Week 6 of Covid-19 UK Public Inquiry Module 3

This week is the sixth week of our involvement as core participants with the Royal College of Anaesthetists (RCoA), and The Faculty of Intensive Care Medicine (FICM), in Module 3 of the Covid-19 UK Public Inquiry.

The Inquiry heard from Professor Phillip Banfield, Chair of the British Medical Association UK Council. Professor Banfield raised a number of issues during his lengthy evidence session, including some of the issues doctors commonly experienced during the pandemic including; burnout, a rapid decline in their physical and mental wellbeing, and the ways in which doctors felt they lacked adequate support and often felt disposable during the pandemic. Professor Banfield said that the legacy of the pandemic in terms of its impact on the wellbeing of doctors was still being felt with many physicians leaving the health service today because of what they experienced during the pandemic.

Professor Banfield highlighted some of the risks doctors faced throughout the pandemic explaining that at least 50 doctors died during the pandemic, with many hundreds more experiencing long Covid. Professor Banfield added that there were no deaths from anaesthetist or intensivists because of the better PPE available.

When questioned on clinical prioritisation guidance, Professor Banfield said that this was something for both clinicians and governments to provide, stating that doctors make frontline decisions every day, in pandemic these were more dramatic (more patients, needing fewer beds etc) and that doctors need a framework to help with ethical and moral discussions to help with consistency.

The Inquiry also heard from Dr Paul Chrisp, former Director for the Centre for Guidelines and former Programme Director of Medicines and Technologies Programme and Deputy Director of Health and Social Care, National Institute for Health and Care Excellence (NICE). Dr Chrisp raised a number of issues including the way in which NICE developed rapid guidelines on managing Covid-19, and the way in which NICE developed scoring tools related to predicting patient demand in critical care units as well as how this guidance was issued to departments.

Also giving evidence this week were groups representing clinically vulnerable patients including disabilities and older peoples charities. Caroline Abrahams from Age UK said that age was the single biggest risk factor for experiencing serious illness or dying from Covid-19 and spoke about fear that clinical prioritisation tools may be used to deny older people care and how difficult it is to assess a patients frailty status. Lesley Moore from Clinically Vulnerable Families raised the impact of infection control on clinically vulnerable patients including how often patients forced to shield in the early stages of the pandemic were unable to access a number of resources including ventilators.

The Inquiry also heard from a number of organisations representing those impacted by long Covid who raised a number of issues including a lack public awareness of the condition, the long term impact of long-Covid on many people and the impact of a lack of messaging early in the pandemic on the potential for Covid to become a chronic condition.

The Inquiry also heard from Professor Aneel Bhangu and Dr Dmitri Nepogodiev, both experts in colorectal cancer, as well as Professor Andrew Metcalfe and Chloe Scott, experts in hip replacement, and Julie Pashley from MIND and Dr Guy Northover, a consultant child and adolescent psychiatrist.

The Inquiry continues next week with nurses, pharmacists and public health officials all giving evidence in week 7.