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Sixth Report - Coronavirus: lessons learned to date

Health and Social Care Committee HC 92 Published 12 October 2021
Report Status
Government responded
Conclusions & Recommendations
200 items (44 recs)
Government Response
AI assessment · 155 of 200 classified
Accepted 37
Accepted in Part 21
Acknowledged 23
Deferred 1
Not Addressed 61
Rejected 12
Government response
Government’s Response to the Health and Social Care Committee and Science and Technology Committee Joint Report: Coronavirus: Lessons Learned to Date · published 30 Jun 2022
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Recommendations & Conclusions

200 items
58 Conclusion Not Addressed

The UK has established procedures and structures to prepare for the nation’s major future risks,...

Conclusion
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 … Read more
Government Response Summary
The government states it partially accepts this conclusion, but provides no further details or specific actions in its response.
Department for Science, Innovation and Technology Department of Health and Social Care
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59 Conclusion Accepted in Part

Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did...

Conclusion
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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60 Conclusion Rejected

The operation of COBR was not well-suited to the modern demands of a pandemic response.

Conclusion
The operation of COBR was not well-suited to the modern demands of a pandemic response. It is especially concerning that its culture of confidentiality was considered by some to be so unreliable that alternative meetings were arranged that could command … Read more
Government Response Summary
The government explicitly states it does not accept the committee's conclusion that COBR's operation was not well-suited to a pandemic response and had unreliable confidentiality.
Department for Science, Innovation and Technology Department of Health and Social Care
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61 Conclusion Rejected

The Civil Contingencies Secretariat did not have adequate resources to maintain a substantial standing capability...

Conclusion
The Civil Contingencies Secretariat did not have adequate resources to maintain a substantial standing capability to survey the development of potential threats, and it had a limited reach into the range of Government departments required to respond to a pandemic. … Read more
Government Response Summary
The government rejects the premise that the Civil Contingencies Secretariat had inadequate resources, stating that a range of existing capabilities, including the CCS itself, already identify and assess current and future risks effectively.
Department for Science, Innovation and Technology Department of Health and Social Care
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62 Conclusion Accepted

Protocols to share data between public bodies involved in the response were too slow to...

Conclusion
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 Summary
The government proposes that arrangements should be established and tested to allow immediate data flows between relevant bodies during an emergency, including a mechanism for dispute resolution.
Department for Science, Innovation and Technology Department of Health and Social Care
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63 Conclusion Not Addressed

The NHS responded quickly and strongly to the demands of the pandemic, but compared to...

Conclusion
The NHS responded quickly and strongly to the demands of the pandemic, but compared to other health systems it “runs hot”—with little spare capacity built in to cope with sudden and unexpected surges of demand such as in a pandemic. … Read more
Government Response Summary
The government's response is a verbatim restatement of a separate committee recommendation (ID 17545) and therefore does not provide a direct response to this conclusion about the NHS's lack of spare capacity.
Department for Science, Innovation and Technology Department of Health and Social Care
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64 Recommendation Accepted in Part

A greater diversity of expertise and challenge—including from practitioners from other countries and a wider...

Recommendation
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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65 Recommendation Rejected

A standing capability should be established in Government, or reporting to it, to scan the...

Recommendation
A standing capability should be established in Government, or reporting to it, to scan the horizon for future threats, with adequate resource and counting on specialists with an independence from short-term political and administrative pressures.
Government Response Summary
The government rejects the recommendation, stating a dedicated standing capability is not needed as a range of existing complementary capabilities already identify and assess future risks.
Department for Science, Innovation and Technology Department of Health and Social Care
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66 Recommendation Not Addressed

The Government should ensure comprehensive plans are made for future risks and emergencies.

Recommendation
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 … Read more
Government Response Summary
The government response reiterates the committee's recommendation without providing any specific action, commitment, or stance.
Department for Science, Innovation and Technology Department of Health and Social Care
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67 Recommendation Not Addressed

The resourcing and capabilities of the Civil Contingencies Secretariat should be improved.

Recommendation
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 … Read more
Government Response Summary
The government's response provides a generic statement about establishing and testing arrangements for data flows and dispute resolution during an emergency, failing to address the specific recommendations to improve CCS resourcing, empower stress testing, or include results in annual reports.
Department for Science, Innovation and Technology Department of Health and Social Care
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68 Recommendation Accepted

Arrangements should be established and tested to allow immediate flows of data between bodies relevant...

Recommendation
Arrangements should be established and tested to allow immediate flows of data between bodies relevant to an emergency response with a mechanism to resolve immediately and decisively any disputes.
Government Response Summary
The government accepts the recommendation, stating UKHSA will work with partners to improve data sharing agreements, ensuring GDPR compliance and data security.
Department for Science, Innovation and Technology Department of Health and Social Care
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69 Recommendation Accepted in Part

The Armed Forces should have a more central and standing role in preparing for and...

Recommendation
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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70 Recommendation Accepted

The Government and the NHS should consider establishing a volunteer reserve database so that volunteers...

Recommendation
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 Summary
The government accepts the recommendation and is exploring options for establishing a volunteer reserve database for rapid deployment in future emergencies. NHS England is collaborating with the Royal Voluntary Service and St John Ambulance to develop rapid volunteer deployment methods.
Department for Science, Innovation and Technology Department of Health and Social Care
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71 Recommendation Accepted

The experience of the demands placed on the NHS during the covid-19 pandemic should lead...

Recommendation
The experience of the demands placed on the NHS during the covid-19 pandemic should lead to a more explicit, and monitored, surge capacity being part of the long term organisation and funding of the NHS.
Government Response Summary
The government accepts the recommendation, stating that NHS England is developing proposals for explicit, monitored surge capacity plans within the NHS, considering staff, beds, and equipment, which will be incorporated into routine planning and funding.
Department for Science, Innovation and Technology Department of Health and Social Care
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72 Recommendation Accepted

The NHS should develop and publish new protocols for infection prevention and control in pandemics...

Recommendation
The NHS should develop and publish new protocols for infection prevention and control in pandemics covering staffing, bed capacity and physical infrastructure. In developing these protocols the NHS should consider the importance of maintaining access for people accompanying some patients … Read more
Government Response Summary
The government accepts the recommendation, stating NHS England is committed to developing and publishing new protocols for infection prevention and control, and will consider maintaining access for patient companions.
Department for Science, Innovation and Technology Department of Health and Social Care
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73 Recommendation Accepted

Comprehensive analysis should be carried out to assess the safety of running the NHS with...

Recommendation
Comprehensive analysis should be carried out to assess the safety of running the NHS with the limited latent capacity that it currently has, particularly in Intensive Care Units, critical care units and high dependency units.
Government Response Summary
The government accepts the recommendation and confirms NHS England is undertaking comprehensive analysis to assess the safety of the NHS's limited latent capacity, which will inform future surge capacity plans.
Department for Science, Innovation and Technology Department of Health and Social Care
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74 Recommendation Accepted

Building on the experience of staff working more flexibly during the pandemic and to enable...

Recommendation
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 … Read more
Government Response Summary
The government accepts the recommendation, stating NHS England and Health Education England are collaborating to develop proposals for enabling NHS staff to change clinical specialty mid-career and train in sub-specialties.
Department for Science, Innovation and Technology Department of Health and Social Care
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75 Conclusion Acknowledged

Much of the impact of covid-19 during the first wave was determined by decisions made...

Conclusion
Much of the impact of covid-19 during the first wave was determined by decisions made during the early weeks of the pandemic, between January and late March 2020. The seriousness of the threat to the UK was recognised in January … Read more
Government Response Summary
The government acknowledges the importance of positive learning and engagement with other countries. They describe ongoing efforts by the Cabinet Office to review and improve the National Security Risk Assessment (NSRA) methodology, considering ways to increase external expert accessibility and diversify challenge during the process.
Department for Science, Innovation and Technology Department of Health and Social Care
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76 Conclusion Rejected

The veil of ignorance through which the UK viewed the initial weeks of the pandemic...

Conclusion
The veil of ignorance through which the UK viewed the initial weeks of the pandemic was partly self-inflicted. As we examine in depth in Chapter 4, the UK failed to turn an early lead in developing a test for covid … Read more
Government Response Summary
The government rejects the committee's conclusion, arguing it already has a range of complementary standing capabilities for identifying and assessing risks, including horizon scanning, the Joint Intelligence Organisation, the National Situation Centre, and the NSRA process, as well as future work by GO-Science to build futures capability.
Department for Science, Innovation and Technology Department of Health and Social Care
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77 Conclusion Not Addressed

The initial UK policy was to take a gradual and incremental approach to introducing non-pharmaceutical...

