• Video report by ITV News Reporter Martha Fairlie

The Royal College of Nursing (RCN) is urging its members to refuse to treat patients as a “last resort” if adequate personal protective equipment (PPE) could not be provided.

The advice came as the UK coronavirus death toll topped 10,000 and NHS trusts confirmed the deaths of more health workers, after Health Secretary Matt Hancock paid tribute to 19 NHS staff who died after contracting Covid-19.

Among the latest health workers to die during the outbreak were Sara Trollope, a matron for older adult mental health services in Hillingdon, west London, who died after testing positive for the virus and Julie Omar, 52, a trauma and orthopaedics nurse at Redditch’s Alexandra Hospital, in Worcestershire, who died at home while self-isolating with symptoms.

In a bid to prevent further frontline deaths, the RCN issued new guidance which says if sufficient PPE cannot be supplied and treatment cannot be delayed or carried out in another format, nurses should decline to work.

“For nursing staff, this will go against every instinct. But their safety must not be compromised," a RCN spokesman said.

Some of the NHS staff who have now died with the virus.

The RCN said it would provide legal assistance to those making what it acknowledged was an “enormously difficult decision” and warned them that they could face criminal prosecution for corporate manslaughter in “very rare” cases for walking away.

The representative body 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.

“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.

Home Secretary stopped short of offering an apology over PPE failings. Credit: PA

Leading the government's daily coronavirus briefing on Sunday, Mr Hancock defended the Government's record on PPE, declaring there there to be "record amounts of PPE in the system".

Quizzed on the RCN's fresh advice, Mr Hancock replied that he had been in contact with the organisation as part of the Government's bid to "get this right".

The Health Secretary had been forced to defend comments he made on PPE during an interview on Saturday when he said NHS staff should “not being used more than is needed”.

His words were criticised by the RCN general secretary Dame Donna Kinnair who said on Saturday that PPE was not “more precious a resource than a healthcare worker’s life, a nurse’s life, a doctor’s life”.

Coronavirus: Everything you need to know

Mr Hancock defended the Government's record on PPE, declaring there there to be 'record amounts of PPE in the system'. Credit: PA

Labour leader Sir Keir Starmer said it was “insulting” to suggest health care workers were “wasting” PPE.

Sir Keir tweeted: “There are horrific stories of NHS staff and care workers not having the equipment they need to keep them safe.

“The Government must act to ensure supplies are delivered.”

Speaking on Sophy Ridge On Sunday on Sky News, the Labour leader said there is a “mismatch” in what the Health Secretary and frontline NHS staff are saying about the availability of PPE.

He said: “This is a difficult exercise, I understand the Government is trying to rise to the challenge here but there’s a mismatch and that’s the sort of thing that Parliament needs to pursue through individual MPs putting the points to ministers.”

Asked if nurses should follow Royal College of Nursing guidance and effectively refuse to treat coronavirus patients if they do not have the right protective equipment and clothing, Sir Keir replied: “They’re in a position to give guidance to those in their association and they should give that guidance.”