News & Views

UK pulls plug on scheme to support innovative anti-Covid masks

UK-made Brilliansee clear masks have helped children at Alder Hey hospital in Liverpool communicate with parents and medical staff

UK pulls plug on scheme to support innovative anti-Covid masks

The government has abandoned plans to back a novel type of anti-viral face mask, denting the ambitions of a group of innovative UK manufacturers and developers as Covid cases rise.

Transparent face masks are especially helpful for people with hearing loss and other communication difficulties – a group that has struggled to cope with conventional masks because they hide the wearer’s lower face and mouth. Masks are a critical element of public health strategies to combat Covid and related viruses: medical-grade face coverings accounted for roughly a third of the £12bn the government has spent on personal protective equipment (PPE) since coronavirus became a threat.

As a result of the recent surge in Covid cases, some health advisers have called for a return to mandatory mask wearing in shops, hospitals and on public transport. Up to 10 per cent of demand for medical-grade masks could eventually be accounted for by transparent versions, say industry observers, especially if they can be made cheaper.

I tried out clear masks – made by Contechs, a Warwick company best known for automotive engineering – at a care home for old people in London where my 95-year-old mother Marguerite is a resident. She said: "It is so nice if I can see people's mouth and lips so I can tell if someone is smiling."

Demonstrating Contechs clear face mask
Care home resident Marguerite Marsh in conversation with her son Peter, trying out a Contechs clear mask

A carer at the home said: "I’ve been saying for some time that we need masks such as this so we can communicate much more easily with the people we are trying to help."

The new masks include a clear plastic window fitting inside the normal fibrous material of a conventional mask. Due to the difficulty of adding this window using automated machines, clear masks are currently much more expensive than conventional ones, although industry experts believe prices should fall over time.

After more than a year of talks with industry representatives about a project to procure approved clear masks made or developed in the UK, the Department of Health and Social Care said it had “unfortunately” shelved the scheme as “products have not entered the market quickly enough to pilot by the DHSC-led PPE programme”. It added that it "continues to actively encourage manufacturers to develop new, innovative products which meet the standard for transparent face masks”.

Roger Wicks of the Royal National Institute for the Deaf, a charity, said access to healthcare for people with hearing loss had been “exceptionally difficult during the pandemic [due to] communication barriers”. The pilot project’s abandonment was therefore “incredibly disappointing”.

Gavin Killeen, a director of North West Medical, which makes its own brand of clear masks near Londonderry in Northern Ireland, said the DHSC’s decision followed long delays in the granting of technical approvals to companies working on the devices. “The whole process has been very frustrating” he said.

The DHSC’s reason for cancelling its pilot programme puzzled some industry representatives, because a big part of the scheme’s rationale had been to help stimulate the clear-mask market. Also – with three clear masks including the Contechs product having received technical approval and others in the pipeline – health officials had a reasonable choice of coverings from which to select for the pilot. The compliance procedures for clear masks were devised by the DHSC representing England along with partner health agencies in Wales, Scotland and Norther Ireland.

North West medical lab
The government has encouraged the development of clear masks such as this one made by North West Medical, but has shelved a planned funding scheme

Under the outline for the pilot, the DHSC was to have distributed masks from a central pool to healthcare facilities and care homes throughout the UK. While the money allocated to the scheme was modest – between £3m and £10m, according to industry executives, enough to pay for perhaps 20m masks – it had been designed to “pump prime” supply to allow proper testing in real-life conditions and help the products gain acceptance.

The DHSC declined to elaborate on its decision. But in seeking an explanation some observers have pointed to the large costs so far of buying PPE for Covid – along with evidence that some of the money has been spent unwisely on poor-quality or unsuitable items. In addition, the clear masks approved so far are expensive – selling for 35p to £1 each, compared to the price of a hospital-quality Type IIR mask of 5p-20p. Clear masks of the sort approved by the government have a protective performance comparable to Type IIR coverings, of which 1.5bn were used in the National Health Service in England in the year to June 30 2022, accounting for 96 per cent of total NHS demand, according to DHSC figures.

Chris Endicott, managing director of Britannia Safety, which distributes another of the approved clear masks, the Smile Shield, said: “The cancellation of the DHSC pilot was annoying – we spent over a year on this including nine months on the actual testing and compliance, not to mention possibly hundreds of emails to various ministries, councils, police forces etc…However, I can fully understand the massive costs that Covid has cost the country in grants and furlough, as well as a myriad of other unforecastable costs such as the vaccine program – something had to give.”

Smile Shield was developed by TAD Medical of Bristol, which makes its masks in China but wants to bring production to the UK. The third certified product is made by Globus Medical, a US group making masks at two UK plants.

At Bluetree – a company based near Rotherham, with several clear masks in development, though none yet authorised by the DHSC – James Kinsella, co-chief executive, said he was “relaxed” about the cancellation. Bluetree, which is a Made Here Now sponsor, is continuing to press the case for government approvals of its transparent products, while stepping up efforts to sell its masks overseas.

