Recommendations & Conclusions
53 items
59
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did not squarely address a disease with the characteristics of covid-19. Nevertheless, some useful lessons were learned and applied, such as the drafting of legislative measures that might be needed. 93 Healthcare Infection Society (CLL0071) 94 …
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Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did not squarely address a disease with the characteristics of covid-19. Nevertheless, some useful lessons were learned and applied, such as the drafting of legislative measures that might be needed. 93 Healthcare Infection Society (CLL0071) 94 Q872; Paragraphs 318–19 95 Healthcare Infection Society (CLL0071) 96 Q941 30 Coronavirus: lessons learned to date
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Government response AI summary
The government partially accepts the (implied) recommendation, agreeing on the importance of learning and engagement, and detailing how the Cabinet Office is reviewing and improving the NSRA methodology to increase expert accessibility and challenge, alongside committing to international learning and frameworks for emergency preparedness.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
64
Recommendation
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
A greater diversity of expertise and challenge—including from practitioners from other countries and a wider range of disciplines—should be included in the framing of the National Risk Register and the plans that emanate from it. Plans for the future should include a substantial and systematic method of learning from international …
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A greater diversity of expertise and challenge—including from practitioners from other countries and a wider range of disciplines—should be included in the framing of the National Risk Register and the plans that emanate from it. Plans for the future should include a substantial and systematic method of learning from international practice during the course of an emergency.
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Government response AI summary
The government partially accepts, agreeing to flexible engagement and commissioning the Royal Academy of Engineering to review the NSRA methodology and recommend improvements for external expert challenge and diversity. The Cabinet Office is also considering ways to increase expert accessibility and challenge.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
69
Recommendation
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
The Armed Forces should have a more central and standing role in preparing for and responding to emergencies like pandemics, given the depth of capability and experience they have in planning, logistics and rapid mobilisation. The Civil Contingencies Secretariat should work with the Armed Forces to improve operational expertise in …
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The Armed Forces should have a more central and standing role in preparing for and responding to emergencies like pandemics, given the depth of capability and experience they have in planning, logistics and rapid mobilisation. The Civil Contingencies Secretariat should work with the Armed Forces to improve operational expertise in emergencies in public bodies. Coronavirus: lessons learned to date 31
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Government response AI summary
The government partially accepts, acknowledging the Armed Forces' important role and committing the Civil Contingencies Secretariat to continue working with them to improve operational expertise. However, it also emphasizes the primary leadership role of civilian agencies in future emergency responses.
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Department for Science, Innovation and Technology
Department of Health and Social Care
78
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
As a result, decisions on lockdowns and social distancing during the early weeks of the pandemic—and the advice that led to them—rank as one of the most important public health failures the United Kingdom has ever experienced. This happened despite the UK 97 GOV.UK, ‘Precautionary SAGE 1 minutes: Coronavirus (COVID-19) …
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As a result, decisions on lockdowns and social distancing during the early weeks of the pandemic—and the advice that led to them—rank as one of the most important public health failures the United Kingdom has ever experienced. This happened despite the UK 97 GOV.UK, ‘Precautionary SAGE 1 minutes: Coronavirus (COVID-19) response, 22 January 2020’, accessed 17 August 2021 98 See, for example: Q114, Q473, Q716, Q746 and Q1227 99 GOV.UK, ‘Prime Minister’s statement on coronavirus (COVID-19): 23 March 2020’, accessed 17 August 2021 100 See, for example: On 16 March SAGE advised “that there is clear evidence to support additional social distancing measures be introduced as soon as possible”—GOV.UK, ‘SAGE 16 minutes: Coronavirus (COVID-19) response, 16 March 2020’, accessed 17 August 2021 101 Oral evidence taken before the Science and Technology Committee on 10 June 2020, HC (2019–21) 136, Q883 Coronavirus: lessons learned to date 33 counting on some of the best expertise available anywhere in the world, and despite having an open, democratic system that allowed plentiful challenge. Painful though it is, the UK must learn what lessons it can of why this happened if we are to ensure it is not repeated. The initial policy: flattening the peak
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Government response AI summary
The government partially accepts the need to learn lessons, agreeing to continuous engagement with international partners and disciplines. The Cabinet Office is considering ways to increase external expert access and challenge to the National Security Risk Assessment (NSRA) process as its methodology review concludes.
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Department for Science, Innovation and Technology
Department of Health and Social Care
94
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
The UK did not impose blanket or rigorous border controls at the onset of the covid-19 pandemic as compared to other countries, particularly in East and South East Asia.140 Instead, the UK implemented light-touch border controls only on countries and regions where there was a recorded high incidence rate. While …
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The UK did not impose blanket or rigorous border controls at the onset of the covid-19 pandemic as compared to other countries, particularly in East and South East Asia.140 Instead, the UK implemented light-touch border controls only on countries and regions where there was a recorded high incidence rate. While the UK initially focused on China, Iran, South Korea and Italy, a significant number of cases came from elsewhere. A 131 Oral evidence taken before the Science and Technology Committee on 16 July 2020, HC (2019–21) 136, Q1079 132 GOV.UK, SAGE 16, 16 March 2020 133 Oral evidence taken before the Science and Technology Committee on 16 July 2020, HC (2019–21) 136, Q1079 134 Imperial College COVID-19 Response Team, Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand, 16 March 2020 135 Imperial College COVID-19 Response Team, Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand, 16 March 2020 136 For example, see: Financial Times, ‘The shocking coronavirus study that rocked the UK and US’ 137 GOV.UK, SPI-M-O: consensus view on behavioural and social interventions, 16 March 2020 138 See paragraph 91. 139 GOV.UK, SAGE 15, 13 March 2020 140 For example, on 28 January 2020, all inbound travellers from Wuhan were subject to isolation; from 26 February 2020, Singapore banned all arrivals from Cheongdo and Daegu in South Korea; from 3 February 2020, Hong Kong began to close border crossing posts. 40 Coronavirus: lessons learned to date study found that 33% of cases during the first wave were introduced from Spain and 29% were introduced from France.141 The number of seeding events that occurred early in the pandemic, coupled with the lack of data, made the lockdown almost inevitable.
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Government response AI summary
The government partially accepts the implied need for learning, agreeing to engage with other countries and improve the National Security Risk Assessment (NSRA) methodology to increase accessibility for external experts and diversify challenge, emphasizing learning from international practice for future emergencies.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
96
Recommendation
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
In the paragraphs that follow we consider some of the potential explanations of why the initial decision-making on lockdowns was wrong, and what lessons can be drawn for the future from this. Should the Government have unilaterally taken a precautionary view in the first weeks, despite the SAGE advice?
