal masks, gloves, and plastic aprons, but we need good supply. I have just had to give our district nurses 50 masks to keep them going.”
Dr Rosena Allin-Khan, the Labour MP for Tooting and an NHS hospital doctor who is treating coronavirus patients at St George’s hospital in Tooting, has continued to raise the issue of a lack of suitable PPE for both hospital and care staff.
Some NHS and care staffers have also raised concerns about the quality of equipment they are being provided with, fearing it will not adequately protect them.
“We need the PPE to keep us safe,” Allin-Khan told BuzzFeed News. “Our NHS and care staff who are on the front lines fighting back against coronavirus. They must have every single resource they need.”
Hospitals were so short on equipment that doctors were wasting time that could be spent treating patients running round the building looking for the right PPE, she said.
“They don’t have the equipment they need and feel it’s being rationed,” she said, “or they don’t have any at all. There are patients waiting around while they’re trying to find the equipment they need.”
Allin-Khan also said that NHS workers were “suspicious” that guidance had changed from wearing a full FFP3 mask, gloves, and a full apron to only wearing gloves and a basic surgical mask.
“It’s made staff very concerned,” she said. “They feel suspicious of the changes. If they’re changes that are evidence-based, we need the reasoning behind it to be completely transparent.
“We must have the protection that we need. The care sector don’t have anything. Carers are going to see the most vulnerable groups, patients who are elderly and unwell, they’re coming off public transport and going in to see patients.”
At his final Prime Minister’s Questions as Labour leader, Jeremy Corbyn also raised the issue: “The Health Care Supply Association has been forced to use Twitter to ask DIY shops to donate protective equipment to NHS staff,” he said, asking the prime minister: “This is an appalling situation. When will NHS staff, social care staff, and community nurses, and all other staff relating to health care, get the PPE equipment they absolutely desperately need?”
In response, Boris Johnson said that “the Army is now distributing the supplies” adding that “in the last 24 hours they have distributed 17 million pieces of equipment.”
A Department of Health and Social Care spokesperson said, “We are working around the clock to give the social care sector and wider NHS the equipment and support they need to tackle this outbreak.
“We have delivered millions more items of personal protective equipment (PPE) for frontline staff at care homes, home care providers, and hospices, as well as to hospitals, ambulance trusts, GP practices, and pharmacists.
“The full weight of the government is behind this effort, and we are working closely with industry, social care providers, the NHS, and the Army to ensure the right equipment continues to be delivered.”