Image: Harvey Allsop [CC BY-SA 4.0], via Wikimedia Commons
Firm’s withdrawal from Ventilator Challenge raises questions about scheme management and number of NHS machines
Just as news was breaking on Friday of the involvement of Dominic Cummings and former Vote Leave data analyst Ben Warner with the Scientific Advisory Group for Emergencies, another story broke about the withdrawal of the Dyson company from the government’s Ventilator Challenge. This second story appeared almost simultaneously in The Telegraph and on the BBC website.
It came as something of a surprise to Research Professional News, which had been asking the government questions about Dyson’s role in the Ventilator Challenge since Wednesday and, just moments before the story broke, was being directed by the Cabinet Office to the Department of Health and Social Care for answers. Those questions remain unresolved as we go to print this morning, while the government is struggling to account for thousands of ventilators it says have been procured since the start of the challenge.
Let’s begin at the beginning. On 26 March, three days after the coronavirus lockdown of the UK started, as part of a call to UK industry to increase ventilator capacity, the government announced to some fanfare that it had ordered 10,000 ventilators from the company led by British inventor James Dyson.
One month later, with health secretary Matt Hancock declaring that the UK had now reached the peak of the pandemic, the Dyson company had yet to deliver any units to the NHS. On Friday, Dyson announced that its machines were “no longer needed” and that although it had spent £20 million of its own money on the scheme, it was now withdrawing from the Ventilator Challenge.
Working with the Cambridgeshire-based Technology Partnership, Dyson had hoped to build ventilators at its UK base in Wiltshire, using aircraft hangars that, as the story goes, were once used to stuff parachutes during the second world war. On 26 March, the BBC was told by Dyson insiders that the company had “a working prototype, designed and built from scratch, which has been tested on humans and is ‘ready to go’”.
However, despite a condensed process, which shrinks the time needed for regulatory approval from six weeks to six days, the Medical and Healthcare Products Regulatory Agency (MHRA) had yet to endorse the Dyson design. To date, only a design adapted from a previous model by a consortium involving the specialist medical instruments company Penlon has been approved for manufacture—on 14 April—by the agency as a result of the challenge.
The ParaPAC, a second type of machine suitable for short-term ventilation, made by existing producer Smiths Medical, has also been ramping up production with a government order of 5,000 machines. Two hundred of these machines have been produced so far.
The consortium making the Penlon machine now has a contract for 15,000 units and has so far delivered 113 machines to the NHS. Prior to the Covid-19 pandemic, the average ventilator production in the UK was 50 units a week. Hancock has set a target of achieving capacity of 18,000 mechanical ventilators across the NHS.
When Research Professional News approached Dyson for comment on Wednesday, the firm responded that it had nothing more to say beyond what was contained in the video update on its website. In the video, dated 14 April, the company says: “Dyson and the Technology Partnership have worked together to develop an entirely new design of ventilator in record time for the clinical needs of Covid-19 patients.
“The project has brought together engineers, scientists, medical device designers, clinical testing and high technology manufacturing knowledge to achieve the NHS specification. Engineering teams and our component manufacturers have worked round the clock.
“Production lines at Hullavington Airfield are now making units for final regulatory approval. If this new ventilator passes MHRA tests, full-scale production can begin. We are ready to make 10,000 ventilators to support the NHS at this vital time.”
On 17 April, the Financial Times reported that Dyson and the Technology Partnership “faced a setback after being told that more sophisticated devices were needed rather than the initially requested mobile field ventilators”, and that “a second model has now been devised that will run off fixed medical gas pipelines”.
The Department of Health and Social Care took the unusual step of issuing a lengthy rebuttal to Peter Foster’s FT article about the Ventilator Challenge. The rebuttal makes no reference to the claims about the Dyson design.
When Research Professional News asked the MHRA—on 22 April—when the Dyson model was likely to be approved, we were referred to the Cabinet Office, which we were told was leading on the Ventilator Challenge. A Cabinet Office spokesman told us that he would not want to put a timescale on it and that approval would be announced when the MHRA was satisfied.
The Cabinet Office was unable to tell us the value of any contract related to the Ventilator Challenge on the basis of commercial sensitivity. However, it did confirm that no supplier would be paid for production until their design was approved by the MHRA. It was confirmed that a provisional order of 10,000 units had been placed with Dyson.
Dyson’s involvement in the Ventilator Challenge was of interest to Research Professional News not only because of James Dyson’s innovation report Ingenious Britain, which he produced for David Cameron’s government, but also because Hullavington Airfield is home to the Dyson Institute of Engineering and Technology. This private provider of higher education will re-open its doors to fresh students in September.
Its degrees are awarded by the University of Warwick. When announced in 2016, the Dyson Institute was praised by then universities minister Jo Johnson as one of a new breed of challenger institutions.
Bigger than Dyson
Our investigation into Dyson’s role in the Ventilator Challenge raises a number of serious questions about the management of the scheme and the government’s approach to national self-sufficiency in innovation.
Research Professional News was told by the Cabinet Office that as part of a three-pronged procurement strategy, the NHS had sourced 2,800 machines—including ones from abroad—while also buying units based on already approved designs.