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In the paragraphs that follow we consider some of the potential explanations of why the initial decision-making on lockdowns was wrong, and what lessons can be drawn for the future from this. Should the Government have unilaterally taken a precautionary view in the first weeks, despite the SAGE advice?
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Government response AI summary
The government partially accepts, agreeing to positive learning and international engagement, and committing to review the National Risk Assessment (NSRA) methodology to increase accessibility for external experts and diversity of challenge.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
104
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
Evidence to the Science and Technology Committee from other academic disciplines included scepticism of the weight being placed on mathematical models during the pandemic. For example Professor Sir John Kay, Economist and Fellow in Economics, St 152 Correspondence from Rt Hon Greg Clark and Rt Hon Jeremy Hunt to Matt …
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Evidence to the Science and Technology Committee from other academic disciplines included scepticism of the weight being placed on mathematical models during the pandemic. For example Professor Sir John Kay, Economist and Fellow in Economics, St 152 Correspondence from Rt Hon Greg Clark and Rt Hon Jeremy Hunt to Matt Hancock, 22 June 2021 153 After the Report was agreed by the Committees a response from Rt Hon Sajid Javid MP, Secretary of State for Health and Social Care, was received. 154 Q743 155 Oral evidence taken before the Science and Technology Committee on 4 November 2020, HC (2019–21) 136, Q282 156 Q1300 157 See, for example: oral evidence taken before the Science and Technology Committee on 25 March 2020, HC (2019–21) 136, Q40 and Q42. 158 Oral evidence taken before the Science and Technology Committee on 10 June 2020, HC (2019–21) 136, Q889 159 For example, see: SAGE 14, 10 March 2020, paragraph 36 160 Oral evidence taken before the Science and Technology Committee on 10 June 2020, HC (2019–21) 136, Q841 Coronavirus: lessons learned to date 43 John’s College, University of Oxford, told the Science and Technology Committee in June 2020 that models did not necessarily respond well to change and should not be used to make predictions: economic models tend to work pretty well as long as nothing much changes, which does not help them to be a great deal of use. What really matters from this point of view is understanding the nature of the underlying change. […] In my view, the use of economic models and other models is not so much to make predictions as to give people better insights into what is going on, and that is the way in which models ought to be used.161 Professor Carol Propper, Professor of Economics, Imperial College London and President of the Royal Economic Society, illustrated that assumptions in models had not always borne out and there was a need for up-to-date data: To give one more example of the need for that data, when we shut down hospitals
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Government response AI summary
The government states that future policy development should involve greater questioning and challenge from Ministers, taking a more robust approach. It commits that the government and SAGE should facilitate strong external and structured challenge to scientific advice from diverse disciplines and international experts.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
106
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
Professor Chris Whitty noted that he preferred advice to be given on the basis of observed data, telling the Science and Technology Committee in November 2020: “It is important to say that a lot of the advice that I have given is not based on significant forward modelling. It is …
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Professor Chris Whitty noted that he preferred advice to be given on the basis of observed data, telling the Science and Technology Committee in November 2020: “It is important to say that a lot of the advice that I have given is not based on significant forward modelling. It is based on what is happening and what is observable.”166
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Government response AI summary
The government states that future policy development should involve greater questioning and challenge from Ministers, taking a more robust approach. It commits that the government and SAGE should facilitate strong external and structured challenge to scientific advice from diverse disciplines and international experts.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
107
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
Yet despite this, throughout the pandemic, detailed modelled projections have assumed a great prominence and have evidently had great influence on Government decisions. Indeed, the publication of the Imperial study of 16 March, is often cited as one of the main triggers for the abandonment of the initial policy of …
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Yet despite this, throughout the pandemic, detailed modelled projections have assumed a great prominence and have evidently had great influence on Government decisions. Indeed, the publication of the Imperial study of 16 March, is often cited as one of the main triggers for the abandonment of the initial policy of flattening the peak of covid, and its replacement with the one of suppression, in line with many other countries.167 Assumptions about behavioural compliance
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Government response AI summary
The government states that future policy development should involve greater questioning and challenge from Ministers, taking a more robust approach. It commits that the government and SAGE should facilitate strong external and structured challenge to scientific advice from diverse disciplines and international experts.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
114
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
Dr Horton expressed concerns about the evidence base that SAGE in its early meetings drew upon. Referring to scientists in East Asia, Dr Horton told the Science and Technology Committee: If I had been Chair of SAGE, I would have wanted to go to those scientists on the frontline saying, …
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Dr Horton expressed concerns about the evidence base that SAGE in its early meetings drew upon. Referring to scientists in East Asia, Dr Horton told the Science and Technology Committee: If I had been Chair of SAGE, I would have wanted to go to those scientists on the frontline saying, “Please come and tell us your experience. What is coming for us in the UK? Why are you sending this warning signal?” because it is not there in the SAGE evidence.178 Local lockdowns: the tier system
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Government response AI summary
The government states that future policy development should involve greater questioning and challenge from Ministers, taking a more robust approach. It commits that the government and SAGE should facilitate strong external and structured challenge to scientific advice from diverse disciplines and international experts.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
131
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
At the press conference, modelling projections were presented which warned of a risk to the ability of the NHS to cope with likely hospital admissions unless the proposed measures were taken. Sir Patrick Vallance in evidence to the Science and Technology Committee on 3 November said: You would expect the …
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At the press conference, modelling projections were presented which warned of a risk to the ability of the NHS to cope with likely hospital admissions unless the proposed measures were taken. Sir Patrick Vallance in evidence to the Science and Technology Committee on 3 November said: You would expect the number of hospitalisations to breach the first wave probably towards the end of November. You would expect the number of deaths, potentially, to equal, the first wave numbers sometime in mid- December.204
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Government response AI summary
The government partially accepts, agreeing on the importance of learning from and engaging with other countries and disciplines. It describes the ongoing review of the NSRA methodology by the Cabinet Office to increase accessibility for external experts and diversify challenge in risk assessment.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
132
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
However, it emerged during the following days that the modelling that was presented at the press conference was based on data that had been superseded by more up-to-date information. It also emerged that the forecasts did not include the impact of the regional restrictions that had been brought in on …
