Nurses should refuse to treat coronavirus patients "as a last resort" if they are not given adequate personal protective equipment (PPE), according to new guidance.

The Royal College of Nursing (RCN) issued the advice to its members in a bid to prevent more frontline deaths, following criticism of the government about the supply of protective gear for NHS staff caring for people with COVID-19.

Ministers have been accused of being too slow to deliver the equipment, putting health workers at risk and meaning those treating coronavirus patients could pass it on.

Image: Criticism over the supply of PPE has led to protests outside St Thomas' Hospital in London

At least 19 NHS workers are known to have died after contracting the virus.

The RCN's new guidance states that if sufficient PPE cannot be supplied and treatment cannot be delayed or carried out in another format, nurses should decline to work.


A spokesman for the union said: "For nursing staff, this will go against every instinct. But their safety must not be compromised."

The RCN said it would provide legal assistance to those making what it acknowledged was an "enormously difficult decision".

It also warned nurses that they could face criminal prosecution for corporate manslaughter in "very rare" cases for walking away.

The RCN issued a seven-point safety plan for nurses to follow, with step six saying: "Ultimately, if you have exhausted all other measures to reduce the risk and you have not been given appropriate PPE in line with the UK Infection Prevention and Control guidance, you are entitled to refuse to work.

Paramedic says PPE is 'substandard'

"This will be a last resort and the RCN recognises what a difficult step this would be for nursing staff."

The RCN recommends those choosing to withdraw care should keep written justifications of their decisions and told nurses to brace for attempts to sack them, claims of clinical negligence, and possibly facing criticism at inquests or even criminal charges.

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Among the NHS staff to die after contracting coronavirus was a doctor who had warned the prime minister that health workers urgently needed more PPE.

Abdul Mabud Chowdhury, 52, died three weeks after writing a message to Boris Johnson asking him to "urgently" ensure protective gear for "each and every NHS worker in the UK".

It came as a survey of surgeons in England found a third (33%) did not believe they had an adequate supply of PPE.

Image: Dr Abdul Mabud Chowdhury died after contracting coronavirus

The poll of nearly 2,000 surgeons and trainees also found more than half (57%) said there had been shortages in the past 30 days.

The Royal College of Surgeons of England, which conducted the survey, said there was "still a lot more work to do to get adequate equipment to the front line".

At the daily Downing Street briefing on Saturday, Home Secretary Priti Patel said she was "sorry if people feel there have been failings" in providing PPE to NHS staff.

She said it was "inevitable" that demand would be high for PPE during a global pandemic, but insisted that the government was working to provide resources more widely.

'I'm sorry if people feel there have been failures'

Health Secretary Matt Hancock has advised NHS workers to only wear exactly the right amount of PPE, saying that getting it distributed was a "Herculean effort".

His remarks prompted Labour leader Sir Keir Starmer to say it was "quite frankly insulting to imply frontline staff are wasting PPE".

On Saturday, the UK recorded the deaths of another 917 coronavirus patients - including an 11-year-old - bringing the total number of deaths to 9,875.