A key point for Bluetree is that some of its clear masks, called Brilliansee, can be washed and reused up to 30-40 times. Virtually all high-grade hospital facemasks currently used in the UK, including most of the clear masks now being evaluated, are single use, adding immensely to the UK waste mountain.

coronavirus-masks face-coverings-shops
Inside the North West Medical mask-making plant near Londonderry

“[The reusable version of] Brilliansee is exciting because we don’t believe any reusable, transparent products exist in the market,” said Kinsella. Alder Hey children’s hospital in Liverpool, which has worked with Bluetree on its mask development said: “The Brilliansee mask [in either its reusable or single-use forms] is as safe as the surgical masks worn daily, safer than if clinicians are removing their masks so they can conduct the session, such as in speech therapy, and safer than cloth masks that are not equivalent to [hospital-grade] masks.”

At TAD Medical, Tom Anderson-Dixon, a director, said that in the absence of the government pilot the company had stepped up its efforts to sell the Smile Shield coverings to individual health trusts. “We’ve been quite successful in getting the products into the market. The mask has had a lot of positive feedback,” he said.

On manufacturing, Anderson-Dixon said: “We are hoping we can move this to the UK at some point so long as we find we can make the products here at a cost that the market will accept. We have formulated a strategy for doing this and have located a potential site for production. We think that making the products in the UK would help our brand and want to make it happen.”

Clear-mask makers aim for greater visibility

Bluetree clear face masks (left to right)  Hannah Sousa (Prototyping ) Zoya Azam (Laboratory)  Meg Hill (Coach) and James Ford (R&D Engineering)
Hannah Sousa, Zoya Azam, Meg Hill and James Ford (left to right) are among the staff at a plant near Rotherham run by Bluetree, a UK leader in developing and making clear masks

News that the government has abandoned a pilot project to support UK companies making transparent face masks has raised doubts about its commitment to boost domestic production of personal protection equipment (PPE) and create a more resilient supply chain.

Demand for fresh stocks of PPE could surge if new strains of Covid or other viruses lead to a sustained rise in infections and hospital admissions, prompting the reimposition of mask-wearing in shops or on public transport.

In the early stages of the crisis, poor planning created a crippling shortage of masks and other protective gear, forcing the Department of Health and Social Care to pay high prices to overseas suppliers, notably in China. Raina Summerson, chief executive of Agincare, a Dorset company that runs care homes, said that transparent masks undoubtedly help communication with elderly people and "given the lessons learned in the pandemic" these should be sourced in the UK if possible.

Official plans call for at least 50 per cent of all protective equipment used in the UK, such as gowns, aprons and masks, to be manufactured domestically. Before the pandemic, just 1% came from UK plants. However, the government has declined to provide details of progress towards its target. The 50 per cent plan was referred to in 2021 by Sir Chris Wormald, DHCS permanent secretary, during parliamentary hearings.

The shelving of this pilot echoes a similar decision in a related project earlier in the pandemic. In 2020 the DHSC dismayed industrial representatives when it pulled out of a mooted £75m scheme to boost UK production of hospital gowns that could be washed and reused up to 100 times.

The initiative had been framed as a bold move to reduce the environmental impact of single-use PPE. The Cabinet Office had estimated that at the peak of the Covid crisis almost half a million single-use gowns were being thrown away by hospitals each day.

As in the previous case, the DHSC encouraged UK manufacturers to develop medical-grade clear masks, to tackle the current lack of supply and to boost the amount of PPE made in the UK. Mask makers can still try to sell their products to health trusts and private-sector users but without the stimulus that a centralised purchasing programme would have given them.

In July 2021, the department said: "DHSC continues to actively encourage manufacturers to develop new, innovative products which meet the standard for transparent face masks…..DHSC has allocated funding for a pilot of new transparent masks in health and social care settings..... We anticipate that these initiatives will result in the availability of safe and effective transparent face masks to health and social care workers."

Clear masks fit tightly against people’s faces, and so offer much higher degree of protection than the transparent visors in widespread use during the pandemic.

According to the DHSC, more than 80 types of clear mask supplied by different developers were submitted for testing while the pilot scheme was under discussion. Some have gone on to be examined in a convoluted “four-nations” testing procedure led by the DHSC and involving several UK-wide health agencies.

The scheme’s demise comes in the wake of controversy over the government’s PPE procurement. The House of Commons’ public accounts committee said in a report in June 2022 that much of the DHSC’s procurement in 2020 was “haphazard, even given the scale of the challenge in building stocks at a time of massive global shortages”. Of the £12bn of PPE purchased during the crisis, the committee found that about a third turned out to be useless and will have to be incinerated or sent to landfill.

The report also criticised the degree of scrutiny the department gave to contract negotiations, finding that almost a quarter of all its PPE contracts were subject to “commercial negotiations, legal review or mediate after they had been awarded.

Gavin Killeen, a director of North West Medical, a manufacturer of clear masks, said: "It's clear that as the pandemic has developed, the UK has strengthened its ability to make masks and other sorts of PPE at more competitive prices, compared with the rest of the world. This has been due to the experience we and other manufacturers have gained over this period, along with the investments in automation. When you factor in the resilience you get from having local manufacturing, the case for buying locally has become more compelling."

A key factor behind what has happened with clear masks is that in the early stages of the pandemic the government massively over-ordered many types of PPE. As a result, some items in the UK stockpile may not need replenishing for several years.

However for innovative products such as high-quality transparent masks, few if any are held in existing stocks, making it far harder for officials to argue that boosting supply is unnecessary – especially if rising Covid infections put mask-wearing back on the agenda.