Advice on protective gear for NHS staff was rejected owing to cost

The Department of Health rejected high-level medical advice about providing NHS staff with certain protective equipment during an influenza pandemic because stockpiling it would be too expensive, the Guardian can reveal.

Evidence based decisions, economic assessment, reconsider, rewrite. It’s all in the words. Questions here for Jeremy Hunt to answer – Owl

Harry Davies 

Documents show that officials working under former health secretary Jeremy Hunt told medical advisers three years ago to “reconsider” a formal recommendation that eye protection should be provided to all healthcare professionals who have close contact with pandemic influenza patients.

The expert advice was watered down after an “economic assessment” found a medical recommendation about providing visors or safety glasses to all hospital, ambulance and social care staff who have close contact with pandemic influenza patients would “substantially increase” the costs of stockpiling.

The documents may help explain a devastating shortage of protective gear in the NHS that is hampering efforts by medical staff to manage the Covid-19 virus pandemic.

Doctors are threatening to quit the profession unless they are properly equipped, and NHS trusts across England have been asking schools to donate science goggles due to the shortages, the Guardian revealed on Wednesday. The health secretary, Matt Hancock, has acknowledged “challenges” with the supply of protective material to NHS staff and has drafted in the army to get supplies to frontline workers.

In recent days, his department says, more than 15m face masks have been delivered to the frontline, including 24.6m gloves and 1.9m sets of eye protection delivered on Wednesday.

However documents seen by the Guardian suggest officials working under his predecessor resisted advice about stockpiling supplies of eye protection in case of a pandemic of this kind.

In 2015, what is now the Department of Health and Social Care tasked one of its independent advisory committees, the new and emerging respiratory virus threat advisory group (Nervtag), to review the UK’s approach to stockpiling personal protective equipment (PPE) for use in an influenza pandemic “to help inform future stockpile and purchasing decisions”.

Nervtag had been created the previous year to advise the government on pandemic influenza and new virus threats to the UK. The advisory group made a series of “formal recommendations” to the department in March 2016, which had been compiled by a subgroup of senior NHS clinicians and scientists, and agreed by the wider committee.

Asked what items of PPE would be required in a pandemic, the government’s advisers recommended “providing eye protection for all hospital, community, ambulance and social care staff who have close contact with pandemic influenza patients.”

They said the protection could be either visors or safety glasses, adding such equipment was necessary because there was some evidence of risk of infection via the eyes when in close contact with pandemic influenza patients.

However, according to minutes of a Nervtag meeting in June 2017, a health department official told the advisers to reconsider their advice as information had emerged about “the very large incremental cost of adding in eye protection.”

A minute from the meeting stated that “a subsequent internal DH health economic assessment has revealed that following these recommendations would substantially increase the cost of the PPE component of the pandemic stockpile four-to six-fold, with a very low likelihood of cost-benefit based on standard thresholds.”

The department asked Nervtag “to clarify the detail of their advice in light of the costings, and reconsider its recommendations against the strength of the scientific evidence of the ocular route as a source of infection, and the likely incremental cost-recommendations”.

The advisory committee then changed its official advice. The recommendation over protective eyewear was rewritten so that it instead told the department to buy enough eye protection for “exceptional usage” in higher-risk circumstances and when used with respirator masks during aerosol generating procedures.

According to a January 2018 minute, the update was made “in light of emerging evidence around cost-effectiveness, and the evidence around the incremental benefits of wearing eye protection.”

It is not clear at what level of seniority in the health department the Nervtag recommendations were considered back in 2016 and 2017. In a statement to the Guardian, DHSC said it would be incorrect to say ministers “intervened in this decision making”.

“As the public rightly expects, decisions of this nature are evidence-based and take into account a number of factors, including expert clinical guidance, cost effectiveness and practical consideration, such as shelf life and storage,” a DHSC spokesperson said.

“The government has prepared and stockpiled for an influenza pandemic. The documents clearly state that the scientific evidence did not support a vast increase in procurement expenditure on face masks with integrated eye protection for pandemic influenza.”

The DHSC is now scrambling to find ways to better supply hospital staff as it faces Covid-19, a highly infectious respiratory disease, with reports of doctors and nurses frantically trying to buy their own PPE and a particularly acute need for eye protection.