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However, it emerged during the following days that the modelling that was presented at the press conference was based on data that had been superseded by more up-to-date information. It also emerged that the forecasts did not include the impact of the regional restrictions that had been brought in on 9 October.205 In practice, the advice of the Government’s most senior scientific advisers that the NHS was likely to be overwhelmed if the advised second lockdown was not imposed made it almost inevitable that it would go ahead: Chair: We come to the importance of the inquiries into these forecasts. Accepting that Ministers decide and advisers advise, in practice, if the advice from advisers to the Prime Minister is that the capacity of the NHS is likely to be overrun within weeks, that is quite difficult advice to gainsay, is it not? That is why there is an interest in understanding the basis of the advice. It is not optional advice in that sense, is it? 201 HC Deb, 2 November 2020, col 24 [Commons Chamber] 202 GOV.UK, ‘Coronavirus (COVID-19) in the UK’, accessed 22 June 2021 203 GOV.UK, ‘Prime Minister’s statement: 19 December 2020’, accessed 17 September 2021 204 Oral evidence taken before the Science and Technology Committee on 3 November 2020, HC (2019–21) 136, Q1438 205 See, for example: Correspondence from Ed Humpherson to Sir Patrick Vallance regarding transparency of data related to COVID-19, 5 November 2020 52 Coronavirus: lessons learned to date Sir Patrick Vallance: That was the forecasting from the NHS. That is what they said. Chair: It is also what you said. Sir Patrick Vallance: Yes. It is what we say from the modelling. As I said, we cannot deal with NHS capacity. I do not have insight into NHS capacity. Chair: But your advice to the Prime Minister and the Government, based on NHS data and the modelling data, was that this is a serious prospect and a serious risk. Sir Patrick Vallance: Yes.206 The Kent or ‘Alpha’ variant
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Government response AI summary
The government partially accepts, agreeing on the importance of learning from and engaging with other countries and disciplines. It describes the ongoing review of the NSRA methodology by the Cabinet Office to increase accessibility for external experts and diversify challenge in risk assessment.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
171
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
As a result the UK squandered a leading position in diagnostics and converted it into one of permanent crisis. On 12 March, testing for covid-19 other than in hospitals was halted. In part this was because of the inadequacy of the early flu-based strategy—a flu-strategy which mandated ending testing when …
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As a result the UK squandered a leading position in diagnostics and converted it into one of permanent crisis. On 12 March, testing for covid-19 other than in hospitals was halted. In part this was because of the inadequacy of the early flu-based strategy—a flu-strategy which mandated ending testing when there was community transmission— but partly also because of a simple lack of capacity. The abandonment of community testing meant that contact tracing—which was fundamental to the success of the Korean approach—also had to be abandoned. If people could not be tested, their contacts could not be traced.
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Government response AI summary
The government partially accepts the implied need for learning, agreeing to engage with other countries and improve the National Security Risk Assessment (NSRA) methodology to increase accessibility for external experts and diversify challenge, emphasizing learning from international practice for future emergencies.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
172
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
Shortly after this seminal failure, in mid-March 2020 responsibility for the testing strategy was taken over by the Department of Health and Social Care from Public Health England.256 It was not until 18 May 2020, when the first wave of covid-19 had begun to wane in the UK, that widespread …
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Shortly after this seminal failure, in mid-March 2020 responsibility for the testing strategy was taken over by the Department of Health and Social Care from Public Health England.256 It was not until 18 May 2020, when the first wave of covid-19 had begun to wane in the UK, that widespread community testing for covid-19—and therefore contact tracing—was able to resume.257
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Government response AI summary
The government partially accepts the implied need for learning, agreeing to engage with other countries and improve the National Security Risk Assessment (NSRA) methodology to increase accessibility for external experts and diversify challenge, emphasizing learning from international practice for future emergencies.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
177
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
As noted earlier, the failure to have enough testing capacity in the early weeks of the pandemic contributed to a lack of knowledge as to how the infection was spreading in the country. Speaking to us in November 2020, Professor Sir Chris Ham, Chair of the Coventry and Warwickshire Sustainability …
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As noted earlier, the failure to have enough testing capacity in the early weeks of the pandemic contributed to a lack of knowledge as to how the infection was spreading in the country. Speaking to us in November 2020, Professor Sir Chris Ham, Chair of the Coventry and Warwickshire Sustainability and Transformation Partnership, reflected that the decision to halt test and trace in the community had been a practical decision, and that any scientific advice behind it had “not been forthcoming”: if you go back to March, we simply did not have the capacity for testing, tracing and isolating that we needed in relation to the volume of cases. […] Testing capacity had to be focused on the high priorities—staff working in health and care and patients receiving that care. It was very sad that that decision had to be taken, but it was not about science. It was about practicalities.261
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Government response AI summary
The government partially accepts the implied need for learning, agreeing to engage with other countries and improve the National Security Risk Assessment (NSRA) methodology to increase accessibility for external experts and diversify challenge, emphasizing learning from international practice for future emergencies.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
7
Recommendation
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
A greater diversity of expertise and challenge—including from practitioners from other countries and a wider range of disciplines—should be included in the framing of the National Risk Register and the plans that emanate from it. Plans for the future should include a substantial and systematic method of learning from international …
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A greater diversity of expertise and challenge—including from practitioners from other countries and a wider range of disciplines—should be included in the framing of the National Risk Register and the plans that emanate from it. Plans for the future should include a substantial and systematic method of learning from international practice during the course of an emergency.
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Government response AI summary
The government partially accepts the recommendation, noting it has commissioned the Royal Academy of Engineering to review the NSRA methodology to improve expert challenge, and is considering ways to increase external expert accessibility and diversity of challenge. It also highlights ongoing international learning and engagement …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
9
Recommendation
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
The Government should ensure comprehensive plans are made for future risks and emergencies. The UK should aim to be a world leader in co-ordinating international resilience planning, including reform of the World Health Organisation to ensure that it is able to play a more effective role in future pandemics.
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The Government should ensure comprehensive plans are made for future risks and emergencies. The UK should aim to be a world leader in co-ordinating international resilience planning, including reform of the World Health Organisation to ensure that it is able to play a more effective role in future pandemics.