Conclusion
The initial UK policy was to take a gradual and incremental approach to introducing non-pharmaceutical interventions. A comprehensive lockdown was not ordered until 23 March 2020—two months after SAGE first met to consider the national response to covid- 19.99 This … Read more
Government Response Summary
The government claims to partially accept an unspecified recommendation, but its response describes measures to improve scientific challenge and international learning related to the NSRA process, failing to address the committee's conclusion about the initial slow lockdown policy.
Department for Science, Innovation and Technology Department of Health and Social Care
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78 Conclusion Accepted in Part

As a result, decisions on lockdowns and social distancing during the early weeks of the...

Conclusion
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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79 Conclusion

There has been considerable debate as to whether the early policy of the Government was...

Conclusion
There has been considerable debate as to whether the early policy of the Government was one of seeking to achieve so-called “herd-immunity”. The US Centres for Disease Control and Prevention defines community immunity/herd immunity as: A situation in which a … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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80 Conclusion

Non-pharmaceutical interventions such as lockdowns, and the testing and isolation of covid cases and their...

Conclusion
Non-pharmaceutical interventions such as lockdowns, and the testing and isolation of covid cases and their contacts, are tools of temporary application. Once they are lifted, there is nothing to stop transmission resuming. When Sir Patrick Vallance said at a Government … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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81 Conclusion

From our evidence this appears to have led to a policy approach of fatalism about...

Conclusion
From our evidence this appears to have led to a policy approach of fatalism about the prospects for covid in the community: seeking to manage, but not suppress, infection. This amounted in practice to accepting that herd immunity by infection … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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82 Conclusion

So in the absence of a vaccine or an effective treatment being available at first,...

Conclusion
So in the absence of a vaccine or an effective treatment being available at first, the UK faced a choice of doing everything possible to halt the virus, or seeking instead to moderate the pace of its spread. The UK chose the latter.106
Department for Science, Innovation and Technology Department of Health and Social Care
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83 Conclusion

Even as late as 12 March 2020, as noted in paragraph 80, Sir Patrick Vallance,...

Conclusion
Even as late as 12 March 2020, as noted in paragraph 80, Sir Patrick Vallance, Government Chief Scientific Adviser, told a Government press conference that it was not possible to stop everyone being infected, and nor was that a desirable … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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84 Conclusion

The Government’s action plan of 3 March indicated that there was no intention to bring...

Conclusion
The Government’s action plan of 3 March indicated that there was no intention to bring in a lockdown as strict as had been implemented in some other parts of the world. The action plan, under the heading ‘the Delay phase … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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85 Conclusion

At its meeting of 5 March 2020, SAGE reconfirmed an explicitly gradual approach: There is...

Conclusion
At its meeting of 5 March 2020, SAGE reconfirmed an explicitly gradual approach: There is epidemiological and modelling data to support implementation– within 1 to 2 weeks–of individual home isolation (symptomatic individuals to stay at home for 14 days) and … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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86 Conclusion

On 9 March 2020, SAGE set out a number of non-pharmaceutical interventions that could in...

Conclusion
On 9 March 2020, SAGE set out a number of non-pharmaceutical interventions that could in due course be introduced by the Government. SAGE advised that “measures relating to individual and household isolation will likely need to be enacted within the … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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87 Conclusion

It is striking, looking back, that it was accepted that the level of covid-19 infection...

Conclusion
It is striking, looking back, that it was accepted that the level of covid-19 infection in the UK could be controlled by turning on particular non-pharmaceutical interventions at particular times. Indeed such was the belief in this ability to calibrate … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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88 Conclusion

This was not the only way to proceed, and indeed the UK was an outlier...

Conclusion
This was not the only way to proceed, and indeed the UK was an outlier internationally in the gradualist approach that was being taken before late March.120 Countries in East Asia were the first to experience covid-19. Their response was … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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89 Conclusion

On 24 February the World Health Organisation published the report of its international mission to...

Conclusion
On 24 February the World Health Organisation published the report of its international mission to Wuhan, and advised that countries should: (1) Immediately activate the highest level of national Response Management protocols to ensure the all-of-government and all-of-society approach needed … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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90 Conclusion

In evidence to the Science and Technology Committee on 25 March 2020, the Editor of...

Conclusion
In evidence to the Science and Technology Committee on 25 March 2020, the Editor of The Lancet, Dr Richard Horton, said that his journal had published articles on 24, 29 and 31 January with an analysis of the situation in … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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91 Conclusion

The UK policy was to change abruptly.

Conclusion
The UK policy was to change abruptly. During the days before 23 March, multiple people within the Government and its advisers experienced simultaneous epiphanies that the course the UK was following was wrong, possibly catastrophically so. In his evidence to … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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92 Conclusion

In evidence to the Science and Technology Committee in July 2020, Sir Patrick Vallance, said...

Conclusion
In evidence to the Science and Technology Committee in July 2020, Sir Patrick Vallance, said that SAGE advised the Government to implement the remainder of the menu of options for social distancing measures—in essence a full lockdown—on 16 or 18 … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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93 Conclusion

It seems astonishing looking back that—despite the documented experiences of other countries; despite the then...

Conclusion
It seems astonishing looking back that—despite the documented experiences of other countries; despite the then Secretary of State referring to data with a Reasonable Worst Case Scenario of 820,000 deaths;138 despite the raw mathematics of a virus which, if it … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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94 Conclusion Accepted in Part

The UK did not impose blanket or rigorous border controls at the onset of the...

Conclusion
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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95 Conclusion Acknowledged

By contrast, other countries implemented more rigorous border controls which were more effective at suppressing...

Conclusion
By contrast, other countries implemented more rigorous border controls which were more effective at suppressing the virus and preventing the need for long and repeated lockdowns. However, even though it is not straightforward to make direct comparisons between countries, and … Read more
Government Response Summary
The government acknowledges the importance of positive learning and international engagement for future emergencies. They detail ongoing work to review the NSRA methodology and increase external expert challenge, and commit to international frameworks for disaster risk reduction.
Department for Science, Innovation and Technology Department of Health and Social Care
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96 Recommendation Accepted in Part

In the paragraphs that follow we consider some of the potential explanations of why the...

Recommendation
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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97 Conclusion Not Addressed

The UK’s structure of scientific advice in emergencies, in which a group is formed of...

Conclusion
The UK’s structure of scientific advice in emergencies, in which a group is formed of relevant experts (SAGE) to advise the Government is a prominent feature of our arrangements—much more so than in many other countries. Initially, participation in SAGE … Read more
Government Response Summary
The government states it 'partially accepts this recommendation' but the item is a conclusion, not a recommendation. The response discusses learning from other countries and the NSRA process, but does not address the descriptive content of conclusion #97.
Department for Science, Innovation and Technology Department of Health and Social Care
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98 Conclusion

SAGE provides advice to Ministers, whose responsibility it is to make policy decisions.

Conclusion
SAGE provides advice to Ministers, whose responsibility it is to make policy decisions. However, witnesses to our Committees confirmed that during the early months of the pandemic the Government acted on the scientific advice it was given. Sir Patrick Vallance, … Read more
Department for Science, Innovation and Technology Department of Health and Social Care
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99 Conclusion Not Addressed

We accept that it is difficult for Ministers to go against a scientific consensus among...

Conclusion
We accept that it is difficult for Ministers to go against a scientific consensus among the body set up to provide scientific advice during a national emergency. We also understand the reluctance to introduce measures with significant negative economic impact. … Read more
Government Response Summary
The government response merely repeats the committee's conclusion without offering any government stance, commitment, or specific action in response.
Department for Science, Innovation and Technology Department of Health and Social Care
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100 Conclusion Acknowledged

Several witnesses to our inquiry, reflecting on the early weeks of the pandemic, were rueful...

Conclusion
Several witnesses to our inquiry, reflecting on the early weeks of the pandemic, were rueful that they did not sufficiently question and challenge the advice they were being given. We heard that challenging an established scientific consensus was difficult. Dominic … Read more
Government Response Summary
The government acknowledges the importance of greater questioning and challenge in policy development, stating ministers and SAGE should facilitate robust external and structured challenge to scientific advice.
Department for Science, Innovation and Technology Department of Health and Social Care
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101 Conclusion Not Addressed

The then Secretary of State, Matt Hancock MP, made the same point regarding the difficulty...

Conclusion
The then Secretary of State, Matt Hancock MP, made the same point regarding the difficulty of challenging a scientific consensus.148 On 28 January 2020, SAGE said that testing asymptomatic individuals would “not be useful”.149 However, at the same meeting, SAGE … Read more
Government Response Summary
The government response outlines a future approach of greater questioning and challenge in policy development and scientific advice, but does not address the committee's specific query regarding why action was not taken earlier on asymptomatic transmission and testing.
Department for Science, Innovation and Technology Department of Health and Social Care
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102 Conclusion Acknowledged

We accept that it is difficult to challenge a widely held scientific consensus.

