Identifying and resolving issues in PPE supply
The COVID-19 pandemic led to a significantly greater need for personal protective equipment (PPE) to protect staff whilst caring for patients. Since 25 February 2020 the Department of Health and Social Care distributed over 8.6 billion items of PPE, predominantly for use by health and social care services in England[1]. This increase in demand happened on a global scale, with subsequent supply challenges in getting PPE consistently to the frontline.
In response there was an increase of innovation activity in the PPE sector. This case study gives an overview of some of the key work to date from four of the AHSNs.
AHSNs supported their local organisations to access PPE
In 2020, many providers were struggling with a consistent supply of PPE. The AHSNs actively engaged with innovators in the PPE space, including those developing reusable equipment, and those researching how to effectively use it.
AHSN North East North Cumbria (AHSN NENC) and Yorkshire and Humber AHSNs teamed up to quickly triage high volumes of new suppliers, find alternative suppliers of PPE in shortage areas, undertake first stage due diligence, and feed this back to providers. Many of the PPE suppliers were smaller operations or new to the PPE market. As such they did not meet national requirements to join the NHS Supply Chain but often had high-quality products in demand by NHS providers.
Together the AHSNs assessed 200 new suppliers against PPE standards, with stock and contact information generated on around 500 companies in total. The AHSNs worked with partners at regional LEPs, local resilience forums, NECS, and other networks across the whole of the North East and Yorkshire and Humber on innovation and economic growth opportunities.
This work has also supported innovators, and product development.
AHSNs supporting economic growth
AHSN NENC worked closely with Dräger to develop a proposal around its plans to open a PPE manufacturing plant, in response to the growing demand for respiratory masks during the pandemic. This was pitched to the regional and national leads involved in the NHS procurement cell. Dräger needed to ascertain where to concentrate their offer around mask production. Using their networks, AHSN NENC were able to establish the model and type of mask required by the NHS. AHSN NENC also coordinated with NHS trusts across the North East and Yorkshire region to provide samples of Dräger’s products, which received positive responses from the frontline. Consequently, Dräger were successful in winning a multimillion pound contract and have set up a manufacturing facility in the North East, creating 40 jobs.
Alex Duthie, UK Sales Director, Dräger, said: “The AHSN NENC were invaluable to our bid for the PPE Government contract. They were able to get our name to the right people and assisted in building our profile as an existing and trusted supplier within the NHS. Whenever an opportunity arose, AHSN NENC, Innovation SuperNetwork and North East LEP were advocates of ours, and we couldn’t have done it without them.”
AHSNs supporting the development of innovation
PeRSo
From March 2020, Wessex AHSN were asked to support the development of a Personal Respirator Hood (PeRSo). Outline plans had been drawn up between Southampton Hospital and University Hospital Southampton NHS Foundation Trust. Taking an active role in the cross-organisational project team, they brought in expertise to understand the pathway to regulatory approval, and engaged with BSI as the notified body to gain the appropriate CE mark and HSE approval for use. This has been a rapid product development with the AHSN playing a significant part in accelerating progress.
3,500 PeRSo 3 units have been manufactured locally for University Hospital Southampton and are in use, and 15,000 units have been sold nationally to 30 NHS trusts.
In August 2020, the co-designers were awarded the Royal Academy of Engineering President’s Special Award and in October 2020, MBEs in the Queens’s Birthday Honours for this work.
Blue Mirror
Like many other AHSNs, Yorkshire and Humber AHSN is supporting new innovators help to ensure NHS staff have access to a safe supply of PPE. The AHSN has been working with Blue Mirror, a training tool for use in proper ‘doffing and donning’ of PPE. Blue Mirror provides a scalable PPE training buddy using Artificial Intelligence on a tablet. The system provides a real-time visual and audio guide to users, advising on the next steps of the protocol whilst also highlighting errors as they are observed to support safety and continual learning with compliance reporting.
The Blue Mirror technology is being introduced into the UK through CorrMed Limited, a UK company that specialises in infection control and safety products. It has been well received by infection control teams, especially for the training of staff. The team are seeking a Blue Mirror pilot site here in the UK, with the aim of replicating the work already underway in two major healthcare installations in New Zealand and Australia.
Developing the potential of reusable PPE
This collaborative work has continued and is expanding to consider sustainability, as disposable PPE has a huge environmental impact.
From November 2020, representatives from three AHSNs (Oxford, NENC and Yorkshire and Humber AHSNs) have been meeting weekly with the National PPE programme and the PPE Innovation and Sustainability team who are leading nationally on reusable PPE. Workshops were held in December and January with 60 attendees, representing a wide range of stakeholders from multiple disciplines including; infection prevention and control, procurement, sustainability, supply chain, regulators and clinicians.
These workshops have been highly successful in providing visibility of the many initiatives that are underway in the NHS with regard to reusable PPE. Networking, exchange, sharing and learning have been a feature. For example, the Yorkshire Ambulance Service are leading on a trial involving 50 healthcare organisations. The aim is to reduce the reliance on single use Type IIR facemasks. The assessment will look at the cost benefits as well as IPC requirements, cleaning, washing and decontamination.
Another example is a pilot for re-usable gowns involving 41 trusts. Initial findings from this pilot have shown a cost saving in the region of £1.54 per use based on 75 washes and including laundry costs. The sustainability benefits are significant; 28% less energy, 41% less water and 66% less emissions are required/generated in the production and laundering of a disposable gown compared with the equivalent number of disposable gowns.
Lessons Learned
Bringing about behaviour change is particularly challenging in a fast-paced, evolving situation such as a pandemic. Early coordination across organisations is key. Visibility and communication of activities being undertaken across the NHS in the area of reusable PPE is vitally important as is the clear identification of decision makers and the involvement and management of stakeholders. Through working together, AHSNs have been able to have a much larger impact.
Future Plans
All AHSNs will continue to work with PPE innovators through the Innovation Exchange offer of access to business expertise from AHSN teams across the country. AHSNs will continue to share best practice and support economic growth of UK manufacturers and support services.
The AHSNs will maintain their active engagement with the National PPE programme and the PPE Innovation and Sustainability team.
The AHSN environmental sustainability community of interest group is expanding and will develop a new strategy that will include a clear objective to support a Net Zero NHS in supporting and implementing innovative, reusable PPE.
Yorkshire and Humber AHSN is due to launch a local green mentoring programme, which may lead to a PPE organisation being supported. AHSNs are also supporting the Green Surgery Challenge national initiative with the Royal College of Surgeons and partners, which will likely include a PPE focus.
[1] https://www.gov.uk/government/collections/ppe-deliveries-statistics-england-weekly-reports