Week 4 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 fourth week of our involvement as core participants with the Association of Anaesthetists and Royal College of Anaesthetists (RCoA) in Module 3 of the Covid-19 UK Public Inquiry.

Unfortunately – due to unforeseen circumstances – some of the hearings this week were cancelled which meant that Dr Daniele Bryden was unable to give oral evidence on behalf of the Faculty, Association, and RCoA. The session has now been rescheduled for the afternoon of Tuesday 8 October and can be viewed on the Inquiry’s YouTube channel.  

The Inquiry also decided that they no longer needed to hear oral evidence from Dr Stuart Edwardson, Immediate Past Chair of the Association’s Trainee Committee. Dr Edwardson has provided written evidence about his experiences as a trainee during the pandemic and the Inquiry has now published this on their website. We would like to take this opportunity to thank Dr Edwardson for the time he has spent engaging with the Inquiry – and sharing his story – and hope that the Inquiry will take the points he raised about the impact on training into consideration when producing their recommendations.

Before the hearings were postponed, the Inquiry heard from Professor Kathryn Rowan OBE, Founder and Former Director of Intensive Care National Audit & Research Centre (ICNARC) who spoke about the work ICNARC did during the pandemic around guidance on patient admissions, critical care transfers, pressures on intensive care and experiences of patients in ICUs. She spoke about the daily reports that were provided to NHS England about the number of people admitted to ICUs as well as the decision not create Covid-19 related data sets to prevent adding an additional burden to the system. Professor Rowan also spoke about the reduced admission rate for critical care and how lack of capacity and the length of stay for Covid-19 patients impacted on this along with the cancellation of elective care.

Professor Charlotte Summers and Dr Ganesh Suntharalingam also began delivering their oral evidence to the Inquiry in their roles as expert witnesses on intensive care on 2 October before the hearing was postponed. They are likely to be asked to return to complete their evidence at a later date. Dr Suntharalingam spoke about the redeployment of staff to ICUs and the impact this had on those who had not worked in the area before. He also spoke of the impact on staff of units running at double or even triple their normal capacity and the moral distress and moral injury this caused. Professor Summers spoke about the disparency between the number of ventilators available in England and the number that were potentially going to be needed.

At the beginning of the week, the Inquiry also heard from Sir Frank Atherton, deputy chief medical officer for Wales who spoke about the impact an ageing hospital infrastructure inhibited an effective response. He also highlighted how the use of multiple data systems made a coordinated response more challenging in Wales.

Dr Catherine McDonnell, former Medical Director of the Western Health and Social Care Trust, spoke about the impact of the pandemic on Altnagelvin Hospital and highlighted issues that arose as a result of the hospitals proximity to the border with Ireland. She said the border closure as well as the two different approaches to lockdowns created unique issues in Donegal and a surge in cases in the Northwest of Ireland.

Tuesday 1 October saw the first impact witnesses give evidence to the Inquiry. Impact witnesses have been asked to provide personal – rather than organisational – evidence about the impact the pandemic had on them and their role. Ambulance technician Mark Tilley spoke about the availability of PPE, how the work of the ambulance service changed and the impact this had on staff.

GP Dr Tilna Tilakkumar spoke about the impact of the pandemic on General Practice and her experience in being moved to work on hospital wards. She spoke of the mental and emotional strain of working of this as well as the impact of the low availability of adequate PPE.

Anthony Marsh, National Ambulance Adviser to NHS England and former Chair of Association of Ambulance Chief Executives, was the final witness to give evidence in week four. He discussed impact on paramedics and some of the wider impacts on ambulance services including how services responded to increased demand as the pandemic progressed, the ways in which staff were exposed to great risk and how risk was assessed in relation to staff.