The government has accepted that some personal protective equipment (PPE) is in short supply and promised that a large consignment, including 400,000 gowns, is due to arrive in the UK from Turkey on Sunday. On Saturday, unions and professional bodies said that NHS staff may refuse to work if there was not enough PPE to ensure their safety, in response to new guidance from Public Health England (PHE), revealed by the Guardian on Friday, which instructs healthcare workers to reuse disposable PPE. The guidelines also recommended that medics wear aprons if they are unable to access full-length gowns. There are concerns that some PPE supplies are close to running out. The NHS is using about 150,000 gowns a day. Speaking at the government press conference on Saturday, Robert Jenrick, the housing, communities and local government secretary, said more needed to be done to get personal protective equipment to the frontline. He said 84 tonnes of PPE was due to arrive in the next 24 hours, although he acknowledged that “demand is also very high”. “Supply in some areas, particularly gowns and certain types of masks and aprons, is in short supply at the moment, and that must be an extremely anxious time for people working on the frontline, but they should be assured that we are doing everything we can to correct this issue, and to get them the equipment that they need,” he said. Prof Stephen Powis, the national medical director of NHS England, said as a former doctor the issue was “very personal” to him. “I know government is working incredibly hard to get those procurements in as you have heard, but what I hear from my clinical colleagues is that what they need is PPE delivered to the frontline to follow the guidance that was agreed with them two weeks ago,” he said. Responding to fears of extreme shortages of some PPE, including gowns, Sara Gorton, the head of health at Unison, said: “If gowns run out, staff in high-risk areas may well decide that it’s no longer safe for them to work. “No part of the NHS should use this move as an excuse to ration supplies of gowns when they still have stocks. That would cause a damaging breakdown of trust at a time when staff are working under intense pressure.” The Royal College of Surgeons of England (RCS) has also advised surgeons not to risk their health by working without adequate personal protective equipment, and said it was deeply disturbed by changes to official guidance. He echoed advice from the Royal College of Nursing (RCN) that nurses should refuse to treat patients as a last resort if they are not provided with adequate equipment. “If fluid repellent gowns or coveralls are not available, then surgeons should not risk their health,” he said in a statement. Unite’s assistant general secretary, Gail Cartmail, said the union had advised healthcare staff to refuse to work if they felt they were not being protected from the virus. “Unite has already advised its 100,000 members that reluctantly NHS and social care staff could legitimately and lawfully decline to put themselves in further danger and risk of injury at work,” she said. “The continued lack of PPE is a national scandal and the government’s litany of broken promises over the last month is shameful.” Cartmail said the health secretary, Matt Hancock, may have to consider his position if he was not able to secure the necessary PPE. She said the situation could not continue, and that health professionals would be quite right to decline to put themselves in danger. “We are not just talking about NHS staff in hospitals, but those working in the community, such as health visitors and community nurses, and those employed in social care settings, such as care homes,” she said. The Royal College of Nursing published guidance for its members last week, assuring them that if they “refuse to treat for lack of PPE, and are criticised subsequently, the RCN will provide you with legal representation and other support in any proceedings that ensue, without judgment”. It acknowledges that criticism could have legal consequences, including dismissal. The guidance says that under employment law, if there are “circumstances of danger which the employee reasonably believed to be serious and imminent and which they could not reasonably have been expected to avert”, they cannot be fairly dismissed. An RCN spokesperson said: “For nursing staff, this will go against every instinct. But their safety must not be compromised.” The GMB union refused to be drawn on whether its members would walk out if they felt unprotected, but the national secretary, Rehana Azam, said it was “advising all members to contact us if they feel as though their health and safety is being put at risk due to lack of PPE”. The union said it had written to the government “stating in the strongest possible terms” the need to protect frontline workers. The GMB national officer, Rachel Harrison, accused the government of being too slow to release a PPE plan and of hastily redrawing guidance, describing the process as a “litany of failure”. “NHS and ambulance staff will now face unacceptable risks as a result of gross ministerial incompetence. We won’t let this go unchallenged and will now review the steps we need to take to protect our members,” she said. The new guidelines mark a U-turn on original guidance that full-length waterproof surgical gowns should be worn during high-risk procedures. More than 50 frontline healthcare workers have died of coronavirus, as concerns mount that they are not being adequately protected while working with Covid-19 patients. Hancock admitted to MPs on the Commons health and social care select committee on Friday that the NHS was “tight on gowns”, describing it as a “pressure point”. About 55,000 gowns were due to be delivered on Friday.