A further non-invasive design supplied by a consortium involving University College London and the Mercedes Formula One team was approved by the MHRA on 29 March. UCL has told Research Professional News that “10,000 devices have been manufactured following an order by the UK government. The numbers aren’t part of the Ventilator Challenge as they are continuous positive airway pressure devices, not ventilators.”
We were told by the Cabinet Office that the NHS had access to a total of 10,800 ventilators. However, we have struggled to reconcile that figure with the numbers supplied to us by the Department of Health and Social Care.
The Cabinet Office has confirmed (twice) that the number of machines now produced by Penlon is 113 and that a further 200 ParaPAC devices have been produced. The Department of Health and Social Care tells us that 806 mechanical ventilators have been purchased from abroad along with “hundreds” of non-invasive machines—those imported units came from the European Union (Germany and Sweden), China and the United States.
Before the Ventilator Challenge began, the NHS had access to 8,000 ventilators. Adding together the number of imported machines, plus the Penlon and ParaPAC devices, we do not arrive at the increase of 2,800 machines stated by the Cabinet Office.
Yesterday evening, the Department of Health and Social Care finally responded to us. It said: “Today (27 April), there are around 10,900 mechanical ventilators available to the NHS across the UK. The additional stock comprises ventilators from established UK suppliers, abroad, new UK suppliers (prime minister’s Ventilator Challenge) and the private sector. In addition, today, there are also 4,387 non-invasive ventilators available to the NHS across the UK which were not available before the start of the crisis in mid-March.”
This response raises further questions. Given that the figures do not add up for new machines from existing and recently approved suppliers, plus imports, are the missing machines—our investigation accounts for only 1,119 ventilators—to be found in “the private sector”?
In other words, is the government counting machines in private hospitals as part of the NHS stock? Furthermore, is this sort of counting being repeated for non-invasive machines “available to the NHS…which were not available before the start of the crisis”?
What has the cost of the Ventilator Challenge been for industry and the government? What does the government intend to do with the excess machines it has now ordered as a result of the challenge? The Department of Health and Social Care says it is on track to reach Hancock’s target of 18,000 machines “in the next few weeks”, but it now has MHRA-approved orders exceeding 20,000 machines to add to existing stock.
The health department says: “We continue to take advice from the scientific and clinical experts about the potential implications—the numbers of ventilators required will change depending on how effectively we can flatten the curve.”
The government has been criticised for its failure to participate in an EU procurement scheme for ventilators, with ministers blaming a communications snafu for the missed chance to join the buying consortium. To date, the EU scheme has not delivered any ventilators to member states.
Imperfect timing
Yesterday, Research Professional News returned to Dyson, the Cabinet Office and the health department in an attempt to understand the timeline that led to the firm’s withdrawal from the scheme and the subsequent breaking of that story by The Telegraph and the BBC.
We were told by the Cabinet Office that the government had not cancelled its provisional contract with Dyson and was still testing the machine along with others as part of the MHRA approval process. However, the government would now be cancelling contracts with suppliers whose devices failed to obtain regulatory approval.
Asked when the decision was made to withdraw from the scheme and whether the company had discussed this with the government before making an announcement, Dyson simply referred us to a statement made by James Dyson on Friday. It says: “Dyson people welcomed the government’s challenge. Mercifully they are not required, but we don’t regret our contribution to the national effort for one moment.
“I have some hope that our ventilator may yet help the response in other countries, but that requires further time and investigation. We have spent around £20m on this project to date, but we will not accept any public money. The team have worked 24/7 to design and manufacture a sophisticated ventilator in a short timeframe—I hope they can spend this weekend with their families who will not have seen them for weeks!”
In a post on LinkedIn over the weekend, Nicholas Cranfield, global director of legal operations at Dyson, wrote: “There seems to be a degree of cynicism in some of the reporting that the UK government no longer requires ventilators made by Dyson. I understand that journalists always want to find an angle but to me there is a simple story here of a company which was asked to help, in a time of crisis, and then poured huge effort and resource in attempting to answer the call. The fact the ventilators are not needed is good news.”
Questions remain about who the “sources close to the government project” are who were briefing The Telegraph on Friday afternoon that Dyson was to be stood down from the Ventilator Challenge, and why an alternative narrative was being spun to the newspaper that the government was “furious” with Dyson. The Telegraph says the company was “accused of ‘point-scoring’ after saying it had been awarded a contract for its clean-sheet ventilator design ahead of a planned government announcement”.
This story of government outrage does not tally with any of the press coverage of the initial announcement of Dyson’s provisional contract or the unveiling of the Ventilator Challenge as an example of national self-sufficiency. Dyson’s decision to withdraw, having spent £20m on designs, is hard to reconcile with commercial imperatives.
The timing of all this might make a cynic wonder if someone in government took a decision on Friday to throw Dyson under a bus, perhaps as a distraction from the breaking news about the Scientific Advisory Group for Emergencies.
We have asked the Department of Health and Social Care how many of the mechanical and non-invasive machines identified in its total number “available to the NHS” are held by the private sector. We will bring you clarification as we receive it.
This story originally appeared as part of our 8am Playbook service, to subscribe contact clientservices@researchresearch.com