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Government response AI summary
The government partially accepts the recommendation, agreeing on the importance of comprehensive planning and UK leadership in international resilience. It commits to specific actions regarding World Health Organisation (WHO) reform, including playing a key role in developing a new WHO convention and supporting its wider …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
17
Recommendation
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
Building on the experience of staff working more flexibly during the pandemic and to enable more flexible staffing in the NHS, NHS England and Health Education England should develop proposals to better enable NHS staff to change clinical specialty mid- career and train in sub-specialties. (Paragraph 74) Lockdowns and social …
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Building on the experience of staff working more flexibly during the pandemic and to enable more flexible staffing in the NHS, NHS England and Health Education England should develop proposals to better enable NHS staff to change clinical specialty mid- career and train in sub-specialties. (Paragraph 74) Lockdowns and social distancing
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Government response AI summary
The government partially accepts the recommendation, detailing ongoing work by NHS England and HEE to create a more flexible workforce, including exploring routes for doctors to change specialties and making curricula more flexible for training in sub-specialties.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
22
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
The second wave of covid infections, hospitalisations and deaths during the autumn and winter of 2020/21 was significantly driven by the emergence of a new variant, known as the Kent or Alpha variant. It is likely that a “circuit break” of temporary lockdown measures if introduced in September 2020, and …
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The second wave of covid infections, hospitalisations and deaths during the autumn and winter of 2020/21 was significantly driven by the emergence of a new variant, known as the Kent or Alpha variant. It is likely that a “circuit break” of temporary lockdown measures if introduced in September 2020, and earlier lockdown measures during the winter, could have impeded the rapid seeding and spread of the Kent variant. However, the existence of the Kent or Alpha variant was not known by the Government until 11 December 2020 so that the justification for taking earlier measures could not rely on information available at the time.
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Government response AI summary
The government partially accepts, responding with a focus on general positive learning, engagement with other countries and disciplines, and efforts to improve the National Risk Assessment (NSRA) process and external expert challenge.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
27
Recommendation
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
In a pandemic, the scientific advice from the SAGE co-chairs to the Government should be published within 24 hours of it being given, or the policy being decided, whichever is the later, to ensure the opportunity for rapid scientific challenge and guard against the risk of ‘groupthink’. In addition, minutes …
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In a pandemic, the scientific advice from the SAGE co-chairs to the Government should be published within 24 hours of it being given, or the policy being decided, whichever is the later, to ensure the opportunity for rapid scientific challenge and guard against the risk of ‘groupthink’. In addition, minutes and SAGE papers should be published within 48 hours of the meeting taking place.
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Government response AI summary
The government partially accepts the recommendation for transparency, but states that publishing SAGE advice and papers within 24-48 hours is not always feasible due to complexity, quality assurance needs, and sensitive content.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
32
Conclusion
Sixth Report - Coronavirus: lessons lea…
Accepted in Part
The new Test and Trace operation eventually established in May 2020 was a step in the right direction but set up much too late. Because of that delay there was huge pressure to get results quickly which meant that it followed a centralised model initially, meaning assistance from laboratories outside …
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The new Test and Trace operation eventually established in May 2020 was a step in the right direction but set up much too late. Because of that delay there was huge pressure to get results quickly which meant that it followed a centralised model initially, meaning assistance from laboratories outside PHE—particularly university laboratories—was rebuffed. The same was true for contact tracing, where the established capabilities of local Directors of Public Health and their teams were Coronavirus: lessons learned to date 129 not effectively harnessed during the initial response to the pandemic, despite local approaches providing effective in places where they were pursued. It is now clear that the optimal structure for test and trace is one that is locally driven with the ability to draw on central surge capacity—but it took the best part of a year to get to that point. In short, implementation was too centralised when it ought to have been more decentralised.
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Government response AI summary
The government partially accepts, focusing on general learning from international practice, improving the National Risk Assessment (NSRA) methodology, and increasing accessibility for external experts, rather than specifically addressing the centralization or timing of the Test and Trace system.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
58
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
The UK has established procedures and structures to prepare for the nation’s major future risks, including a National Risk Register, the Civil Contingencies Secretariat and the Scientific Advisory Group for Emergencies (SAGE). However, the anticipated future risk of pandemic disease focused too closely on influenza rather than diseases like SARS …
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The UK has established procedures and structures to prepare for the nation’s major future risks, including a National Risk Register, the Civil Contingencies Secretariat and the Scientific Advisory Group for Emergencies (SAGE). However, the anticipated future risk of pandemic disease focused too closely on influenza rather than diseases like SARS and MERS that had in recent years appeared in Asian countries.
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Government response AI summary
The government partially accepts the observation, committing to improve the NSRA methodology through an external review by RAEng and exploring ways to increase accessibility for external experts and diversify challenge in risk assessment.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
59
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did not squarely address a disease with the characteristics of covid-19. Nevertheless, some useful lessons were learned and applied, such as the drafting of legislative measures that might be needed. 93 Healthcare Infection Society (CLL0071) 94 …
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Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did not squarely address a disease with the characteristics of covid-19. Nevertheless, some useful lessons were learned and applied, such as the drafting of legislative measures that might be needed. 93 Healthcare Infection Society (CLL0071) 94 Q872; Paragraphs 318–19 95 Healthcare Infection Society (CLL0071) 96 Q941 30 Coronavirus: lessons learned to date
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Government response AI summary
The government partially accepts, acknowledging that lessons from previous pandemic exercises should have been better identified and implemented, and commits to improving future preparedness by developing a new pandemic strategy, investing in R&D, and strengthening international partnerships.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
64
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
A greater diversity of expertise and challenge—including from practitioners from other countries and a wider range of disciplines—should be included in the framing of the National Risk Register and the plans that emanate from it. Plans for the future should include a substantial and systematic method of learning from international …
Read more
A greater diversity of expertise and challenge—including from practitioners from other countries and a wider range of disciplines—should be included in the framing of the National Risk Register and the plans that emanate from it. Plans for the future should include a substantial and systematic method of learning from international practice during the course of an emergency.
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Government response AI summary
The government partially accepts the recommendation, agreeing on learning from diverse international expertise and detailing how the National Risk Register methodology is being reviewed by the Royal Academy of Engineering to increase external challenge and accessibility.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
66
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
The Government should ensure comprehensive plans are made for future risks and emergencies. The UK should aim to be a world leader in co-ordinating international resilience planning, including reform of the World Health Organisation to ensure that it is able to play a more effective role in future pandemics.
Read more
The Government should ensure comprehensive plans are made for future risks and emergencies. The UK should aim to be a world leader in co-ordinating international resilience planning, including reform of the World Health Organisation to ensure that it is able to play a more effective role in future pandemics.
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Government response AI summary
The government partially accepts, agreeing on positive learning and engagement with international partners and disciplines, and is considering ways to increase external expert accessibility and challenge in the National Risk Assessment process.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
67
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
The resourcing and capabilities of the Civil Contingencies Secretariat should be improved. The Civil Contingencies Secretariat should be empowered to ‘stress test’ plans and to ensure that Departments are able to carry out a contingency plan if required. The details and results of these stress tests should be included in …
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The resourcing and capabilities of the Civil Contingencies Secretariat should be improved. The Civil Contingencies Secretariat should be empowered to ‘stress test’ plans and to ensure that Departments are able to carry out a contingency plan if required. The details and results of these stress tests should be included in the Cabinet Office’s annual report.
