Week 8 of Covid-19 UK Public Inquiry Module 3

Our thanks to the Association of Anaesthetists communications team, who collated this update and shared with the Faculty and College as joint Core Participants in Module 3.
 

This week is the eighth week of our involvement as core participants with the Association of Anaesthetists and Royal College of Anaesthetists in Module 3 of the Covid-19 UK Public Inquiry.

Returning at the start of week eight, Professor Powis spoke about the need to produce guidance quickly in a fast moving environment and how there was not always time to consult with patients or the public. On resilience he said he agreed the pandemic is still having an impact and that staff are struggling saying ‘staff are everything in the NHS’.

Amanda Pritchard, Chief Executive Officer, NHS England, said that the NHS was still in recovery from the pandemic – there are still Covid patients in hospital, staff are still recovering, the health of the nation is poorer and there are new challenges like long Covid. She said staff didn’t need to be asked to do the extraordinary things they did and that the main concern was the impact this had on them especially critical care staff who were ‘in the eye of the storm’.

Ms Pritchard spoke about how everyone who needed a critical care bed got one but that this doesn’t mean the situation didn’t feel completely overwhelming to staff or that the care provided was anything like normal. She said that NHS England was currently reviewing support for staff and was looking at where national initiatives could make the biggest difference.

She confirmed that NHS England had requested 10,000 extra beds to help with recovery and potential future surges but that the Treasury and Number 10 refused. Ms Prichard spoke about plans to create a central inventory for all the ventilators in the NHS and said NHS Supply chain was currently working on an asset register.

She said a focus on the importance of community prevalence data and testing would enable the NHS to be on the front foot in any future pandemic. She highlighted the importance of a strong partnership between the NHS and social care and the need for a more resilient data infrastructure.

In his evidence Sir Chris Wormald KCB, Permanent Secretary of the Department of Health and Social Care, said that during the pandemic the Department did well in areas like research and testing that it was already strong in. He highlighted areas of previous weakness that the pandemic magnified including social care, issues in some aspects of the NHS, international supply chains and the underlying poor health of the nation.  

He said that around 15 billion items of personal protective equipment (PPE) were used in the pandemic and that it wasn’t possible to stockpile that number of items. He confirmed that policies around stockpiling had been reviewed.

Looking at the pandemic from a Welsh perspective, Dr Philip Kloer, Chief Executive Officer of Hywel Dda University Health Board spoke about the issues with the design of Glangwili Hospital - a lack of side rooms, poor ventilation and no air conditioning – and the impact this had. He said they had only received a third of the ventilators requested from Welsh Government and that those provided with were not suitable.

Dr Andrew Goodall CBE, Director General of Health and Social Services and Chief Executive Officer, NHS Wales, used his evidence to speak about critical care capacity in Wales and how this was increased. He also spoke about the role the Welsh critical care network played in helping them understand the data they received as well as the reality of the pressures being felt across critical care. He accepted that it would be useful for CritCon status to be used across Wales in future pandemics.

The restoration of elective care was delayed in Wales compared to England and Dr Goodall confirmed that in retrospect this should have happened earlier. Speaking about lessons learnt he said there was a need to ensure staff have emotional support and counselling available to them in their normal working lives and that this needs to be enhanced if another pandemic occurs.

Judith Paget, Chief Executive Officer of NHS Wales, confirmed there was no official mechanism for reporting NHS staff deaths from Covid-19 in Wales and that they relied on Office for National Statistics data. Looking ahead, she said that in any future pandemic it would be helpful if English and Welsh guidance could be issued on the same day.

The week concluded with evidence from Professor Colin McKay, Deputy Medical Director, NHS Greater Glasgow and Clyde, and Caroline Lamb, Chief Executive of NHS Scotland and Director General Health and Social Care, looking at the impact the pandemic had on the health system in Scotland.