Conclusion
We accept that it is difficult to challenge a widely held scientific consensus. But accountability in a democracy depends on elected decision-makers taking advice, but examining, questioning and challenging it before making their own decisions. We find it surprising that … Read more
Government Response Summary
The government acknowledges the need for greater questioning and challenge in future policy development, stating ministers and SAGE should facilitate robust external and structured challenge to scientific advice from a wider range of disciplines.
Department for Science, Innovation and Technology Department of Health and Social Care
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103 Conclusion Acknowledged

In his evidence to the Science and Technology Committee during the early weeks of the...

Conclusion
In his evidence to the Science and Technology Committee during the early weeks of the pandemic, on 25 March, the Editor of the Lancet expressed concern that mathematical modelling was playing too influential a role in UK scientific advice.157 The … Read more
Government Response Summary
The government acknowledges that future policy development should include greater questioning and challenge, with ministers and SAGE facilitating robust external scrutiny of scientific advice.
Department for Science, Innovation and Technology Department of Health and Social Care
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104 Conclusion Accepted in Part

Evidence to the Science and Technology Committee from other academic disciplines included scepticism of the...

Conclusion
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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105 Conclusion Acknowledged

Sir John also highlighted concerns about how different academic disciplines did not collaborate sufficiently on...

Conclusion
Sir John also highlighted concerns about how different academic disciplines did not collaborate sufficiently on models.164 Professor James Poterba, Mitsui Professor of Economics, Massachusetts Institute of Technology, explained to the Science and Technology Committee that the consequence of this was … Read more
Government Response Summary
The government stated that future policy development should involve greater questioning and challenge, with Ministers confidently probing scientific advice and SAGE facilitating strong external challenge from diverse disciplines, but did not specifically detail how interdisciplinary collaboration in modelling, particularly regarding economic costs, would be ensured.
Department for Science, Innovation and Technology Department of Health and Social Care
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106 Conclusion Accepted in Part

Professor Chris Whitty noted that he preferred advice to be given on the basis of...

Conclusion
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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107 Conclusion Accepted in Part

Yet despite this, throughout the pandemic, detailed modelled projections have assumed a great prominence and...

Conclusion
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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108 Conclusion Accepted

Another potential reason for the late lockdown was the behavioural advice that was being tendered...

Conclusion
Another potential reason for the late lockdown was the behavioural advice that was being tendered to the Government. Behavioural advice is tendered to the Government through SAGE’s sub-group, the Scientific Pandemic Insights Group on Behaviours (SPI- B).168 SPI-B’s first publicly … Read more
Government Response Summary
The government commits to a future policy development approach characterized by greater questioning and challenge of scientific advice. Ministers will be more robust in challenging advice, and the government and SAGE will facilitate strong external and structured challenge, including from international experts and a wider range of disciplines.
Department for Science, Innovation and Technology Department of Health and Social Care
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109 Conclusion Accepted

The initial action plan did not consider the possibility of ceasing all non-essential contact.

Conclusion
The initial action plan did not consider the possibility of ceasing all non-essential contact. Dominic Cummings told us that the idea of behavioural fatigue was a part of “false groupthink”: One of the critical things that was completely wrong in … Read more
Government Response Summary
The government committed to ensuring future policy development is characterised by greater questioning and challenge, with Ministers taking a robust approach to advice and the government/SAGE facilitating strong external challenge from diverse disciplines and international experts.
Department for Science, Innovation and Technology Department of Health and Social Care
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110 Conclusion Not Addressed

It transpired that the UK public were very compliant with the eventual lockdown measures.175 Professor...

Conclusion
It transpired that the UK public were very compliant with the eventual lockdown measures.175 Professor Chris Whitty also said in November 2020: Across the board, my reflection is that the great majority of people—and this is reflected in all the … Read more
Government Response Summary
The government's response does not address the committee's conclusion about the public's high compliance with lockdown measures, instead discussing the need for greater questioning and challenge in future policy development.
Department for Science, Innovation and Technology Department of Health and Social Care
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111 Conclusion Accepted

The restrictions eventually imposed on the UK public because of the pandemic were unprecedented.

Conclusion
The restrictions eventually imposed on the UK public because of the pandemic were unprecedented. Even in wartime there had been no equivalent of the order to make it a criminal offence for people to meet each other and to remain … Read more
Government Response Summary
The government commits to a future policy development approach characterized by greater questioning and challenge of scientific advice. Ministers will be more robust in challenging advice, and the government and SAGE will facilitate strong external and structured challenge, including from international experts and a wider range of disciplines.
Department for Science, Innovation and Technology Department of Health and Social Care
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112 Conclusion Accepted

We have referred to early evidence from Dr Richard Horton, the Editor of the Lancet,...

Conclusion
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, … Read more
Government Response Summary
The government commits to ensuring that, in future, policy development includes a more robust approach to challenging scientific advice. This includes facilitating strong external and structured challenge from international experts and a wider range of disciplines, directly addressing the concern about insufficient international perspectives.
Department for Science, Innovation and Technology Department of Health and Social Care
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113 Conclusion Accepted

It is a characteristic of the best UK scientific institutions, and the people that work...

Conclusion
It is a characteristic of the best UK scientific institutions, and the people that work in them, that much of their research involves extensive international collaboration. However, for a virus that has affected every country in the world and which … Read more
Government Response Summary
The government commits to adopting an approach of greater questioning and challenge in policy development, with Ministers taking a more robust approach to scientific advice, and SAGE facilitating strong external and international expert challenge.
Department for Science, Innovation and Technology Department of Health and Social Care
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114 Conclusion Accepted in Part

Dr Horton expressed concerns about the evidence base that SAGE in its early meetings drew...

Conclusion
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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115 Conclusion Accepted

Although introduced several weeks after it should have been, the national lockdown brought in on...

Conclusion
Although introduced several weeks after it should have been, the national lockdown brought in on 23 March succeeded in reducing the incidence of covid across the country, so that from May 2020 national restrictions were eased. However, tougher restrictions were … Read more
Government Response Summary
The government accepts the committee's observation, acknowledging that it should have acted faster to introduce measures like social distancing, mask-wearing, and an earlier lockdown in the pandemic's early stages. It commits to learning lessons for future public health emergencies, as reflected in the 'Living with COVID-19' strategy.
Department for Science, Innovation and Technology Department of Health and Social Care
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116 Conclusion

The Government sought to agree with local leaders the package of restrictions that would apply...

Conclusion
The Government sought to agree with local leaders the package of restrictions that would apply in particular areas. However, the consequence of this approach led to political differences between national government and some local leaders as to what measures were … Read more
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117 Conclusion

By mid-September 2020, case rates were rising across the country, but there were significant local...

Conclusion
By mid-September 2020, case rates were rising across the country, but there were significant local differences. For example, on 30 September, the incidence of covid ranged from 607 per 100,000 population per week in East Sussex, to 4,318 in Knowsley.182 … Read more
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118 Conclusion

As we discuss in Chapter 4, there had been hopes that by Autumn 2020 an...

Conclusion
As we discuss in Chapter 4, there had been hopes that by Autumn 2020 an effective test, trace and isolate system—promised to be “world-beating”—would allow covid levels to be contained without recourse to extensive lockdown restrictions. Indeed the business case … Read more
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119 Conclusion

The experience of the tiered system during the autumn was, however, unsatisfactory.

Conclusion
The experience of the tiered system during the autumn was, however, unsatisfactory. In the absence of effective contact tracing, the regional restrictions proved not to be anywhere near watertight enough to prevent infections spreading, compounded by delays in getting test … Read more
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120 Conclusion

Professor Dame Angela McLean, Chief Scientific Adviser to the Ministry of Defence and a participant...

Conclusion
Professor Dame Angela McLean, Chief Scientific Adviser to the Ministry of Defence and a participant of SAGE, told the Science and Technology Committee in February 2021 that the tier system waited until prevalence was high before any action was taken, … Read more
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121 Conclusion

Another problem with the tiered restrictions that were implemented during the autumn of 2020 was...

Conclusion
Another problem with the tiered restrictions that were implemented during the autumn of 2020 was that it was not fully clear what criteria would cause a particular area to be placed in a given tier, nor what would be required … Read more
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122 Conclusion

There has also been a lack of transparency over the scientific case for particular interventions.

Conclusion
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 … Read more
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123 Conclusion

Scientific advice was cited in justification for increasingly fine-grained restrictions— with which some of the...

Conclusion
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 … Read more
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124 Conclusion

The two months between September 2020 and 31 October 2020 were an unsatisfactory period in...