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Government response AI summary
The government partially accepts, highlighting ongoing engagement with international practices and efforts to improve the National Risk Assessment (NSRA) methodology and external challenge, though it does not explicitly commit to increasing CCS resourcing or reporting specific stress test results.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
78
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
As a result, decisions on lockdowns and social distancing during the early weeks of the pandemic—and the advice that led to them—rank as one of the most important public health failures the United Kingdom has ever experienced. This happened despite the UK 97 GOV.UK, ‘Precautionary SAGE 1 minutes: Coronavirus (COVID-19) …
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As a result, decisions on lockdowns and social distancing during the early weeks of the pandemic—and the advice that led to them—rank as one of the most important public health failures the United Kingdom has ever experienced. This happened despite the UK 97 GOV.UK, ‘Precautionary SAGE 1 minutes: Coronavirus (COVID-19) response, 22 January 2020’, accessed 17 August 2021 98 See, for example: Q114, Q473, Q716, Q746 and Q1227 99 GOV.UK, ‘Prime Minister’s statement on coronavirus (COVID-19): 23 March 2020’, accessed 17 August 2021 100 See, for example: On 16 March SAGE advised “that there is clear evidence to support additional social distancing measures be introduced as soon as possible”—GOV.UK, ‘SAGE 16 minutes: Coronavirus (COVID-19) response, 16 March 2020’, accessed 17 August 2021 101 Oral evidence taken before the Science and Technology Committee on 10 June 2020, HC (2019–21) 136, Q883 Coronavirus: lessons learned to date 33 counting on some of the best expertise available anywhere in the world, and despite having an open, democratic system that allowed plentiful challenge. Painful though it is, the UK must learn what lessons it can of why this happened if we are to ensure it is not repeated. The initial policy: flattening the peak
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Government response AI summary
The government, without directly acknowledging the "public health failures" conclusion, commits to reforming SAGE in the future to include more diverse and international representation, aiming to improve learning and preparedness.
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Department for Science, Innovation and Technology
Department of Health and Social Care
112
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
We have referred to early evidence from Dr Richard Horton, the Editor of the Lancet, who was concerned that SAGE in its early months was taking insufficient account of international perspectives. At the time he gave his evidence, Dr Horton, like the rest of the public, was not aware of …
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We have referred to early evidence from Dr Richard Horton, the Editor of the Lancet, who was concerned that SAGE in its early months was taking insufficient account of international perspectives. At the time he gave his evidence, Dr Horton, like the rest of the public, was not aware of the membership of SAGE. Now we are, and it is notable that 173 GOV.UK, SAGE 14, 10 March 2020 174 GOV.UK, SAGE 16, 16 March 2020 175 Office for National Statistics, ‘Coronavirus and the social impacts on behaviours during different lockdown periods, Great Britain: up to February 2021’, accessed 17 September 2021 176 Oral evidence taken before the Science and Technology Committee on 3 November 2020, HC (2019–21) 136, Q1517 46 Coronavirus: lessons learned to date of the 87 people listed as having participated in at least one meeting of SAGE, all bar one person (Dr Pasi Penttinen, European Centre for Disease Prevention and Control) are from UK institutions.177
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Government response AI summary
The government partially accepts, stating it agrees on the importance of learning and engagement with other countries and is considering ways to increase external expert access and diversity of challenge, especially for the National Risk Assessment.
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Department for Science, Innovation and Technology
Department of Health and Social Care
122
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
There has also been a lack of transparency over the scientific case for particular interventions. After the initial, broad lockdown had been lifted specific prohibitions were introduced in later months. Such restrictions were typically justified by Ministers as 186 Q164 187 Oral evidence taken before the Science and Technology Committee …
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There has also been a lack of transparency over the scientific case for particular interventions. After the initial, broad lockdown had been lifted specific prohibitions were introduced in later months. Such restrictions were typically justified by Ministers as 186 Q164 187 Oral evidence taken before the Science and Technology Committee on 17 February 2021, HC (2019–21) 136, Q1990 188 GOV.UK, SAGE 69, 19 November 2020 189 Science and Technology Committee, First Report of Session 2019–21, The UK response to covid-19: use of scientific advice, HC 136, paragraphs 59–64. We note that since the publication of the Science and Technology Committee’s Report some information has been published by the JBC. Some of this was outlined in DHSC, ‘The Government’s Response to the Science and Technology Committee report: The UK Response to Covid-19: Use of Scientific Advice’, May 2021, CP 432 190 Q184 Coronavirus: lessons learned to date 49 being scientifically based. But supporting scientific reasoning and evidence was usually lacking. For example, no SAGE paper, or scientific evidence, was published to support the imposition from 24 September 2020 of a 10pm curfew on pubs—a decision that affected the livelihoods of many people in the hospitality sector.191
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Government response AI summary
The government partially accepts the recommendation, stating it has published scientific evidence and advice, including SAGE papers, within 10 days of meetings, arguing this strikes a reasonable balance for transparency. They commit to continuing to publish advice and note this will be considered by the …
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Department for Science, Innovation and Technology
Department of Health and Social Care
123
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
Scientific advice was cited in justification for increasingly fine-grained restrictions— with which some of the Government’s scientific advisers were often visibly uncomfortable. When Sir Patrick Vallance, the Government Chief Scientific Adviser, was asked on 3 November why children’s outdoor sport was banned, despite by then widespread evidence that outdoor transmission …
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Scientific advice was cited in justification for increasingly fine-grained restrictions— with which some of the Government’s scientific advisers were often visibly uncomfortable. When Sir Patrick Vallance, the Government Chief Scientific Adviser, was asked on 3 November why children’s outdoor sport was banned, despite by then widespread evidence that outdoor transmission of covid was very rare, Sir Patrick said: They have had advice from us in terms of the general principles and some of the areas, but, as I say, not down to individual specific activities like that, and the same is true on the medical side as well. […] Chair: Would you advise that children’s outdoor sports should banned? Sir Patrick Vallance: As Chris said, we just do not go down to that level of individual activities.192
