PPE stocks ran so low at the height of the first wave of Covid in Scotland that there was less than a day’s supply of protective gowns and only 24 hours’ worth of hospital-grade masks left, according to the public spending watchdog.

Audit Scotland revealed that the expiry date had to be extended on FFP3 filtration masks used in intensive care “until supply chains became more stable”.

The watchdog also found that 29 PPE contracts worth a total of £98 million were awarded to new suppliers without competition during the first four months of the pandemic.

Scotland’s PPE stockpile had been developed in preparation for a flu pandemic and Audit Scotland noted that demand triggered by Covid-19 was “unprecedented”.

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During 2019/20, NHS National Services Scotland was distributing an average of 5.6 million items of PPE a week, worth £162,000, to hospitals, social and primary care.

Since March 2020, this has increased to an average of 17.4 million items a week costing £3.6 million.

At the start of 2020 none of the PPE used in Scotland was manufactured here, compared to 88 per cent now - excluding gloves, which are mostly made in Malaysia.

In its report today on PPE procurement, Audit Scotland said that a huge global spike in demand coupled with factories overseas closing due to coronavirus lockdowns led the international supply chain “to falter” by March 2020.

It added: “There were particular pressures on gowns and visors at the start of the pandemic, as these items had not been held in the UK stockpile.

“By April 2020, centrally held PPE stocks were very low, with NHS NSS holding less than a day’s worth of stock of long sleeve gowns and a few days’ of other key items in its warehouses.”

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This included FFP3 masks needed to protect healthcare staff performing aerosol-generating procedures (AGPs) or working in intensive care units.

By April 2020 there was only a day’s worth of supplies, along with two days’ worth of visors and just eight hours' worth of long-sleeved gowns.

The Herald: Source: Audit Scotland Source: Audit Scotland

At this point, Audit Scotland says the Scottish Government "authorised the release of PPE from the PIPP [Pandemic Influenza Preparedness Plan] stockpile", adding: "As most of the FFP3 masks had passed their original expiry date, they were independently tested, and their expiry dates extended.

"The Scottish Government had no concerns with the efficacy of this stock, and it was used to supplement existing arrangements until supply chains became more stable."

This echoes the results of a survey by the BMA of its Scottish members which found that, by the end of April 2020, 29 per cent of those carrying out AGPs were encountering shortages of full-face visors and 13% running out of FFP3 masks.

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In contrast, by May 2021 there were over 100 days' worth of stock for every item of PPE, including enough FFP3 masks to last 176 days and 249 days' worth of gowns.

Despite the unprecedented nature of the pandemic, Audit Scotland said the Scottish Government "could have been better prepared" in relation to PPE supplies and training if it had fully implemented the improvements identified as part of pandemic preparedness exercises in 2015 and 2018.

Audit Scotland also notes that the average unit price of PPE during the pandemic "doubled compared to the previous year", adding: "Had NHS NSS been able to buy PPE at the same prices as 2019, it would have spent £37.4 million less on PPE stock in the first five months of the pandemic."

The Herald:

In March 2020, the cost of a single pair of protective gloves soared from three pence to 17 pence; a single apron went from two pence to 45 pence each; and the price per long-sleeved gown peaked at £8.17 in April 2020, up from £1.71 pre-pandemic.

Under normal circumstances any public contract worth more than £50,000 must be awarded through a competitive tender, but the majority of PPE procured during the pandemic - 69 out of 77 deals - saw NHS NSS award contracts directly to suppliers "uniquely placed" to meet them or due to "extreme urgency".

This included 40 contracts worth £166m awarded to known suppliers, and 29 contracts worth £98m to new suppliers without competition.

The Herald: Source: Audit ScotlandSource: Audit Scotland

Scottish Labour's health spokeswoman Jackie Baillie said frontline workers "were put in danger" by the Scottish Government's "catastrophic failure "to ensure adequate PPE supplies at the outset of the pandemic.

She added: "The Scottish Government's procurement process was not fit for purpose and it is clear that they handed out big money contracts without the normal due diligence and questions remain as to whether this represents value for the taxpayer.”

Dr Graeme Eunson, chair of the BMA’s Scottish Consultants Committee, said it was "very concerning to see how short supplies actually were in April last year".

However, Stephen Boyle, Auditor General for Scotland, said the Scottish Government and NSS had "worked well together under extremely challenging circumstances".

He added: "The challenge now will be in developing a longer-term approach to PPE supply and distribution that includes both business as usual needs as well as preparing for future pandemics."

A Scottish Government spokesman said: “Scotland never ran out of PPE. Work undertaken by the Scottish Government and its partner organisations at that time included setting up a whole new Scottish supply chain from scratch, with the creation of hundreds of jobs.

“The Scottish Government agrees with Audit Scotland that we need to learn from this pandemic and bring that learning into planning for future pandemics.”