At prime minister’s questions on Wednesday, the Labour leader, Jeremy Corbyn, highlighted that the Healthcare Supplies Association had appealed to DIY shops to donate PPE. On Twitter, the association said it needed visors and protective glasses, tweeting: “Do we have to commandeer the stocks of DIY stores?????”

Hunt, who ran the department between 2012 and 2018 and now chairs the House of Commons health select committee, has in recent days led calls to better equip frontline staff battling the coronavirus. Last week, he told the BBC: “We must sort this out. We are asking people to put their own lives at risk on the NHS frontline…It is absolutely heartbreaking when NHS frontline professionals don’t have the equipment that they need.”

His spokeswoman told the Guardian: “Jeremy does not believe he was personally involved in decisions about PPE for NHS staff, but was acutely aware of the shortage of funds in the NHS budget which was why that year he fought for and secured an £8bn rise in the NHS annual budget followed by a £20bn rise two years later.”

However, the documents suggest the efforts by Hunt’s department to water down the advice on PPE impacted a round of procurement that was due to take place in 2017 to stockpile for a possible pandemic.

In addition to the discussions over eye protection, the documents also raise questions about the UK government’s policy regarding face masks for doctors, nurses and other health professionals dealing with Covid-19 patients.

In 2016, Nervtag advisers told the government that intensive care units (ICUs) should be designated “hot spots” carrying out aerosol generating procedures. Therefore, they said, a particular kind of mask known as an FFP3 respirator “should be recommended for all staff at all times in these areas when a patient with pandemic influenza is present”, except for some circumstances.

One intensive care nurse at a hospital in Yorkshire told the Guardian earlier this week she had had to spend £100 of her own money to buy a full FFP3 respirator mask online. In her unit on Monday, there were no masks or surgical gowns, another vital piece of PPE kit which has also been in short supply.

There have been other reports in recent days of NHS improvising in the face of insufficient PPE, with nurses in the Royal Free hospital in north London affixing clinical waste bags around their legs, while at North Middlesex hospital they have been tying plastic aprons around their heads.

Back in 2016, Nervtag advisers also recommended the government commission an update to its infection control guidance, which by then was seven years old. The guidance, they said, needed to recommend PPE usage “in line with the current evidence base and guidelines”.

In June that year, the department responded to Nervtag’s initial recommendations about pandemic stockpiling, saying work to reflect the advice was being prioritised and progressed. However, with regard to updating the control guidance to bring it in line with current evidence, officials replied: “This work is not considered a priority at this time and will be deferred for consideration at a future time.”

Frontline doctors and nurses have said recent changes to official advice in the UK have meant many NHS staff have been wearing less protective gear than the World Health Organization (WHO) recommends when caring for Covid-19 patients. The WHO’s advice recommends different standards of PPE to the UK advice in certain clinical situations.


Work stops on Exmouth’s new watersports centre due to coronavirus

As mentioned in a comment posted earlier today, work on Exmouth’s new seafront watersports centre has been temporarily paused as a result of the coronavirus outbreak. 

Another set-back to the ill fated plans to “regenerate” Exmouth. (Owl recently catalogued  these  going back to 2002. )

Another costly road to nowhere.

LINO (Leader in name only) Ben Ingham is well and truly floundering in the Exmouth surf. He’s drowning, not waving. 

Daniel Clark

Developer Grenadier and building contractors Devon Contractors Ltd have confirmed they have temporarily stopped work at the Sideshore watersports centre development in Queen’s Drive.

They said while Government advice would enable them to continue work, they strongly feel the health and safety of the staff should be put first.

Grenadier’s plans for Exmouth seafront, which include the watersports centre, were due to be finished in time for the summer of 2020.

As well as the watersports centre, the Sideshore development will be home to dining facilities run by renowned award-winning celebrity chef, Michael Caines.

Exmouth-based company Edge Watersports are set to run the sea-based activity side of the centre.

Aiden Johnson-Hugill, director of Grenadier, said: “The creation of Sideshore may have been temporarily put on hold, but we are committed to creating something rather extraordinary.

“We are confident that once open, Sideshore, Exmouth’s new community focused watersports centre will offer visitors and residents of Exmouth unrivalled access to two miles of waterfront, alongside space to eat, meet and enjoy the beach.

“In the meantime, we are adhering to Government advice to protect the health and safety of our workforce.