Conclusion
The two months between September 2020 and 31 October 2020 were an unsatisfactory period in which the comparative simplicity of the rules in place from the evening of 23 March onwards were replaced by a complex, inconsistent, shifting and scientifically … Read more
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125 Conclusion

Throughout September and October 2020, case numbers and hospitalisations continued to rise nationwide.

Conclusion
Throughout September and October 2020, case numbers and hospitalisations continued to rise nationwide. As the virus started to spread and a second wave appeared to have started, SAGE advised on 21 September 2020 that a two week ‘circuit breaker’, a … Read more
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126 Conclusion

In evidence to the Science and Technology Committee in November 2020, Sir Patrick Vallance added...

Conclusion
In evidence to the Science and Technology Committee in November 2020, Sir Patrick Vallance added that the intention of the circuit breaker was to enable the test and trace system—which in September had once again been found to be inadequate—to … Read more
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127 Recommendation

Dominic Cummings told our inquiry that Downing Street held a meeting on 20 September 2020...

Recommendation
Dominic Cummings told our inquiry that Downing Street held a meeting on 20 September 2020 for the Prime Minister to hear both sides of the argument. He explained that Professor John Edmunds put forward the view that the Government should … Read more
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128 Conclusion

It is impossible to know whether a circuit breaker would have had a material effect...

Conclusion
It is impossible to know whether a circuit breaker would have had a material effect in preventing a second lockdown, given that such an approach was pursued in Wales, which still ended up having further restrictions in December 2020. But … Read more
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129 Conclusion

On 31 October 2020, the Prime Minister announced tougher nationwide restrictions in England—the second lockdown.200...

Conclusion
On 31 October 2020, the Prime Minister announced tougher nationwide restrictions in England—the second lockdown.200 The UK public were once again told to “stay at 194 GOV.UK, SAGE 59, 24 September 2020 195 Oral evidence taken before the Science and … Read more
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130 Conclusion Not Addressed

The circumstances of the lockdown announced on 31 October were controversial.

Conclusion
The circumstances of the lockdown announced on 31 October were controversial. A Downing Street press conference had been hastily convened on the Saturday evening following leak to newspapers of the Government’s likely intention to bring in a further lockdown. Read more
Government Response Summary
The government's response, identical to another, focuses on learning from other countries and improvements to the National Security Risk Assessment (NSRA), which does not directly address the committee's conclusion regarding the controversial circumstances and leaks surrounding the October 31 lockdown.
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131 Conclusion Accepted in Part

At the press conference, modelling projections were presented which warned of a risk to the...

Conclusion
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 … Read more
Government Response 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.
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132 Conclusion Accepted in Part

However, it emerged during the following days that the modelling that was presented at the...

Conclusion
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 … Read more
Government Response 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.
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133 Conclusion Not Addressed

Whilst it is clear the first lockdown was called too late, it is not however...

Conclusion
Whilst it is clear the first lockdown was called too late, it is not however possible to make such a clear cut judgement about the second lockdown from 31 October for two reasons. First, since the advice was taken and … Read more
Government Response Summary
The government's response, despite stating "partially accepts," discusses learning from international engagement and reviewing the NSRA methodology, which is unrelated to the committee's conclusion about the unknowability of the second lockdown's impact.
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134 Conclusion Not Addressed

Following genomic sequencing, PHE found that the Alpha variant first appeared in Kent in September...

Conclusion
Following genomic sequencing, PHE found that the Alpha variant first appeared in Kent in September 2020 and rapidly became the dominant variant in Kent, and subsequently, the rest of England.207 The new variant was first brought to the attention of … Read more
Government Response Summary
Despite stating 'partially accepts,' the government's response discusses its commitment to learning from international practice and details the methodology review of the National Risk Assessment (NSRA) process, without directly addressing the committee's observation regarding the emergence and impact of the Alpha variant.
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135 Conclusion Not Addressed

Leading virologists who gave evidence to the Science and Technology Committee on 23 December said...

Conclusion
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 … Read more
Government Response Summary
The government states it partially accepts 'this recommendation' and outlines its commitment to learning from other countries and disciplines, improving the NSRA process, and sharing international best practice for emergency preparedness, without directly addressing the committee's positive observation about swift past action.
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136 Conclusion Not Addressed

The second wave of the pandemic was more numerous in terms of hospital admissions and...

Conclusion
The second wave of the pandemic was more numerous in terms of hospital admissions and deaths than the first wave. It peaked on 8 January 2021 with 68,053 new infections per day reported in the UK,214 and on 20 January … Read more
Government Response Summary
The government's response 'partially accepts' a non-recommendation and provides a general statement about learning from other countries and reviewing the National Security Risk Assessment methodology, without addressing the committee's factual observations about the scale or characteristics of the pandemic's second wave.
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137 Conclusion Acknowledged

Due to the much higher transmissibility of the Alpha variant, in the absence of a...

Conclusion
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 … Read more
Government Response Summary
The government acknowledges the importance of positive learning and international engagement for future emergencies, outlining efforts to review the NSRA methodology and enhance external expert challenge and international practice.
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138 Conclusion Not Addressed

But these decisions were taken before the existence of the Alpha variant was known.

Conclusion
But these decisions were taken before the existence of the Alpha variant was known. So the justification for an earlier lockdown is greatly influenced by information that was not available at the time. It serves to illustrate that, in a … Read more
Government Response Summary
Despite stating 'partially accepts,' the government's response discusses its commitment to learning from international practice and details the methodology review of the National Risk Assessment (NSRA) process, without directly addressing the committee's observation about decisions being made with incomplete information during the pandemic.
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139 Recommendation Accepted

Several public health experts stressed to us that an effective messaging and communications strategy was...

Recommendation
Several public health experts stressed to us that an effective messaging and communications strategy was a crucial part of the response to a pandemic. In July 2020, Sir Paul Nurse argued in evidence to the Health and Social Care Committee … Read more
Government Response Summary
The government accepts the recommendation, committing UKHSA to continue building on lessons learned in health communications. This includes ensuring messaging is clear, consistent, accessible, working with trusted messengers, investing in research, and collaborating with local partners to ensure cultural sensitivity and accessible formats.
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140 Conclusion Accepted

At the outset of the pandemic, the Prime Minister’s “stay at home” order was accompanied...

Conclusion
At the outset of the pandemic, the Prime Minister’s “stay at home” order was accompanied by a public messaging campaign that clearly instructed the public to “stay home, protect the NHS, save lives”. This message was driven by regular televised … Read more
Government Response Summary
The government accepts the (implied) recommendation, committing to ensure future health communications from UKHSA are clear, consistent, and accessible, working with trusted messengers and local partners, and investing in research to understand public compliance.
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141 Conclusion Accepted

Much of the evidence to our inquiry has acknowledged that this “Stay at Home” slogan...

Conclusion
Much of the evidence to our inquiry has acknowledged that this “Stay at Home” slogan was successful in fostering sufficient levels of awareness and understanding among the public. For example, during this period there was a marked fall in the … Read more
Government Response Summary
The government accepts the principle of effective communication, committing to UKHSA ensuring clear, consistent, accessible messaging, working with trusted messengers, investing in research on public motivation, and partnering with local authorities to deliver culturally sensitive and accessible information in various formats.
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142 Conclusion Accepted

Evidence from University College London (UCL) showed that during the first lockdown, the simplicity and...

Conclusion
Evidence from University College London (UCL) showed that during the first lockdown, the simplicity and clarity of public health messaging did indeed translate into high levels of compliance with the stay at home order. According to UCL, during this period … Read more
Government Response Summary
The government commits to UKHSA building on lessons learned to ensure clear, consistent, and accessible messaging, working with trusted messengers and local authorities, and investing in research to understand public compliance.
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143 Conclusion Accepted

Although the communications strategy in the initial phase of the pandemic was broadly successful, it...

Conclusion
Although the communications strategy in the initial phase of the pandemic was broadly successful, it is worth noting that there was some confusion over who the stay at home order applied to, and there was criticism of the Government’s decision … Read more
Government Response Summary
The government accepts the recommendation, recognizing the importance of accessible communication, including British Sign Language, and commits to continuing to work with stakeholders to ensure all messaging is accessible.
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144 Conclusion Accepted

On 10 May 2020, the Government announced that society would begin to reopen in England...

Conclusion
On 10 May 2020, the Government announced that society would begin to reopen in England through a staged series of lockdown easing measures.226 From this point, there were divergent approaches to messaging across the four nations of the UK. To … Read more
Government Response Summary
The government commits to UKHSA building on lessons learned to ensure clear, consistent, and accessible messaging, working with trusted messengers and local authorities, and investing in research to understand public compliance.
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145 Conclusion Not Addressed

Written evidence to our inquiry suggested that the loss of consistency across the four nations...

