Sustainable Safety: Personal Protective Equipment In The Covid World

Pei-Ling Chay is a Consultant at PPL. She has been helping to support the response to COVID-19, including working with the People Directorate at NHS England and Improvement Workforce Disability Equality Standard (WDES) Team to understand the experience of disabled staff through the pandemic; and separately led research into the use of PPE during the height of the pandemic.

The COVID-19 pandemic saw significant challenges globally in ensuring an adequate supply of PPE to health and social care workers.

The severe shortages of PPE and the continued pressure on supply chains meant there was a need to take a pragmatic approach, in particular for respiratory protective equipment (RPE). This meant that governments, researchers, manufacturers and practitioners had to explore the feasibility of reusing PPE in health and care settings, which is not normally considered practicable.

At PPL, we supported clients to understand the emerging guidance on re-use produced by the World Health Organisation (WHO) during the pandemic.

Developments in PPE re-use guidance will ultimately have to be driven by further technical research, particularly into the feasibility of sanitising existing PPE ranges and rendering existing items fit for re-use.

Nevertheless, we identified a number of specific opportunities to optimise reuse in a time of shortages.

1. Ensure that there is consistent understanding and monitoring of what PPE is re-usable and actually being re-used.

This includes in care settings previously less accustomed to undertaking largescale infection control, such as care homes and domiciliary care.

Public Health England and others did produce guidance, but there is further potential to work with wider partners (including the CQC, local authorities and care providers) to understand how this was applied and what further support or resources might be helpful. Central will be positioning appropriate re-use as a way of promoting safe practice, not an alternative to it.

2. Ensuring that differences in type and manufacture of PPE are understood and leveraged across different care settings.

Within categories of PPE, some are more robust or re-usable and some designed with disposal in mind. There is an opportunity to ensure the right types of PPE are being directed to the right settings. For example, PPE that can be re-sanitised should be directed to those institutions which have the facilities to process items for re-use, freeing up supplies of equivalent disposable items for single use elsewhere.

3. Implement sourcing strategies to source PPE that is more capable of being used safely multiple times.

This includes working with procurement teams to ensure that, wherever possible, the ranges being procured are capable of being re-used.

4. Work with manufacturers to design PPE that can be more easily reused.

For example, through the use of different materials, modular designs can allow for the replacement of specific components. This allows for re-use and can extend the number of times an item can be safely re-used.

5. Ensure that processes and facilities are in place to support safe recycling of PPE after the end of its useful life.

It is important that organisations investigate opportunities to establish local or centralised facilities to collect and re-process PPE that cannot be further sanitised or used by end users to reduce the impact of the increased waste that will be produced.

The research we conducted was initially aimed at supporting decision makers in health and social care settings. At the time of writing, the UK government has mandated face coverings for the general public on public transport and in shops and supermarkets.

In the “new normal”, PPE is now far more commonplace and extends beyond health and care settings, and this is likely to continue for some period of time.

Organisations which would not have used PPE prior to the pandemic are now having to ensure an adequate supply and suitable training for their staff. As lockdown measures continue to be lifted worldwide, there is a pressing need to further develop the evidence base around safe, re-usable PPE, both to support contingency planning in the event of a second wave of COVID-19 and to operate sustainably in the world of the “new normal”.