Document Five
Health Report
Response to the Auditor-General's recommendations on the procurement,
distribution and management of PPE stocks
Date due to MO:  15 July 2020
Action required by:
20 July 2020
Security level:
IN CONFIDENCE
Health Report number:  HR20201184
To:
Hon Chris Hipkins, Minister of Health
Contact for telephone discussion
Name
Position
Telephone
Sue Gordon
Deputy Chief Executive, COVID-19 Health  section 9(2)(a)
System Response
Kelvin Watson
Manager, COVID-19 Health and Disability  section 9(2)(a)
Supply Chain
under the Official Information Act
Action for Private Secretaries
Return the signed report to the Ministry of Health.
Date dispatched to MO:
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Document Five

Response to the Auditor-General's recommendations on
the  procurement, distribution and management of PPE
stocks
Purpose of report
This report provides information and talking points to enable you to provide an update to Cabinet
on work to address recommendations made by the Auditor-General in the report titled Ministry of
Act
Health: Management of personal protective equipment in response to COVID-19.

Summary
•  CAB-20-MIN-0330 requires you as Minister of Health to report to Cabinet by 20 July 2020
with an update on the Ministry of Health’s (the Ministry) progress on addressing the
Auditor-General's recommendations on the procurement, distribution and management of
personal protective equipment (PPE) stocks.
Information
•  The Auditor-General released their report titled Ministry of Health: Management of personal
protective equipment in response to COVID-19 on 17 June 2020. The report found that while
the Ministry and district health boards (DHBs) had planned for a national health emergency,
there were gaps in the planning about how PPE would be procured and distributed to
mitigate risks of any shortages. In addition, reserve stock had not been well managed nor
maintained, and guidelines for the use of PPE evolved during the pandemic causing some
Official
confusion among users.
•  The report concludes that COVID-19 would have chal enged any public health and disability
system, and that the Ministry moved quickly to establish a new centralised system for
the
procuring, prioritising, and distributing stock.
•  The Ministry largely agree with the conclusions of the report and accepts all ten
recommendations. In some cases, work ahead of the release of the report has addressed
some recommendations. Overal , the recommendations provide useful guidance to the
under
Ministry as we look to strengthen the systems and processes that support the supply of PPE
and improve our preparedness for any future events.

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Recommendations
The Ministry recommends that you:
a)
Note  the progress the Ministry have made on addressing the Auditor-
Yes/No
General recommendations on the management of PPE in the early stages
of COVID-19
b)
Agree to provide an update to Cabinet on the Ministry’s progress, on 20
Yes/No
July 2020

Act

  Sue Gordon
  Hon Chris Hipkins
Deputy Chief Executive
  Minister of Health
COVID-19 Health System Response
  Date:

Information

Official

the

under

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Document Five

Appendix 1: Talking points
•
Earlier in July, it was agreed that an update would be provided to Cabinet by 20 July
2020 on the Ministry’s progress on addressing the Auditor-General's recommendations
on the procurement, distribution and management of PPE stocks.
•
The Auditor-General released their report 17 June 2020. The report found that while the
Ministry and DHBs had planned for a national health emergency, there were gaps in the
planning about how PPE would be procured and distributed to mitigate the risks of any
shortages. In addition, reserve stock had not been well managed nor maintained, and Act
guidelines for the use of PPE evolved during the pandemic causing some confusion
among users.
•
The report concludes that COVID-19 would have chal enged any public health and
disability system, and that the Ministry moved quickly to establish a new centralised
system for procuring, prioritising, and distributing stock.
•
The Ministry largely agree with the conclusions of the report and has accepted al  ten
recommendations.
•
While the Ministry is stil  working through al  the actions that wil  be undertaken to
Information
address the recommendations made in the report, several pieces of work are either
already underway or wil  be started in the coming months in response to the report and
the wider learnings from COVID-19.
Progress against recommendations
Official
•
The Ministry is completing an interim update to the National Reserve Supplies
Management and Usage Policy (3rd edition) to clarify roles and responsibilities for the
national reserve supply, eligibility for accessing the national reserve and prioritisation. A
the
full update wil  be completed once activities to address the recommendations made in
the report are implemented.
•
In the 2020/21 year, the National Health Emergency Plan (NHEP) wil  be reviewed. The
updated NHEP wil  reflect any changes to the national reserve supply model and
include clear direction to the health and disability sector on the purpose and scope of
under
the national reserve supply, roles and responsibilities in readiness and response, and
distribution at the time of an event.
•
The Ministry wil  review the processes and accountability documents referring to the
national reserve supply, to ensure alignment and clarity on roles and responsibilities at
all levels. The Ministry will also work with DHBs to re-establish a national y consistent
process to review DHB health emergency plans to ensure alignment and that they meet
legislative requirements and responsibilities.
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•
The scope and makeup of the national reserve wil  be reviewed in response to the
recommendations and the lessons learned from the response to COVID-19, and include
consideration of:
o  the range of PPE items required be held in the national reserve
o  the types, specifications and sizing requirements for each identified item
o  the volume required to meet forecast requirements.