Conclusion
Written evidence to our inquiry suggested that the loss of consistency across the four nations led to confusion, with “messages from numerous national bodies that, at times, appeared to contradict each other”.229 We heard that at this stage, these contradicting … Read more
Government Response Summary
The government acknowledges the importance of public health communications but asserts its own early pandemic messaging was strong and effective, without addressing the committee's conclusion about inconsistent messaging causing public confusion.
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146 Conclusion Not Addressed

The three-tier approach to local lockdown restrictions in England (see paragraph 117) introduced more complexity...

Conclusion
The three-tier approach to local lockdown restrictions in England (see paragraph 117) introduced more complexity to Government messaging which was, understandably different in different parts of the country.231 It was therefore unsurprising that this more differentiated messaging strategy meant that … Read more
Government Response Summary
The government acknowledges the importance of public health communications and the effectiveness of early messaging but does not address the committee's point about the deterioration of understanding due to messaging complexity.
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147 Conclusion Rejected

Written evidence suggested that the inconsistency in Government messaging after the first wave of the...

Conclusion
Written evidence suggested that the inconsistency in Government messaging after the first wave of the pandemic was also damaging to public trust in official information.233 Analysis submitted by Leeds Beckett University showed that most members of the public did not … Read more
Government Response Summary
The government rejects the committee's implied criticism by asserting that its messaging early in the pandemic was strong and effective in achieving public compliance, without addressing the specific concerns about inconsistency after the first wave or the negative impact of certain events on public trust.
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148 Conclusion Not Addressed

Lower levels of public trust and understanding of the regulations also created a gap into...

Conclusion
Lower levels of public trust and understanding of the regulations also created a gap into which misinformation was able to spread. Research conducted by Ofcom in the first six weeks of the pandemic found that 47% of respondents said they … Read more
Government Response Summary
The government acknowledges the importance of public health communications but primarily responds by stating that its messaging early in the pandemic was strong, effective, and contributed to public understanding and compliance, without committing to specific future actions based on the report's highlighted critical importance.
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149 Conclusion Not Addressed

The covid pandemic is a global emergency that is not yet over.

Conclusion
The covid pandemic is a global emergency that is not yet over. While the UK’s trajectory may have changed in recent months with vaccines, the vast majority of the world is still grappling with the disease. It would be prudent … Read more
Government Response Summary
The government's response, identical to others, focuses on learning from other countries and improving the National Security Risk Assessment (NSRA), which does not address the committee's conclusion about reserving judgment on the UK's pandemic performance until the global emergency has passed.
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150 Conclusion Not Addressed

One of the key ways to measure a country’s success in fighting covid-19 is to...

Conclusion
One of the key ways to measure a country’s success in fighting covid-19 is to measure deaths from covid-19. However, countries across the world measure deaths in different ways. The UK has reported covid deaths as those who died within … Read more
Government Response Summary
The government's response is phrased as a recommendation that the government, via the WHO, should advocate for international standards for reporting COVID-19 and future pandemic deaths, thus not addressing the committee's observation directly.
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151 Conclusion Not Addressed

There are also other factors to be considered.

Conclusion
There are also other factors to be considered. Each country has a unique set of characteristics which might have contributed to its health related covid-19 outcomes. For example, the UK has the tenth-highest rate of obesity in the world,241 which … Read more
Government Response Summary
The government response focuses on the 'Build Back Better' plan for social care and its funding, and does not address the committee's conclusion about obesity and other country-specific factors influencing COVID-19 outcomes.
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152 Conclusion Not Addressed

During the first three months of the covid pandemic, the UK followed the wrong policy...

Conclusion
During the first three months of the covid pandemic, the UK followed the wrong policy in its use of non-pharmaceutical interventions. When the UK moved from the ‘contain’ to ‘delay’ stage, there was a policy of seeking to only moderate … Read more
Government Response Summary
The government generically stated that its decision-making was informed by science and evidence, and it took quick and decisive action, without directly addressing the committee's specific criticisms of past policy errors and 'groupthink'.
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153 Conclusion Rejected

The flattening the curve policy was implemented by introducing new restrictions only gradually and slowly,...

Conclusion
The flattening the curve policy was implemented by introducing new restrictions only gradually and slowly, acting as if the spread of the virus were susceptible to calibrated control. Modelling at the time suggested that to suppress the spread of covid-19 … Read more
Government Response Summary
The government implicitly rejects the committee's criticism of the 'flattening the curve' policy, stating that its decision-making was always informed by science and evidence and that quick and decisive action was taken when needed.
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154 Conclusion Not Addressed

There are several possible explanations for what was a significant error in policy and advice...

Conclusion
There are several possible explanations for what was a significant error in policy and advice early in the pandemic. These include: • the lack of adequate data on the spread of covid-19, as a result of the inadequacy of the … Read more
Government Response Summary
The government's response provides boilerplate text stating that decision-making was informed by science and evidence, and quick action was taken, but it does not address the committee's specific conclusions regarding errors in policy, advice, or listed inadequacies.
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155 Conclusion Rejected

Science proceeds through challenge and disputation, and new theories are tested unflinchingly against evidence.

Conclusion
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 … Read more
Government Response Summary
The government implicitly rejects the committee's conclusion about the lack of challenge to scientific advice and the inconsistency of non-pharmaceutical interventions. It asserts that NPIs were key, decision-making was evidence-based, and quick decisive action was taken.
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156 Conclusion Not Addressed

The second wave of covid infections, hospitalisations and deaths during the autumn and winter of...

Conclusion
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” … Read more
Government Response Summary
The government provides a general statement that its decisions were informed by science and that it took quick action, but does not specifically address the committee's conclusion about the impact of the Kent variant or the timing of potential "circuit break" measures.
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157 Conclusion Acknowledged

Government public health communications are key to the public’s understanding of and compliance with non-pharmaceutical...

Conclusion
Government public health communications are key to the public’s understanding of and compliance with non-pharmaceutical interventions. Initial messaging from the Government early in the pandemic was strong, effective and undoubtedly contributed to the success of the first lockdown. After the … Read more
Government Response Summary
The government acknowledges the importance of public health communications and agrees that early messaging was strong and effective, but does not address the committee's conclusion that later guidance became increasingly complex and inconsistent.
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158 Conclusion Not Addressed

In the early days of a crisis, scientific advice may be necessarily uncertain: data may...

Conclusion
In the early days of a crisis, scientific advice may be necessarily uncertain: data may be unavailable, knowledge limited and time may be required for analysis to be conducted. In these circumstances it may be appropriate to act quickly, on … Read more
Government Response Summary
The government response exactly repeats the committee's conclusion about acting quickly on a precautionary basis during a crisis without providing any specific action or acknowledging its implications.
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159 Recommendation Not Addressed

In future an approach of greater questioning and challenge should characterise the development of policy.

Recommendation
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. … Read more
Government Response Summary
The government's response is an exact copy of the committee's recommendation and provides no actual stance or commitment to action.
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160 Recommendation Not Addressed

In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK...

Recommendation
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, … Read more
Government Response Summary
The government's response is an exact copy of the committee's recommendation and provides no actual stance or commitment to action.
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161 Recommendation Not Addressed

In a pandemic, the scientific advice from the SAGE co-chairs to the Government should be...

Recommendation
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 … Read more
Government Response Summary
The government's response is a direct copy of the recommendation, not providing its own stance or committing to any specific action regarding the publication timelines for SAGE advice, minutes, and papers.
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162 Recommendation Not Addressed

The Government, via the World Health Organisation, should make the case for an international standard...

Recommendation
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. 60 Coronavirus: lessons learned to date 4 Testing and contact … Read more
Government Response Summary
The government's response is a direct copy of the recommendation, not providing its own stance or committing to any specific action to pursue an international standard for reporting COVID-19 deaths and future pandemic-related deaths.
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163 Conclusion Acknowledged

While, as we will illustrate in Chapter 7, the UK’s vaccination programme has been a...

Conclusion
While, as we will illustrate in Chapter 7, the UK’s vaccination programme has been a national success, the record during the pandemic of the test, trace and isolate programme is more mixed. The slow, uncertain, and often chaotic performance of … Read more
Government Response Summary
The government acknowledges the test, trace, and isolate legacy by outlining plans to ensure a resilient infrastructure, work closely with local authorities for future tracing, and maintain UKHSA's local relationships.
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164 Conclusion Acknowledged

This Chapter looks at a number of different facets of the test, trace and isolate...