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Government response AI summary
The government partially accepts the recommendation, stating it has published scientific evidence and advice, including SAGE papers, within 10 days of meetings, arguing this strikes a reasonable balance for transparency. They commit to continuing to publish advice and note this will be considered by the …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
135
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
Leading virologists who gave evidence to the Science and Technology Committee on 23 December said that the Government had acted quickly in response to the new evidence. For example, Professor Peter Horby, Chair of the New and Emerging Respiratory Virus 206 Oral evidence taken before the Science and Technology Committee …
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Leading virologists who gave evidence to the Science and Technology Committee on 23 December said that the Government had acted quickly in response to the new evidence. For example, Professor Peter Horby, Chair of the New and Emerging Respiratory Virus 206 Oral evidence taken before the Science and Technology Committee on 3 November 2020, HC (2019–21) 136, Qq1443–1445 207 GOV.UK, ‘COVID-19 (SARS-CoV-2): information about the new virus variant’, accessed 17 September 2021 208 Susan Hopkins, Strategic Response Director, COVID-19, PHE, explained in a media interview on 20 December that the Government was first notified of the new variant on 11 December: @RidgeonSunday Twitter, 20 December 2020, 12.53pm 209 Following work by modellers and academics, Dr Susan Hopkins explained to The Andrew Marr Show on 20 December that, a difference in transmissibility and infectiousness was identified and the Government was notified of this on 18 December and “immediately started to take action”: BBC One, ‘Professor Susan Hopkins on the new coronavirus variant’, accessed 17 August 2021. 210 GOV.UK, ‘Coronavirus (COVID-19) in the UK’, web archive, accessed 17 August 2021 Coronavirus: lessons learned to date 53 Threats Advisory Group (NERVTAG),211 gave a positive assessment of the timeliness of Government action on the new variant: “We sent our first note to them raising a significant concern on the 18th, and on the 19th measures were put in place.”.212 The Government moved to cancel most of the previously announced relaxations of restrictions at Christmas, and thereafter introducing a third national lockdown from 6 January 2021.213
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Government response AI summary
The government partially accepts, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
137
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
Due to the much higher transmissibility of the Alpha variant, in the absence of a test, trace and isolate system capable of arresting the spread of the virus, a circuit-breaker in September and an earlier, more stringent lockdown, would likely have reduced deaths. Had more stringent social distancing measures been …
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Due to the much higher transmissibility of the Alpha variant, in the absence of a test, trace and isolate system capable of arresting the spread of the virus, a circuit-breaker in September and an earlier, more stringent lockdown, would likely have reduced deaths. Had more stringent social distancing measures been adopted during the autumn they could have reduced the seeding of the Alpha variant across the country, slowed its spread and therefore have saved lives. However, this is something we know now, but was not knowable at the time lockdown decisions were taken during the autumn: the existence of the Alpha variant was known only in December 2020.
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Government response AI summary
The government partially accepts, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
156
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
The second wave of covid infections, hospitalisations and deaths during the autumn and winter of 2020/21 was significantly driven by the emergence of a new variant, known as the Kent or Alpha variant. It is likely that a “circuit break” of temporary lockdown measures if introduced in September 2020, and …
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The second wave of covid infections, hospitalisations and deaths during the autumn and winter of 2020/21 was significantly driven by the emergence of a new variant, known as the Kent or Alpha variant. It is likely that a “circuit break” of temporary lockdown measures if introduced in September 2020, and earlier lockdown measures during the winter, could have impeded the rapid seeding and spread of the Kent variant. However, the existence of the Kent or Alpha variant was not known by the Government until 11 December 2020 so that the justification for taking earlier measures could not rely on information available at the time.
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Government response AI summary
The government partially accepts, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
171
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
As a result the UK squandered a leading position in diagnostics and converted it into one of permanent crisis. On 12 March, testing for covid-19 other than in hospitals was halted. In part this was because of the inadequacy of the early flu-based strategy—a flu-strategy which mandated ending testing when …
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As a result the UK squandered a leading position in diagnostics and converted it into one of permanent crisis. On 12 March, testing for covid-19 other than in hospitals was halted. In part this was because of the inadequacy of the early flu-based strategy—a flu-strategy which mandated ending testing when there was community transmission— but partly also because of a simple lack of capacity. The abandonment of community testing meant that contact tracing—which was fundamental to the success of the Korean approach—also had to be abandoned. If people could not be tested, their contacts could not be traced.
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Government response AI summary
The government partially accepts, agreeing to learn from international engagement and committing to review the National Risk Assessment (NSRA) methodology to increase external expert challenge and diversity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
174
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
For a country with a world-class expertise in data analysis, to face the biggest health crisis in a hundred years with virtually no data to analyse was an almost unimaginable setback. The reasons for this initial inadequacy to translate testing technology into deployable testing capacity are varied. Public Health England …
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For a country with a world-class expertise in data analysis, to face the biggest health crisis in a hundred years with virtually no data to analyse was an almost unimaginable setback. The reasons for this initial inadequacy to translate testing technology into deployable testing capacity are varied. Public Health England seemed to be better at its scientific responsibilities than in its operational response to a mass outbreak of disease and was not clearly instructed to rectify the issue.259 Public Health England reported directly to the Department of Health and Social Care, with only limited operational independence, so the Department too should have been more aware of the issue.