“We look forward to unveiling Sideshore to the public as soon as possible, and we are confident it will not only operate as a sustainable business, but create a lasting legacy for the local community.”

A spokesman for Devon Contractors added: “We have been following Public Health England guidance to ensure we protect our people, our subcontractors, and our suppliers’ health and safety.

“We will continue to monitor the impact and provide an update in due course.”

The watersports centre marks the second phase of a three step plan to regenerate Exmouth seafront. [Not by Owl’s reckoning – Don’t forget the Bowling Alley/Ocean, and Elizabeth Hall redevelopment ].

The first part was the realignment of the Queen’s Drive road and car park, completed in 2019.

Plans for an 80-bedroom hotel and luxury restaurant as part of phase three are on hold as East Devon District Council’s scrutiny committee raised concerns over the make-up of a select committee tasked with overseeing the plans.


Housebuilder shares plunge after people urged to delay moves

Shares in housebuilding companies plunged when the market opened on Friday after the government put the brakes on the housing market, telling people to delay their home moves if possible and to stop new viewings.

Mark Sweney 

Shares in housebuilding companies plunged when the market opened on Friday after the government put the brakes on the housing market, telling people to delay their home moves if possible and to stop new viewings.

The government, which announced the new guidance on Thursday night, urged buyers and sellers to put plans on hold until the coronavirus restrictions are no longer in place.

The move prompted a sell-off of shares in some of the UK’s largest housebuilding firms. Persimmon, Barratt Developments and Taylor Wimpey were among the biggest fallers on the FTSE 100 on Friday morning, all down 7%.

Redrow shares fell 6% after the housebuilder issued a Covid-19 update to investors. The company said it had stopped building new homes, wasputting a significant number of employees on temporary leave and was in talks with banks to shore up its finances as the coronavirus hammers the construction industry.

The company, which has already moved most office-based staff to homeworking and shut sales centres, had been operating with reduced construction staff to try to finish projects that are close to completion. The housebuilder said it will shut down all work immediately.

“It has become increasingly impracticable as our supply chain has been significantly impacted in recent days,” the company said. “As a result, the board has now decided to go further and commence, with immediate effect, an orderly and safe closure of all of our sites and offices.”

The north Wales-based company said that as a result it has put a “significant number” of employees on furlough – unpaid leave, save for the £2,500 a month available as part of the government’s bailout.

Redrow said it had a strong balance sheet with assets of £1.6bn but, given the company was facing a “prolonged period of inactivity”, it had started talks with its six banks.

The company is seeking to increase its £250m revolving credit facility and double an additional facility to £100m. The company has also applied to the government’s Covid-19 corporate financing facility.

“These are unprecedented times,” said John Tutte, the executive chairman of Redrow. “The actions we have announced today will give us the flexibility to manage the business through this turbulent period to ensure we are ready to resume production when it is safe to do so.”

The company said it has an order book of projects worth £1.4bn, with £900m of that already contracted to complete.

Rightmove said it was cancelling its final dividend for 2019, which was due to give £38m to shareholders, because of the uncertainties arising from the coronavirus crisis.

The property website also scrapped its financial guidance for 2020 but added that the board was confident the company had the “financial capacity to withstand this challenging period”.


Coronavirus: Prime Minister Boris Johnson tests positive (tested very quickly – unlike other self-isolaters)

In a video on Twitter, Boris Johnson says he is self-isolating and will continue to work from home.

Media captionIn a video on Twitter, Boris Johnson says he is self-isolating and will continue to work from home.

Prime Minister Boris Johnson has tested positive for coronavirus.

Mr Johnson said he developed mild symptoms over the past 24 hours, including a temperature and cough.

He is self-isolating in Downing Street but said he will “continue to lead the government’s response via video-conference as we fight this virus”.

Mr Johnson was last seen on Thursday night, clapping outside No 10 as part of a nationwide gesture to thank NHS staff.

In a video on his Twitter account, Mr Johnson, 55, said: “I’m working from home and self-isolating and that’s entirely the right thing to do.

“But, be in no doubt that I can continue thanks to the wizardry of modern technology to communicate with all my top team to lead the national fightback against coronavirus.
“I want to thank everybody involved and, of course, our amazing NHS staff.”

“So thank you to everybody who’s doing what I’m doing, working from home to stop the spread of the virus from household to household,” he added.
“That’s the way we’re going to win.”