Conclusion
This Chapter looks at a number of different facets of the test, trace and isolate system— though they are illustrative rather than exhaustive. While it describes an unsatisfactory history, there are signs that the UK has now arrived at a … Read more
Government Response Summary
The government acknowledges the observation by outlining its ‘Living with COVID-19’ strategy to build on the legacy of test, trace, and isolate, ensuring resilient infrastructure, working with local authorities for future contact tracing, and UKHSA maintaining local relationships.
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165 Conclusion Acknowledged

In this Chapter we consider in particular: • the initial testing capacity available; • the...

Conclusion
In this Chapter we consider in particular: • the initial testing capacity available; • the decision to abandon testing in the community; • the 100,000 tests a day target introduced by the then Secretary of State; • the centralisation of … Read more
Government Response Summary
The government acknowledges the committee's observation by outlining its strategy to build on the test, trace, and isolate legacy, ensuring resilient infrastructure, and working with local authorities for future contact tracing, with UKHSA maintaining local relationships.
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166 Conclusion Not Addressed

During the early days of the pandemic, the Government believed—and told the public—that testing for...

Conclusion
During the early days of the pandemic, the Government believed—and told the public—that testing for covid-19 was a field in which the UK had a leading position. This assessment was shared, and possibly arose out of, the views of scientific … Read more
Government Response Summary
The government states it will build on the pandemic's legacy for test, trace, and isolate by ensuring resilient infrastructure and collaboration with local authorities, but does not address the committee's conclusion about past deficiencies in translating scientific leadership into operational testing success.
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167 Conclusion Accepted

SAGE minutes from 28 January 2020 recorded that notwithstanding the scientific lead in establishing a...

Conclusion
SAGE minutes from 28 January 2020 recorded that notwithstanding the scientific lead in establishing a test, PHE only had operational capacity to administer “400 to 500 tests per day” for the whole country.248 Other countries such as South Korea and … Read more
Government Response Summary
The government committed to building on the pandemic's legacy by ensuring a resilient and scalable test, trace, and isolate infrastructure is in place, and by working closely with local authorities to support future contact tracing and public health emergency responses.
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168 Conclusion Acknowledged

Professor Martin explained to us that early in the pandemic there were “very severe constraints...

Conclusion
Professor Martin explained to us that early in the pandemic there were “very severe constraints in equipment and consumables” which acted as a drag on testing capacity: Bear in mind that those were all new tests coming on stream at … Read more
Government Response Summary
The government acknowledges the need for a resilient and scalable infrastructure for test, trace, and isolate, committing to build on existing responses and work with local authorities and UKHSA for future public health emergencies, but does not specifically address the previous constraints in equipment and consumables.
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169 Conclusion Not Addressed

However, throughout the pandemic, our Committees have taken a great interest in what might be...

Conclusion
However, throughout the pandemic, our Committees have taken a great interest in what might be learned and applied from how other countries tackled the virus. In March 2020, the World Health Organisation recommended that nations “plan for surge capacity by … Read more
Government Response Summary
The government states it will build on the pandemic's legacy for test, trace, and isolate by ensuring resilient infrastructure and collaboration with local authorities, but does not address the committee's conclusion about learning from other countries regarding decentralized testing capacity.
Department for Science, Innovation and Technology Department of Health and Social Care
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170 Conclusion Not Addressed

In evidence to the Science and Technology Committee on 25 March 2020 Public Health England...

Conclusion
In evidence to the Science and Technology Committee on 25 March 2020 Public Health England claimed to have formally studied, but rejected, the South Korean approach.255 Despite repeated requests by the Committee no evidence of such an evaluation has ever … Read more
Government Response Summary
The government's response discusses building resilient test, trace, and isolate infrastructure for future pandemics, but it does not address the committee's specific conclusion regarding the negligent omission of formally evaluating the South Korean pandemic response approach.
Department for Science, Innovation and Technology Department of Health and Social Care
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171 Conclusion Accepted in Part

As a result the UK squandered a leading position in diagnostics and converted it into...

Conclusion
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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172 Conclusion Accepted in Part

Shortly after this seminal failure, in mid-March 2020 responsibility for the testing strategy was taken...

Conclusion
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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173 Conclusion Not Addressed

The consequences of this initial failure were profound.

Conclusion
The consequences of this initial failure were profound. Testing not only allowed individuals to be identified who had covid-19—and were infectious—but test results for an invisible virus were the only way to be able to accurately monitor the incidence and … Read more
Government Response Summary
The government's response 'partially accepts' a non-recommendation and provides general information about learning from other countries and reviewing the National Security Risk Assessment methodology, without specifically addressing the committee's conclusion about the failure of initial COVID-19 testing and monitoring.
Department for Science, Innovation and Technology Department of Health and Social Care
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174 Conclusion Not Addressed

For a country with a world-class expertise in data analysis, to face the biggest health...

Conclusion
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 … Read more
Government Response Summary
The government partially accepts, but the response details ongoing NSRA methodology review and plans to increase external expert engagement in future risk assessments, failing to directly address the committee's observation about initial data and testing capacity failures.
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175 Conclusion Not Addressed

We also consider that the Government’s scientific advisers were too passive in accepting assurances that...

Conclusion
We also consider that the Government’s scientific advisers were too passive in accepting assurances that the clinical operational capacity of Public Health England could not be changed. Even in March 2020, Professor Neil Ferguson explained that “much 254 Q129 255 … Read more
Government Response Summary
The government states it 'partially accepts' the recommendation but then discusses the National Security Risk Assessment (NSRA) process, its methodology review, and international learning, without addressing the committee's criticism regarding scientific advisors' passivity on testing capacity.
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176 Conclusion Not Addressed

It is clear that there should have been more challenge to Public Health England to...

Conclusion
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 … Read more
Government Response Summary
The government states it partially accepts this recommendation, but its response focuses on general future learning, international engagement, and improving expert challenge within the NSRA process, rather than directly addressing the committee's critique of insufficient challenge to PHE on testing capacity.
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177 Conclusion Accepted in Part

As noted earlier, the failure to have enough testing capacity in the early weeks of...

Conclusion
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 … Read more
Government Response 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.
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178 Conclusion Not Addressed

The lack of data resulting from suspending community testing also affected the UK’s understanding of...

Conclusion
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 … Read more
Government Response Summary
The government's response, identical to previous boilerplate replies, mentions international learning and NSRA review but completely fails to address the committee's conclusion regarding the critical impact of inadequate community testing and data on understanding the disease and informing lockdown decisions.
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179 Conclusion Not Addressed

Professor Chris Whitty told the Health and Social Care Committee in July 2020 that the...

Conclusion
Professor Chris Whitty told the Health and Social Care Committee in July 2020 that the lack of testing capacity available at the beginning of the pandemic meant that the Government had to focus resources very closely on the hospital sector, … Read more
Government Response Summary
The government partially accepts 'this recommendation' (despite it being a conclusion) and states it agrees on the importance of learning from other countries and improving the National Security Risk Assessment (NSRA) methodology, which does not directly address the conclusion's points on testing capacity failures and nosocomial infections.
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180 Conclusion Accepted

The lack of available testing for social care was particularly damaging, as we discuss in...

Conclusion
The lack of available testing for social care was particularly damaging, as we discuss in more detail later in this Report. Crucially, it was not until mid-April that covid-19 testing was made a requirement for people discharged from hospital to … Read more
Government Response Summary
The government recognises the impact on the social care sector and points to the existing 'Build Back Better' plan from September 2021, which outlines reforms, funding models, and closer working between health and social care.
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181 Conclusion Not Addressed

The Health and Social Care Committee’s Reports on social care and the delivery of core...

Conclusion
The Health and Social Care Committee’s Reports on social care and the delivery of core NHS and care services during the pandemic also highlighted the impact of a lack of testing for social care staff in the initial wave of … Read more
Government Response Summary
The government's response outlines the ‘Build Back Better’ plan for general social care reform and funding, but does not specifically address the conclusion's point about the lack of testing for social care staff during the pandemic.
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182 Conclusion

Following the initial shortage of testing capacity and the slow increase in the availability of...

Conclusion
Following the initial shortage of testing capacity and the slow increase in the availability of tests during the critical first eight weeks of the pandemic, responsibility for the testing strategy was removed from Public Health England and vested in the … Read more
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183 Conclusion

Subsequently, Dominic Cummings, in evidence to our inquiry, strongly criticised the then Secretary of State...

Conclusion
Subsequently, Dominic Cummings, in evidence to our inquiry, strongly criticised the then Secretary of State for naming this target, describing it as “an incredibly stupid thing to do.”272 However, Mr Hancock defended the target, saying to the Committees, “that 100,000 … Read more
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184 Conclusion

Given the painfully slow increase in the availability of testing before April 2020, we consider...

Conclusion
Given the painfully slow increase in the availability of testing before April 2020, we consider that the impact of the Secretary of State’s target to have been an appropriate one to galvanise the rapid change the system needed. However, as … Read more
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185 Conclusion

As a result of the increase in testing capacity driven during April, the UK Government...