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•
section 9(2)(f)(iv)

•
The Ministry is working with the Health Quality and Safety Commission and health
sector to establish a national clinical network. The network wil  consider the various
COVID-19 reviews and reports in order to provide sector direction related to Infection
Prevention and Control (IPC) and PPE. An initial meeting wil  be confirmed by end of
July to commence this process.
•
More broadly, the Ministry is establishing a governance framework with clear roles and
responsibilities to determine and agree on the criteria for the management and
purchasing of PPE in the current environment, which it would also seek to retain in a
post-COVID environment. This wil  include:
o  a national procurement coordination function performed by an external body, with
oversight, strategic direction, monitoring and funding continuing to be provided
from the Ministry
o  working with stakeholders to strengthen the short-, medium- and long-term
procurement strategies and plan for the active and reactive management of critical
medical supplies (including PPE)
o  working with DHBs and procurement category leads to implement a reporting
structure that wil  provide clarity on inventory forecasting and support better quality
sourcing.
Timeline for addressing the recommendations
•
It is anticipated that many of these actions wil  be completed by the end of July 2020,
positioning the Ministry well to continue responding to COVID-19. This will include
under the Official Information Act
establishing the governance framework and completing an interim update to the
National Reserve Supplies Management and Usage Policy. Other actions, such as
changes to the national reserve inventory management model for PPE (and other
supplies, if appropriate), may require structural shifts that wil  require longer to develop
and implement.
•
In any event, the Ministry anticipates al  changes in response to the report to be
implemented by the end of the 2020/21 year.

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Appendix  2: Activities underway against
the recommendations they address
Activity
Recommendations
The Ministry is completing an interim update to the National Reserve
2
Supplies Management and Usage Policy (3rd edition) to clarify roles
and responsibilities for the national reserve supply, eligibility for
accessing the national reserve and prioritisation. A full update wil  be
completed once activities to address the recommendations made in
the report are implemented.
In the 2020/21 year, the National Health Emergency Plan (NHEP) wil
2
be reviewed. The updated NHEP wil  reflect any changes to the
national reserve supply model and include clear direction to the
health and disability sector on the purpose and scope of the national
reserve supply, roles and responsibilities in readiness and response,
and distribution at the time of an event.
The Ministry wil  review the processes and accountability documents
1, 2
referring to the national reserve supply, to ensure alignment and
clarity on roles and responsibilities at all levels. The Ministry will also
work with DHBs to re-establish a national y consistent process to
review DHB health emergency plans to ensure alignment and that
they meet legislative requirements and responsibilities.
The scope and makeup of the national reserve wil  be reviewed in
3b, 6
response to the recommendations and the lessons learned from the
response to COVID-19, and include consideration of:
•
the range of PPE items required be held in the national
under the Official Information Act
reserve
•
the types, specifications and sizing requirements for each
identified item
•
the volume required to meet forecast requirements.
section 9(2)(f)(iv)

2, 5, 7, 8 and 9

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section 9(2)(f)(iv)

4, 7, 10



   ormation Act
The Ministry of Health is working with the Health Quality and Safety
3a
Commission and health sector to establish a national clinical
network. The network wil  consider the various COVID-19 reviews
and reports in order to provide sector direction related to IPC and
PPE. An initial meeting wil  be confirmed by end of July to commence
this process.

under the Official I
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