Mr Johnson was tested at No 10 by NHS staff, on the personal advice of England’s chief medical officer, Prof Chris Whitty, Downing Street said.

He will still be in charge of the government’s handling of the crisis, the statement added. Earlier this week, the prime minister’s spokesman said if Mr Johnson was unwell and unable to work, Foreign Secretary Dominic Raab, as the first secretary of state, was the selected minister to stand in.

It is not known whether Mr Johnson will still be living with his fiancee Carrie Symonds, who is several months pregnant…

Mr Johnson has been seen at several of the government’s televised daily briefings in the past week, where he has appeared alongside senior medical officials to update the country on the virus.

Neither the PM’s senior adviser Dominic Cummings nor Chancellor Rishi Sunak – who Mr Johnson has recently appeared alongside, while following social distancing advice – have symptoms or have been tested.

East Devon dairy sees milk vending machine sales double

As supermarkets struggle to keep shelves stocked during the Covid-19 pandemic, the team at Clinton Dairy in East Devon is continuing to work around the clock to ensure organic milk supplies are maintained.

It also runs a 24/7 fresh milk vending machine at the nearby Otterton Mill visitor centre and has seen sales double since the crisis began. The machine was set up in an effort to reduce food miles, waste, and connect the farm with the local community, something that is hugely important for the Farms Partnership at this time.


The Clinton Devon Farms Partnership, a Clinton Devon Estates farming business, manages two organic dairy farms, Otter farm and Dalditch farm, where a herd of 750 cows graze locally. The dairy supplies milk to the firm Muller, producing 5.4million litres of milk each year.

It also runs a 24/7 fresh milk vending machine at the nearby Otterton Mill visitor centre and has seen sales double since the crisis began. The machine was set up in an effort to reduce food miles, waste, and connect the farm with the local community, something that is hugely important for the Farms Partnership at this time.

Farms manager Sam Briant-Evans, said: “It’s pretty much business as usual at the dairy. Even at an immensely difficult time like this, the animals still need to be fed and milked, so the work doesn’t stop and we will continue to meet demand. Additionally, our vending machine usually sells 10 to 12 litres a day, whereas we are currently seeing sales of 25 to 30 litres a day, and we expect that to continue to rise.

“We are taking all the correct precautions and following daily government advice to ensure our teams are safe and protected at all times. We are observing all social distancing guidelines and following strict hygiene and sanitisation protocols.”

The refrigerated vending machine at Otterton Mill holds 100 litres of whole milk and is fitted with a cash and card payment facility. Customers can purchase a re-useable, recyclable glass bottle, or bring their own.


Pandemic psychologist explains lavatory roll panic

A heightened sense of disgust to dirt and germs during outbreaks of disease could have set off the panic-buying of lavatory paper, according to the author of a book on how pandemics affect the mind.

[Owl advises to shop locally for a variety of good reasons – you may also find your loo rolls as well, but please only buy what you need]

Andrew Ellson

Professor Steven Taylor, of the University of British Columbia, says that when people are threatened with infection, their sensitivity to disgust increases and are more motivated to avoid it. He concedes that the problem can also snowball due to a more prosaic reason — the simple desire not to run out when others are buying so much.

The professor, who published Psychology of Pandemics only a month before the pandemic struck, said: “People have a built-in alarm system that keeps us away from danger. So when people become frightened their sensitivity to disgust increases. In a pandemic, people are more likely to experience the emotion of disgust and are more motivated to avoid it.

“In that sense, the purchase of toilet paper makes sense because it is linked to our ability to avoid disgusting things. It’s not that surprising. It has also become a symbol.

“In psychology research, it is called a conditioned safety signal. It’s almost like a good luck charm or a way of keeping safe. This type of behaviour is very instinctive and prominent in pandemics.”

He added that panic-buying can also amplify itself, especially in the internet age. “Graphic images of people buying and fighting over toilet paper have gone viral. This creates a sense of urgency and the fear of scarcity snowballs and creates real scarcity. This is the first pandemic in the era of social media and it is having an effect.”

Professor Taylor said governments needed to be thoughtful and positive in their communications and instructions if they want people to stop panic-buying.

“Just telling people to stop is not going to stop them. People are panic buying because of the need to feel they are in control. They need to be told or given something positive to do, such as helping out their elderly neighbours in isolation or donating to food banks, so they feel they are doing something to help their communities. Then people stop thinking so much about themselves.”