Conclusion
As a result of the increase in testing capacity driven during April, the UK Government finally resumed community testing on 18 May 2020, following an expansion of capacity, which included more than a doubling of the NHS and PHE laboratory … Read more
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186 Conclusion

Evidence received by the Science and Technology Committee suggested that taking a centralised approach to...

Conclusion
Evidence received by the Science and Technology Committee suggested that taking a centralised approach to increasing testing capacity was appropriate as it might not have been practical to focus on boosting local-level capacity alone. For example, Dr Richard Harling, Director … Read more
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187 Conclusion Not Addressed

However, both our Committees heard that other resources could have been used more effectively in...

Conclusion
However, both our Committees heard that other resources could have been used more effectively in the initial expansion of testing capacity. Professor Sir Chris Ham explained that initially the Government was “very much focused on building capacity in the commercial … Read more
Government Response Summary
The government states it 'partially accepts' the recommendation but then discusses the National Security Risk Assessment (NSRA) process, its methodology review, and international learning, without addressing the committee's findings on the under-utilisation of university and NHS laboratories for testing capacity.
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188 Conclusion

Despite this, it appeared that there was a disconnect between the testing operation in the...

Conclusion
Despite this, it appeared that there was a disconnect between the testing operation in the Lighthouse Laboratories and NHS labs. For example, the Institute of Biomedical Science suggested that there was a “lack of integration and collaboration” between the laboratories … Read more
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189 Conclusion

Throughout the last 18 months, the test and trace system has had labels applied that...

Conclusion
Throughout the last 18 months, the test and trace system has had labels applied that have been at variance with the reality. Ministers began by promising the test and trace system would be “world-beating” in May 2020 when the truth … Read more
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190 Conclusion

In May 2020 the label “NHS” was applied by the Department of Health and Social...

Conclusion
In May 2020 the label “NHS” was applied by the Department of Health and Social Care to the test and tracing system, despite it being operated outside the NHS. It was notable that in evidence to our inquiry, the then … Read more
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191 Conclusion

The Government has pursued both mass antibody testing (to identify who previously had covid-19) and...

Conclusion
The Government has pursued both mass antibody testing (to identify who previously had covid-19) and mass diagnostic testing (to identify those currently infected) as means to return to normality. In its April 2020 testing strategy, the Government said it was … Read more
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192 Conclusion

That optimism does not appear to have been shared by scientists advising the Government, who...

Conclusion
That optimism does not appear to have been shared by scientists advising the Government, who struck a more cautious note. For example, at the same press conference Sir Patrick Vallance pointed out that the technologies still had to be trialled, … Read more
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193 Conclusion

As with other aspects of covid-19 testing, the Government has put a significant amount of...

Conclusion
As with other aspects of covid-19 testing, the Government has put a significant amount of public money towards mass testing. The NAO’s December 2020 report on test and trace indicated that (leading up to October) £2.9 billion had been earmarked … Read more
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194 Conclusion

During the summer of 2020, rates of covid infection declined markedly in most parts of...

Conclusion
During the summer of 2020, rates of covid infection declined markedly in most parts of the United Kingdom. Average hospitalisations from covid fell to 119 per day on 1 August 2020 compared to 3,000 per day in early April. Yet … Read more
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195 Conclusion

Despite undergoing a large increase in testing capacity over the first lockdown period— reaching over...

Conclusion
Despite undergoing a large increase in testing capacity over the first lockdown period— reaching over 200,000 daily tests by the beginning of June 2020298—the test and trace service in England then struggled to keep up with a sharp increase in … Read more
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196 Conclusion

During September 2020, the Science and Technology Committee heard from Baroness Harding that NHS Test...

Conclusion
During September 2020, the Science and Technology Committee heard from Baroness Harding that NHS Test and Trace had “planned for a sizeable increase” but that she “[did] not think anybody was expecting” the level of demand experienced.301 She explained one … Read more
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197 Conclusion

The NAO’s December 2020 report pointed out further that NHS Test and Trace was unable...

Conclusion
The NAO’s December 2020 report pointed out further that NHS Test and Trace was unable to meet demand due to insufficient laboratory capacity as a result of: • delays in getting new laboratories up and running; • delays in delivering … Read more
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198 Conclusion Not Addressed

Two months earlier, in July 2020, the Government Chief Scientific Adviser, Sir Patrick Vallance, told...

Conclusion
Two months earlier, in July 2020, the Government Chief Scientific Adviser, Sir Patrick Vallance, told the Science and Technology Committee that extra testing capacity would be “essential” ahead of schools reopening.306 However, he suggested that the Government did 298 GOV.UK, … Read more
Government Response Summary
The government partially accepts 'this recommendation' (despite it being a conclusion) and states it agrees on the importance of learning from other countries and improving the National Security Risk Assessment (NSRA) methodology, which does not directly address the conclusion's points on testing capacity planning and modelling failures.
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199 Conclusion Not Addressed

Overall, the National Audit Office concluded that NHS Test and Trace “did not plan for...

Conclusion
Overall, the National Audit Office concluded that NHS Test and Trace “did not plan for a sharp rise in testing demand in early Autumn [2020]” and was therefore “unprepared.”311 Professor Chris Whitty reiterated to both Committees in December 2020 that … Read more
Government Response Summary
The government's response was generic, discussing learning from other countries and the National Risk Assessment process, but it did not specifically address the conclusion regarding the inadequate planning for surges in testing demand and the need to scale up testing capacity.
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200 Recommendation Acknowledged

The failure of the test and trace system to rise to meet even the most...

Recommendation
The failure of the test and trace system to rise to meet even the most predictable of demands in Autumn 2020, especially given many weeks to prepare, suggests that lessons that were learnable during the pandemic were not applied. An … Read more
Government Response Summary
The government states it will build on the pandemic response legacy and ensure resilient, scalable infrastructure, working with local authorities and UKHSA to protect against future health threats, as outlined in the ‘Living with COVID-19’ strategy.
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1 Conclusion Not Addressed
Para 58

The UK has established procedures and structures to prepare for the nation’s major future risks,...

Conclusion
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 … Read more
Government Response Summary
Despite stating "partially accepts," the government's response is generic, discussing international learning and reviewing the NSRA methodology, without specifically addressing the committee's conclusion that past pandemic preparedness focused too narrowly on influenza over other diseases like SARS and MERS.
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2 Conclusion Acknowledged
Para 59

Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did...

Conclusion
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 … Read more
Government Response Summary
The government recognises that previous exercises did not fully address a disease with COVID-19 characteristics and agrees that lessons, such as legislative drafting, can be learned for future outbreaks.
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3 Conclusion Rejected
Para 60

The operation of COBR was not well-suited to the modern demands of a pandemic response.

Conclusion
The operation of COBR was not well-suited to the modern demands of a pandemic response. It is especially concerning that its culture of confidentiality was considered by some to be so unreliable that alternative meetings were arranged that could command … Read more
Government Response Summary
The government rejects the committee's assessment of COBR's suitability and confidentiality, defending its role as the crisis management forum, its culture of confidentiality, and rigorous information security procedures.
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4 Conclusion Deferred
Para 61

The Civil Contingencies Secretariat did not have adequate resources to maintain a substantial standing capability...

Conclusion
The Civil Contingencies Secretariat did not have adequate resources to maintain a substantial standing capability to survey the development of potential threats, and it had a limited reach into the range of Government departments required to respond to a pandemic. … Read more
Government Response Summary
The government partially accepted the underlying issue, noting that CCS capabilities are under regular review and a new Resilience Strategy is being developed to consider the resourcing and capabilities of CCS and other relevant bodies.
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5 Conclusion Acknowledged
Para 62

Protocols to share data between public bodies involved in the response were too slow to...

Conclusion
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 Summary
The government accepts the committee's finding that data sharing protocols were too slow to establish and become functional, particularly between national and local government.
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6 Conclusion Acknowledged
Para 63

The NHS responded quickly and strongly to the demands of the pandemic, but compared to...

Conclusion
The NHS responded quickly and strongly to the demands of the pandemic, but compared to other health systems it “runs hot”—with little spare capacity built in to cope with sudden and unexpected surges of demand such as in a pandemic.
Government Response Summary
The government acknowledges the demands placed on the NHS during the pandemic and states that this experience should lead to a more explicit and monitored surge capacity being integrated into the NHS's long-term organization and funding.
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7 Recommendation Accepted in Part
Para 64

A greater diversity of expertise and challenge—including from practitioners from other countries and a wider...

Recommendation
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 … Read more
Government Response 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 through frameworks like NATO and UN Sendai.
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8 Recommendation Rejected

A standing capability should be established in Government, or reporting to it, to scan the...