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Government response AI summary
The government partially accepts, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
176
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
It is clear that there should have been more challenge to Public Health England to increase testing capacity from the outset by Ministers, scientific advisers and the Department of Health and Social Care rather than accepting it as a fait accompli. Consequences of abandoning testing in the community
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It is clear that there should have been more challenge to Public Health England to increase testing capacity from the outset by Ministers, scientific advisers and the Department of Health and Social Care rather than accepting it as a fait accompli. Consequences of abandoning testing in the community
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Government response AI summary
The government partially accepts the recommendation, agreeing on the importance of learning and engagement, and highlighting efforts to improve expert challenge to the National Security Risk Assessment (NSRA) methodology, including an external review by the Royal Academy of Engineering.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
178
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
The lack of data resulting from suspending community testing also affected the UK’s understanding of the disease at that critical time. Professor Neil Ferguson explained to the Science and Technology Committee in June 2020 that low testing capacity meant it was difficult to estimate the proportion of imported cases which …
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The lack of data resulting from suspending community testing also affected the UK’s understanding of the disease at that critical time. Professor Neil Ferguson explained to the Science and Technology Committee in June 2020 that low testing capacity meant it was difficult to estimate the proportion of imported cases which had been missed: at the time we had a policy of trying to screen people at borders, and we estimated then that maybe two thirds of imported cases had been missed. What we now know, because the epidemic took off in Italy and Spain before anybody had realised, is that probably 90% of cases imported into this country were missed by those border measures, because we were not checking people. […] Had we had the testing capacity […] screening everybody with symptoms coming in would have given us a much better impression of where infection was coming from.262 260 Oral evidence taken before the Science and Technology Committee on 25 March 2020, HC (2019–21) 136, Q20 261 Q319 and Q323 262 Oral evidence taken before the Science and Technology Committee on 10 June 2020, HC (2019–21) 136, Q870, Q873 64 Coronavirus: lessons learned to date Arguably this lack of data could have contributed to the delay in the critical decision to instigate a nationwide lockdown. As Professor Chris Whitty explained: because we had very limited testing capacity, we did not realise quite how far along the curve we were, because we were having to use people in intensive care and who had sadly died, which is quite a late event. If we had the capacity on testing then that we have now, we would have come to very different conclusions using exactly the same science.263 Professor Whitty suggested that one key lesson was to “build our capacity to do testing […] at scale”, which he described would be “a problem with any pandemic we have in the future”.264 Impact on health and social care
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Government response AI summary
The government partially accepts, agreeing on positive learning and engagement with other countries. It details ongoing reviews of the National Security Risk Assessment (NSRA) methodology, including commissioning an external group and considering ways to increase external expert accessibility.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
1
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
The UK has established procedures and structures to prepare for the nation’s major future risks, including a National Risk Register, the Civil Contingencies Secretariat and the Scientific Advisory Group for Emergencies (SAGE). However, the anticipated future risk of pandemic disease focused too closely on influenza rather than diseases like SARS …
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The UK has established procedures and structures to prepare for the nation’s major future risks, including a National Risk Register, the Civil Contingencies Secretariat and the Scientific Advisory Group for Emergencies (SAGE). However, the anticipated future risk of pandemic disease focused too closely on influenza rather than diseases like SARS and MERS that had in recent years appeared in Asian countries.
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Government response AI summary
The government partially accepts the implicit recommendation, agreeing to learn from and engage with other countries. It details ongoing improvements to the National Risk Assessment (NSRA) methodology, including increasing expert challenge and international learning, to better prepare for a broader range of risks.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
2
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did not squarely address a disease with the characteristics of covid-19. Nevertheless, some useful lessons were learned and applied, such as the drafting of legislative measures that might be needed.
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Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did not squarely address a disease with the characteristics of covid-19. Nevertheless, some useful lessons were learned and applied, such as the drafting of legislative measures that might be needed.
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Government response AI summary
The government partially accepts, agreeing to learn from international engagement and committing to review the National Risk Assessment (NSRA) methodology to increase external expert challenge and diversity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
5
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
Protocols to share data between public bodies involved in the response were too slow to establish and to become functional. This was especially true in the data flows from national to local government.
Government response AI summary
The government partially accepts the observation, acknowledging that more needs to be done to improve data sharing and interoperability. It cites numerous ongoing programs and initiatives, including the Data Standards Authority and the NHS Data Sharing Service, and commits to making further progress in this …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
7
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
A greater diversity of expertise and challenge—including from practitioners from other countries and a wider range of disciplines—should be included in the framing of the National Risk Register and the plans that emanate from it. Plans for the future should include a substantial and systematic method of learning from international …
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A greater diversity of expertise and challenge—including from practitioners from other countries and a wider range of disciplines—should be included in the framing of the National Risk Register and the plans that emanate from it. Plans for the future should include a substantial and systematic method of learning from international practice during the course of an emergency.
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Government response AI summary
The government partially accepts the recommendation, agreeing on the importance of diverse expertise and international learning, which it says it already does flexibly. It highlights commissioning an external review of the National Risk Assessment (NSRA) methodology and is considering ways to increase external expert accessibility …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
10
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
The resourcing and capabilities of the Civil Contingencies Secretariat should be improved. The Civil Contingencies Secretariat should be empowered to ‘stress test’ plans and to ensure that Departments are able to carry out a contingency plan if required. The details and results of these stress tests should be included in …
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The resourcing and capabilities of the Civil Contingencies Secretariat should be improved. The Civil Contingencies Secretariat should be empowered to ‘stress test’ plans and to ensure that Departments are able to carry out a contingency plan if required. The details and results of these stress tests should be included in the Cabinet Office’s annual report.
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Government response AI summary
The government partially accepts the recommendation, stating improvements to CCS resourcing are being considered following a review. It claims CCS already conducts stress tests and is considering how to report exercise outcomes in the annual report, balanced against security.
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Department for Science, Innovation and Technology
Department of Health and Social Care
13
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
The Government and the NHS should consider establishing a volunteer reserve database so that volunteers who have had appropriate checks can be rapidly called up and deployed in an emergency rather than needing to begin from scratch.
Government response AI summary
The government partially accepts the recommendation, highlighting existing partnerships with St John Ambulance and Royal Voluntary Service for volunteer deployment in specific programmes like vaccinations, and states NHS England is continuing to consider improvements to the volunteer model.
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Department for Science, Innovation and Technology
Department of Health and Social Care
21
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
Science proceeds through challenge and disputation, and new theories are tested unflinchingly against evidence. Yet Ministers and other advisers reported that they felt it difficult to challenge the views of their official scientific advisers. Those in Government have a duty to question and probe the assumptions behind any scientific advice …
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Science proceeds through challenge and disputation, and new theories are tested unflinchingly against evidence. Yet Ministers and other advisers reported that they felt it difficult to challenge the views of their official scientific advisers. Those in Government have a duty to question and probe the assumptions behind any scientific advice given, particularly in a national emergency, but there is little evidence sufficient challenge took place. However, even when UK policy had changed to bring in a comprehensive national lockdown, the role of non-pharmaceutical interventions against covid-19 was complex, inconsistent and opaque for most of the rest of 2020.
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Government response AI summary
The government partially accepts the recommendation, agreeing on learning from diverse international expertise and detailing how the National Risk Register methodology is being reviewed by the Royal Academy of Engineering to improve expert challenge and accessibility.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
25
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
In future an approach of greater questioning and challenge should characterise the development of policy. Ministers should have the confidence to follow a scientific approach themselves—being prepared to take a more robust approach to questioning and challenging the advice given. The Government and SAGE should also facilitate strong external and …
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In future an approach of greater questioning and challenge should characterise the development of policy. Ministers should have the confidence to follow a scientific approach themselves—being prepared to take a more robust approach to questioning and challenging the advice given. The Government and SAGE should also facilitate strong external and structured challenge to scientific advice, including from experts in countries around the world, and a wider range of disciplines.
