Week 5 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 fifth week of our involvement as core participants with the Associaton of Anaesthetists and the Royal College of Anaesthetists (RCoA),  in Module 3 of the Covid-19 UK Public Inquiry.

Dr Daniele Bryden, Dean of the FICM, delivered her oral evidence to the Inquiry on behalf of the three organisations. Dr Bryden was questioned by the Inquiry’s legal team on a large variety of issues including access to adequate PPE, availability of guidance on decision making, redeployment of anaesthetists and the impact on elective surgery.

On PPE, Dr Bryden spoke about the initial difficulties getting consistent advice on what PPE was appropriate for those treating Covid patients to wear and then – later in the pandemic – issues with availability. She highlighted the inconsistent practice around whether fit testing was carried out and  – even for those who had been tested – the masks that they had been tested for not being available. We were pleased that the Inquiry used quotes from oral histories provided by the Association to illustrate exactly how these issues impacted those working on the frontline.

Dr Bryden also highlighted the lack of national guidance around ethical decision making if resources were limited, and the importance of clinicians being supported in this area. The Inquiry’s legal team asked questions around the redeployment of anaesthetists into intensive care units and Dr Bryden highlighted the crucial role that those redeployed played but noted the impact that this had – and continues to have – on those asked to carry out this role.

She also spoke about the local variability about elective care and whether or not it was able to continue and how level of the resource in the ICU determined this along with availability of anaesthetists to provide the service. Speaking about pre-pandemic workforce shortages, Dr Bryden told the Inquiry that it was already known that there weren’t enough anaesthetists and intensivists and that this also led to the decision to postpone elective care. She highlighted that ICU beds are not operational without the appropriate staff team available.

Further written evidence from the three organisations was also published by the Inquiry this week – this time a statement from our Vice-Dean Dr Jack Parry-Jones setting out the situation with critical care in Wales during the pandemic.

The three organisations will be providing the Inquiry with a closing statement when the hearings for Module 3 finish towards the end of November and will be using this to build on many of the points that Dr Bryden, Dr Parry-Jones and Dr Edwardson was able to highlight in their evidence.

Also on intensive care, this week the Inquiry heard from the conclusion of the evidence from Professor Charlotte Summers and Dr Ganesh Suntharalingam OBE who had been appointed by the Inquiry as expert witnesses. Professor Summers spoke about the impact the pandemic had on the mental wellbeing of those working in intensive care and highlighted that, while many hospitals did try and put processes in place to help people, as they couldn’t deal with the cause of the issue – that people felt unable to deliver the care they wanted – the help wasn’t enough. Dr Suntharalingham called for a UK wide review of current ICU capacity.

Finally, Dr Stephen Mathieu, President of the Intensive Care Society, used his evidence to speak about the Nightingale hospitals and the difficulties of staffing them when the service was already overstretched.

The Inquiry also heard from witnesses representing maternity services this week including Royal College of Midwives Chief Executive Gill Walton who spoke about the important role anaesthetists play on the labour ward.

Completing the week’s hearing, the Inquiry also heard from the Federation of Ethnic Minority Healthcare Organisations, Clinically Vulnerable Families, Resuscitation Council UK and the NHS Race and Health Observatory.

The Inquiry is now taking a two week break and hearings for Module 3 will resume on Monday 28 October. The next weekly update will be in early November.