HSE told nursing homes regulator it could not supply requested PPE

Hiqa chief inspector sought ‘priority’ supply for homes from HSE chief on April 8th

By the peak of the coronavirus crisis in the first half of April, nursing homes were experiencing difficulties accessing sufficient PPE. Photograph:  Alan Betson

By the peak of the coronavirus crisis in the first half of April, nursing homes were experiencing difficulties accessing sufficient PPE. Photograph: Alan Betson

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The HSE told the nursing homes regulator last month, as coronavirus outbreaks rose sharply, that it could not supply three days’ worth of personal protective equipment (PPE) to all nursing homes, as requested, due to shortages.

The Health Information and Quality Authority’s chief inspector Mary Dunnion escalated concerns about reported shortages of PPE within nursing homes and congregated disability centres last month to the highest ranking official with the HSE.

Ms Dunnion wrote to HSE chief executive Paul Reid on April 8th seeking widespread distribution of PPE to nursing homes ahead of further outbreaks.

Deaths

The request came more than a week after Nursing Homes Ireland, which represents private nursing homes operators, sought three days’ worth of PPE for nursing homes in a meeting with the Minister for Health Simon Harris.

The nursing home sector has borne the brunt of the pandemic, accounting for 54 per cent of the deaths from coronavirus in the State.

By the peak of the crisis in the first half of April, nursing homes were experiencing difficulties accessing sufficient PPE.

On April 8th, there were virus clusters – each defined as two cases or more – at 164 residential care facilities, including 117 nursing homes, an increase from 53 a week earlier.

Ms Dunnion asked Mr Reid in her letter that “in the interest of resident and staff protection” and “prior to a Covid-19 outbreak being declared” that a “baseline supply” of appropriate PPE “be made available as a priority within all nursing homes and congregated disability centres”.

“While the national supply of PPE remains a concern, I request that a baseline supply should consider the projected consumption rate relative to the number of residents in the centre and be sufficient to last three days,” she told Mr Reid in her letter.

The correspondence was copied to senior health officials: HSE chief operations officer Anne O’Connor; HSE national director of community operations David Walsh; the HSE’s national director of quality assurance and verification division, Patrick Lynch; Dr Kathleen MacLellan, assistant secretary for social care at the Department of Health; and Hiqa chief executive Phelim Quinn.

Ms Dunnion sought PPE for nursing homes not yet affected by outbreaks comprising long-sleeved, fluid-repellent disposable gowns, non-sterile examination gloves, surgical masks and “FFP2” and “FFP3” medical grade masks for aerosol-generating procedures.

The letter was released by Hiqa to The Irish Times under the Freedom of Information Act.

Under review

The HSE told Hiqa in a response on April 14th that due to difficulties in sourcing PPE that it would not be possible to provide the three-day baseline supply.

PPE was being directed at the areas of greatest risk through a co-ordinated distribution management system for the delivery of the equipment, the HSE said.

In the HSE’s reply, Patrick Lynch, national director of quality assurance, told Hiqa that Ms Dunnion’s requested supply of PPE would be kept under review as the supplies of PPE built up.

By April 14th, the date of the HSE’s response, the number of clusters in residential care facilities had risen to 221, including 158 nursing homes, a further 41 nursing homes in six days.

A spokeswoman for the HSE said last night that in the early days of the response to Covid-19 it “faced an unprecedented challenge in the face of global demand for PPE.”

The HSE’s success in sourcing significant quantities from China and domestically has meant “the supply situation has improved significantly over the past four weeks in particular,” she said.

Each crisis management team across the HSE’s community healthcare area is “prioritising the needs of long-term care residents” and has “offered very significant support to the nursing homes in their areas, particularly those with Covid-19 outbreaks,” said the spokeswoman.

Between April 17th and May 14th some 12.6 million items of PPE - or 39 per cent of all PPE distributed across the health service - went to the long-term residential care sector, she said.