Can German medicine cure our economy?

Strictly speaking, the recession we are entering is a choice, taken on the advice of public health experts. To limit the contagion, we must pause normal life as we know it, which means pausing the economy. When we know more about the disease we will be able to judge whether this was the right call or a miscalculation that inflicted needless economic pain. For the time being, the more pressing question is how to do it without causing an economic meltdown.

Ed Conway, economics editor of Sky News

Some machines you can turn off with the flick of a switch. Others are nearly impossible to shut off. Nuclear reactors fall into the latter category. Decommissioning them takes years. Turning them off temporarily is a risky exercise; indeed, the most famous nuclear accidents — Chernobyl, Fukushima, Three Mile Island — all involved attempts to pause their reactors.

A sophisticated economy is not designed to be shut down either. While we know what should happen when you switch off a nuclear reactor, we have no idea what happens when you do the same to an economy, because until now no one has tried. But one consequence of Covid-19 is that across the world we are about to find out.

Strictly speaking, the recession we are entering is a choice, taken on the advice of public health experts. To limit the contagion, we must pause normal life as we know it, which means pausing the economy. When we know more about the disease we will be able to judge whether this was the right call or a miscalculation that inflicted needless economic pain. For the time being, the more pressing question is how to do it without causing an economic meltdown.

The good news is that since this is no normal recession — a deliberate one rather than one caused by economic malfunction — life should get back to normal once the machine is up and running again. The bad news is that we are flying blind.

There are a few important principles. We know that when people lose their jobs in recessions they often never work again. We know that when the financial system clogs up and businesses can’t borrow, some promising productive companies go belly up. If you want to put your economy into hibernation you need to avoid both of these “scarring” effects.

These principles are what lie behind the extraordinary measures introduced by the chancellor over the past fortnight. Businesses are to get cheap loans while employees and, as of yesterday, many self-employed workers, will be paid by the state to be “furloughed”: stay at home on a slightly reduced salary. While that unfamiliar word comes from America, in reality the job retention scheme has a decidedly continental flavour. Indeed, it is based on a German system called kurzarbeit.

Kurzarbeit, where the Federal Labour Office pays temporarily laid-off workers a chunk of their salaries, has been around for decades but came to prominence during the 2008 financial crisis when it helped to cut German unemployment rates, even as they were soaring elsewhere. The Treasury was considering imposing kurzarbeit as an emergency measure here in the event of a no-deal Brexit last year. In the end, they adapted those Brexit blueprints to create the Covid-19 job retention scheme over a few all-nighters last week.

The challenge is that nothing like this has ever been imposed in Britain — and for good reason. Labour markets in many continental economies, including France, Germany and much of Scandinavia, are comparatively static. Workers are more likely to be employed and to stay in their jobs longer, so there is logic to a scheme like kurzarbeit, since you can generally assume that if someone does a given job one year they are likely to be doing it the next.

But Britain’s labour market is much more fluid. People move between jobs more frequently, and there is more hiring and firing. This fluidity and churn is, economists believe, one of the UK’s strong suits. Yet it has also tended to mean that our unemployment level is higher than that of comparable EU nations during a recession. To see what would happen here without a kurzarbeit, you need only look at the vertiginous increase in universal credit applications before the job retention scheme was unveiled. Or indeed the terrifying jump in US jobless claims yesterday: not just the worst in history, the worst in history by a factor of five.

Statistics like that explain why the Treasury is ploughing on with such a radical programme. But how effective will Britain’s version of kurzarbeit be? Can a continental model, in which millions of workers are effectively paid by the state to stay at home, succeed in our country? Nobody, including the Treasury, knows.

Britain’s financial system is also being asked to stifle its normal behaviour thanks to the other leg of Rishi Sunak’s rescue package. For better or worse, Britain’s banks are less inclined to lend to small and medium sized businessses than, for instance, in Germany, where local savings banks, Sparkassen, offer generous loans to such firms. But the Treasury is now encouraging banks to lend to businesses despite the economic uncertainty. Can banks kick the habit of a lifetime and suspend the stringent checks they normally carry out before lending? The early signs are not encouraging.