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Government response AI summary
The government partially accepts, agreeing to learn from other countries and disciplines. It describes how the Cabinet Office is reviewing the NSRA methodology to increase expert and diverse challenge during and after the process.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
26
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK body. In future, it should include more representation and a wider range of disciplines, from other countries, especially those which have experienced, or are experiencing, the same emergency. (Paragraph 160) 128 Coronavirus: lessons learned to …
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In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK body. In future, it should include more representation and a wider range of disciplines, from other countries, especially those which have experienced, or are experiencing, the same emergency. (Paragraph 160) 128 Coronavirus: lessons learned to date
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Government response AI summary
The government partially accepts the recommendation, agreeing to learn from international engagement and committing to review the National Risk Assessment (NSRA) methodology to increase external expert challenge and diversity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
28
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
The Government, via the World Health Organisation, should make the case for an international standard of reporting covid-19 deaths and a framework for reporting disease related deaths for future pandemics. (Paragraph 162) Testing and contact tracing
Government response AI summary
The government partially accepts, agreeing on positive learning and engagement with other countries, but the response largely details ongoing reviews of the National Security Risk Assessment (NSRA) methodology and increasing external expert accessibility, rather than committing to making the case for international death reporting standards …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
30
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
Testing capacity was treated too much as a parameter rather than a variable that could be changed by the Department of Health and Social Care and scientific advisers. What was being achieved in other countries, particularly East Asia, appeared to be of little interest in the initial weeks of the …
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Testing capacity was treated too much as a parameter rather than a variable that could be changed by the Department of Health and Social Care and scientific advisers. What was being achieved in other countries, particularly East Asia, appeared to be of little interest in the initial weeks of the pandemic. This was an inexcusable oversight. It took a personal intervention by the then Secretary of State in April 2020 to drive a major increase in testing capacity.
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Government response AI summary
The government partially accepts the conclusion, agreeing on the importance of learning from other countries and enhancing challenge. It notes an ongoing review by the Royal Academy of Engineering of the National Security Risk Assessment methodology, and the Cabinet Office is considering ways to increase …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
31
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
The resulting requirement to abandon testing people in the community during the critical early period of the pandemic cost many lives for a number of reasons including because: a) many asymptomatic carriers were not tested and therefore identified and asked to isolate; b) many older people were admitted to care …
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The resulting requirement to abandon testing people in the community during the critical early period of the pandemic cost many lives for a number of reasons including because: a) many asymptomatic carriers were not tested and therefore identified and asked to isolate; b) many older people were admitted to care homes either from the community or hospitals in ignorance of their covid status or that of staff working in care homes; c) low levels of testing meant that the UK lost visibility of where the disease was spreading, among which groups and how quickly. For a crucial period our only insight into the spread of covid was by counting people so sick that they had to be admitted to hospital; and (Paragraph 234.c)) d) the receipt of a positive test result would have been likely to improve compliance with an isolation request.
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Government response AI summary
The government partially accepts the committee's findings, agreeing on the vital need for operational competence to rapidly scale up test, trace, and isolate programmes in future emergencies. It highlights UKHSA's current surge capacity (700-800k PCR, 2.5m LFD daily) and commits to working with local authorities …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
34
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
We recognise that the effectiveness of test and trace in reducing transmission is likely to be reduced when the prevalence of the virus is high, as highlighted by Professor Whitty and others, but it is clear from the latest data and the experience of September 2020 that even at the …
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We recognise that the effectiveness of test and trace in reducing transmission is likely to be reduced when the prevalence of the virus is high, as highlighted by Professor Whitty and others, but it is clear from the latest data and the experience of September 2020 that even at the level of operational effectiveness, NHS Test and Trace has been unable to respond to rising rates of transmission of covid-19.
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Government response AI summary
The government partially accepts the recommendation, agreeing on the vital need for operational competence to scale up test and trace. It details UKHSA's current surge capacity (700-800k PCR, 2.5m LFD daily) and commits to working with local authorities and maintaining local relationships to build resilient …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
50
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
We endorse the Health and Social Care Committee’s call for additional resources to be directed to social care. That Committee has made the case for an increase of £7 billion a year by 2023/4. We note that despite the Government’s recent announcement the level of new investment in social care …
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We endorse the Health and Social Care Committee’s call for additional resources to be directed to social care. That Committee has made the case for an increase of £7 billion a year by 2023/4. We note that despite the Government’s recent announcement the level of new investment in social care from 2023/24 remains unclear.
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Government response AI summary
The government partially accepts, detailing a commitment of £5.4 billion over three years for social care reforms and an additional £1.7 billion for the charging system, with more details to be announced later.
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Department for Science, Innovation and Technology
Department of Health and Social Care
54
Conclusion
Third Report - Coronavirus: lessons lea…
Accepted in Part
Staff from Black, Asian and minority ethnic backgrounds are crucial to the NHS and care sectors. The covid-19 pandemic has brought the experiences of these staff into sharp focus. It is telling that the first ten NHS staff to die from covid-19 were from Black, Asian and minority ethnic backgrounds, …
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Staff from Black, Asian and minority ethnic backgrounds are crucial to the NHS and care sectors. The covid-19 pandemic has brought the experiences of these staff into sharp focus. It is telling that the first ten NHS staff to die from covid-19 were from Black, Asian and minority ethnic backgrounds, and evidence has since confirmed that the impact of covid-19 on this section of the workforce has been significant. While the NHS has made progress in recent years, the experience of people from BAME groups during the pandemic has made it clear that inequalities persist.
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Government response AI summary
The government accepts the recommendation to develop a strategy for securing appropriate PPE for all NHS and care staff, including those from BAME backgrounds, acknowledging the committee's concerns about inequalities. It highlights existing efforts to ensure good fit-test performance for masks and engagement with BAME …
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Department for Science, Innovation and Technology
Department of Health and Social Care
57
Recommendation
Third Report - Coronavirus: lessons lea…
Accepted in Part
The Government should ensure its ‘levelling up’ agenda includes specific policies to reduce health inequalities, with a particular focus on ensuring that certain groups, including people from Black, Asian and minority ethnic backgrounds, do not continue to face unequal health outcomes.
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The Government should ensure its ‘levelling up’ agenda includes specific policies to reduce health inequalities, with a particular focus on ensuring that certain groups, including people from Black, Asian and minority ethnic backgrounds, do not continue to face unequal health outcomes.
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Government response AI summary
The government accepts the recommendation, stating it will consider how to reduce health inequalities as part of the levelling up agenda and commits to continued action including developing a Staff Network Maturity Framework and Staff Network Chair development programme through NHS England.
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Department for Science, Innovation and Technology
Department of Health and Social Care