Scottish health chiefs raised concerns about access to personal protective equipment (PPE) two years before the start of the Covid-19 pandemic, the official inquiry has heard.

Exercise Iris, a 2018 trial by the Scottish government's Health Protection Division, tested how the country would respond to a pandemic within its borders. Findings from the test, which was prompted by an outbreak of MERS-CoV that killed almost 800 people, mostly in Saudi Arabia and Jordan, noted “challenges” in ensuring staff had access to PPE and training on how to use it.

Despite this, the Covid-19 inquiry heard today that work to make sure health workers and patients had the correct protection was not finished by the time the UK recorded its first coronavirus case.

Chief counsel at the inquiry Hugo Keith KC said: “The position in relation to PPE and masks, is that work was done in relation to raising awareness of the need for stockpiles of PPE and masks to be up to date.

“Letters were written to the [Scottish] health boards to say: ‘Are you ready?’. But some of the testing, particularly fit testing around PPE, wasn’t concluded by the time the pandemic struck.”

Responding, Caroline Lamb, chief executive of NHS Scotland, admitted there had been “variability” in the pandemic preparations in Scotland’s hospitals.

She added Scottish NHS boards had been written to in July 2019 to remind them of their responsibilities to ensure staff were prepared for PPE, including ensuring workers were “fit-tested” for the FFP-3 masks needed to safely treat patients.

As well as Exercise Iris, Exercise Alice, carried out by Public Health England, had also flagged the need for pandemic preparations in response to an outbreak of the coronavirus MERS in Asia.

Concerns have also been raised during the inquiry about the availability of appropriate PPE for Black health workers.

No-deal Brexit planning under Operation Yellowhammer was again blamed for hampering pandemic planning during today’s hearing.

As well as Lamb, the 11th day of hearings under the inquiry’s resilience and preparedness module heard from Gillian Russell, the Scottish government’s current director of health workforce and previous director for safer communities between 2015 and 2020.

Catherine Calderwood, Scotland’s former chief medical officer who resigned after breaching lockdown rules, was due to speak, but her appearance is due to be rescheduled for a later date.

Jeanne Freeman, Scotland’s health secretary between 2018 and 2021, appeared remotely to defend her government’s handling of PPE issues, blaming problems on the “difference between supply and distribution”.

She added: “It was largely in the distribution that we had to constantly update how we did that and improve that, often in response to [calls to] our PPE helpline.”

Former first minister Nicola Sturgeon is due to give evidence tomorrow.

The inquiry continues.