Britain’s open, dynamic economy serves the country well in normal times. But these are not normal times. And putting this economy into hibernation will mean confronting all sorts of habits and attitudes many of our companies and businesses took for granted. Not firing staff to protect the balance sheet. Not withholding credit from struggling companies.

If these unfamiliar, continental measures do not succeed, Britain faces a deeper recession than many other nations. If they do, we may spend the following decades working out whether we can ever uproot them.


MPs no longer to get automatic vote on constituency boundary plans

There has been criticism in the past that MPs have vested interests in the boundaries of their constituency, as any redrawing of the map can place into their patch new council wards that might typically vote for other parties, making the constituency more or less safe for their own party.  

Kate Proctor 

The government had planned to reduce the number of MPs from 650 to 600 but announced a U-turn on Wednesday, the last day before parliamentary recess, citing the increased workload expected because of Brexit.

However, it has also emerged that among the many changes planned by the government is that any future decisions from the Boundary Commission would be implemented automatically.

The Cabinet Office minister Chloe Smith said this would stop any “interference” in the process. A set of boundary plans were voted down by opposition MPs in 2013.

There has been criticism in the past that MPs have vested interests in the boundaries of their constituency, as any redrawing of the map can place into their patch new council wards that might typically vote for other parties, making the constituency more or less safe for their own party.

In her written statement to the Commons, Smith said: “This change would provide certainty that the recommendations of the independent boundary commissions – developed through a robust and impartial process that is open to extensive consultation – would then be implemented without interference.”

The government has now changed the rules so that the new map would be implemented automatically by bringing it to parliament through a mechanism called an order in council.

The latest boundary review process, the sixth one to take place since the 1940s, recommended in 2011 that the number of MPs should be reduced from 650 to 600, but the process has been beset with delays. Proposals laid out in 2013 that were backed by the Tories were defeated in parliament.

The Boundary Commission released new proposals in 2018 recommending scrapping 32 seats in England, six in Scotland, 11 in Wales and one in Northern Ireland.

The boundaries would have scrapped Jeremy Corbyn’s Islington North seat and made Boris Johnson’s Uxbridge less safe by bringing in typically Labour-voting wards in Ealing.

A controversial “Devonwall” seat that crossed the counties of Devon and Cornwall was another unpopular proposal in the now-axed 2018 plan.

Smith said the decision to abandon plans to reduce the number of MPs from 650 to 600 was sensible in light of changed circumstances.

“Since that policy was established in the coalition agreement, the United Kingdom has now left the European Union,” she said. “The UK parliament will have a greater workload now we are taking back control and regaining our political and economic independence. It is therefore sensible for the number of parliamentary constituencies to remain at 650.”


A free weekly treat for theatre lovers

A selection of much-loved National Theatre live productions is to be made available to watch on YouTube for free over the next two months.

Chris Carson 

The National Theatre Collection – an online resource for schools, universities, libraries and the wider education sector – is now available to access at home during school closure period

A spokesman said: “During this unprecedented time which has seen the closure of theatres, cinemas and schools, the National Theatre is providing access to content online to serve audiences in their homes.

“Audiences around the world can stream NT Live productions for free via YouTube, and students and teachers have access to the National Theatre Collection at home, delivered in partnership with Bloomsbury Publishing.

From Thursday, April 2, a number of productions previously screened in cinemas globally as a part of National Theatre Live will be made available to watch via the YouTube channel.

The first production to be broadcast will be Richard Bean’s One Man Two Guvnors featuring a Tony Award-winning performance from James Corden.

Each production will be free and screened live every Thursday at 7pm. It will then be available on demand for seven days.

Alongside the streamed productions, there will also be accompanying interactive content such as Q&As with cast and creative teams and post-stream talks.

Lisa Burger, NT executive director and joint chief executive said: “Our ambition is to create work which is challenging, entertaining and inspiring and we’re committed to continuing that through these difficult times.

“Following the UK schools’ closures, pupils now studying at home will be able to access the National Theatre collection remotely.

“It includes high-quality recordings of 24 world-class productions, drawing from 10 years of NT Live broadcasts and never-before-released productions from the NT archive.

“It’s available now for free to pupils and teachers at state schools and state-funded further education colleges, through remote access provided in partnership with Bloomsbury Publishing.

“Schools will be able to share log-in details with pupils to access the National Theatre Collection at home during this period.”

For more on National Theatre at Home go to