Recommendation
A standing capability should be established in Government, or reporting to it, to scan the horizon for future threats, with adequate resource and counting on specialists with an independence from short-term political and administrative pressures. (Paragraph 65) Coronavirus: lessons learned … Read more
Government Response Summary
The government rejected the recommendation, stating that a range of complementary standing capabilities already exist within government (e.g., CCS, JIO, NSC, NSRA, GO-Science) to identify and assess future risks.
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9 Recommendation Accepted in Part
Para 66

The Government should ensure comprehensive plans are made for future risks and emergencies.

Recommendation
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 … Read more
Government Response 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 reform efforts to strengthen its role in future pandemics.
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10 Recommendation Accepted
Para 67

The resourcing and capabilities of the Civil Contingencies Secretariat should be improved.

Recommendation
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 … Read more
Government Response Summary
The government accepts the recommendation, stating the CCS will continue developing capabilities, building relationships, challenging assumptions, and testing plans as part of a new cross-government Resilience Strategy, with updates provided through Cabinet Office reports.
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11 Recommendation Accepted
Para 68

Arrangements should be established and tested to allow immediate flows of data between bodies relevant...

Recommendation
Arrangements should be established and tested to allow immediate flows of data between bodies relevant to an emergency response with a mechanism to resolve immediately and decisively any disputes.
Government Response Summary
The government accepts the recommendation, committing to continuously improve data sharing arrangements for future emergencies by reviewing and developing new agreements, investing in data infrastructure, and strengthening data governance.
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12 Recommendation Rejected
Para 69

The Armed Forces should have a more central and standing role in preparing for and...

Recommendation
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 … Read more
Government Response Summary
The government rejects the recommendation, stating that existing protocols for Armed Forces support (MACA process) are fit for purpose, and highlighting the extensive support provided during the COVID-19 pandemic.
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13 Recommendation Not Addressed
Para 70

The Government and the NHS should consider establishing a volunteer reserve database so that volunteers...

Recommendation
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 Summary
The government's response was incomplete, repeating the first part of the recommendation without indicating any specific action or stance on establishing a volunteer reserve database.
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14 Conclusion Not Addressed
Para 71

The experience of the demands placed on the NHS during the covid-19 pandemic should lead...

Conclusion
The experience of the demands placed on the NHS during the covid-19 pandemic should lead to a more explicit, and monitored, surge capacity being part of the long term organisation and funding of the NHS.
Government Response Summary
The government response is a verbatim repetition of the committee's conclusion, indicating no specific action, agreement, or disagreement has been provided.
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15 Recommendation Accepted
Para 72

The NHS should develop and publish new protocols for infection prevention and control in pandemics...

Recommendation
The NHS should develop and publish new protocols for infection prevention and control in pandemics covering staffing, bed capacity and physical infrastructure. In developing these protocols the NHS should consider the importance of maintaining access for people accompanying some patients … Read more
Government Response Summary
The government accepts the recommendation, stating the NHS is committed to developing new infection prevention and control protocols for pandemics and highlighting existing guidance that emphasizes maintaining access for advocates and birthing partners.
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16 Recommendation Not Addressed
Para 73

Comprehensive analysis should be carried out to assess the safety of running the NHS with...

Recommendation
Comprehensive analysis should be carried out to assess the safety of running the NHS with the limited latent capacity that it currently has, particularly in Intensive Care Units, critical care units and high dependency units.
Government Response Summary
The government's response merely restates the committee's recommendation to carry out a comprehensive analysis of NHS latent capacity, without providing any specific action, commitment, or stance.
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17 Recommendation Accepted in Part

Building on the experience of staff working more flexibly during the pandemic and to enable...

Recommendation
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- … Read more
Government Response 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.
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18 Conclusion Rejected
Para 152

During the first three months of the covid pandemic, the UK followed the wrong policy...

Conclusion
During the first three months of the covid pandemic, the UK followed the wrong policy in its use of non-pharmaceutical interventions. When the UK moved from the ‘contain’ to ‘delay’ stage, there was a policy of seeking to only moderate … Read more
Government Response Summary
The government's response implicitly rejects the committee's finding of 'wrong policy' and 'groupthink,' asserting that its decision-making was always informed by science and evidence and that it took quick, decisive action.
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19 Conclusion Rejected
Para 153

The flattening the curve policy was implemented by introducing new restrictions only gradually and slowly,...

Conclusion
The flattening the curve policy was implemented by introducing new restrictions only gradually and slowly, acting as if the spread of the virus were susceptible to calibrated control. Modelling at the time suggested that to suppress the spread of covid-19 … Read more
Government Response Summary
The government implicitly rejects the committee's critique of the gradual implementation of the 'flattening the curve' policy, asserting instead that its decisions were informed by science and evidence, and it took quick and decisive action.
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20 Conclusion Acknowledged

There are several possible explanations for what was a significant error in policy and advice...

Conclusion
There are several possible explanations for what was a significant error in policy and advice early in the pandemic. These include: • the lack of adequate data on the spread of covid-19, as a result of the inadequacy of the … Read more
Government Response Summary
The government partially accepted the implicit recommendation, acknowledging the importance of learning from other countries and engaging with diverse experts. They highlighted existing international collaborations and stated the Cabinet Office is considering ways to increase external expert challenge within the National Risk Assessment process.
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21 Conclusion Not Addressed
Para 155

Science proceeds through challenge and disputation, and new theories are tested unflinchingly against evidence.

Conclusion
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 … Read more
Government Response Summary
Despite stating 'partially accepts,' the government's response discusses its commitment to learning from international practice and details the methodology review of the National Risk Assessment (NSRA) process, without directly addressing the committee's observation about insufficient challenge to scientific advice or the inconsistent role of non-pharmaceutical interventions.
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22 Conclusion Accepted in Part
Para 156

The second wave of covid infections, hospitalisations and deaths during the autumn and winter of...

Conclusion
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” … Read more
Government Response 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.
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23 Conclusion Not Addressed
Para 157

Government public health communications are key to the public’s understanding of and compliance with non-pharmaceutical...

Conclusion
Government public health communications are key to the public’s understanding of and compliance with non-pharmaceutical interventions. Initial messaging from the Government early in the pandemic was strong, effective and undoubtedly contributed to the success of the first lockdown. After the … Read more
Government Response Summary
The government acknowledges the importance of public health communications and agrees that early pandemic messaging was strong and effective, but it does not address the conclusion's finding that later communications became complex and inconsistent.
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24 Conclusion Not Addressed
Para 158

In the early days of a crisis, scientific advice may be necessarily uncertain: data may...

Conclusion
In the early days of a crisis, scientific advice may be necessarily uncertain: data may be unavailable, knowledge limited and time may be required for analysis to be conducted. In these circumstances it may be appropriate to act quickly, on … Read more
Government Response Summary
The government response is a verbatim repetition of the committee's conclusion, indicating no specific action, agreement, or disagreement has been provided.
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25 Recommendation Accepted
Para 159

In future an approach of greater questioning and challenge should characterise the development of policy.

Recommendation
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. … Read more
Government Response Summary
The government fully accepted the recommendation, reiterating its commitment that future policy development will be characterized by greater questioning and challenge, with ministers taking a more robust approach and SAGE facilitating external and structured scientific challenge.
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26 Recommendation Not Addressed

In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK...

Recommendation
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, … Read more
Government Response Summary
The government response merely repeats the committee's recommendation verbatim, without offering any specific action, agreement, or disagreement regarding SAGE including wider international representation.
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27 Recommendation Accepted in Part
Para 161

In a pandemic, the scientific advice from the SAGE co-chairs to the Government should be...

Recommendation
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 … Read more
Government Response 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.
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28 Recommendation Accepted

The Government, via the World Health Organisation, should make the case for an international standard...

Recommendation
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 Summary
The government accepted the recommendation to advocate for international standards of death reporting via the WHO, noting that the UK already champions mortality surveillance and actively contributes to the development of WHO's International Classification of Diseases standards.
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29 Conclusion Not Addressed
Para 232

Despite being one of the first countries in the world to develop a test for...

Conclusion
Despite being one of the first countries in the world to develop a test for covid in January 2020, the United Kingdom failed to translate that scientific leadership into operational success in establishing an effective test and trace system during … Read more
Government Response Summary
The government partially accepts 'this recommendation' (despite it being a conclusion) and states it agrees on the importance of learning from other countries and improving the National Security Risk Assessment (NSRA) methodology, which does not directly address the conclusion's points on the UK's failure in test and trace operational success.
Department for Science, Innovation and Technology Department of Health and Social Care
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30 Conclusion Not Addressed
Para 233

Testing capacity was treated too much as a parameter rather than a variable that could...

Conclusion
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 … Read more
Government Response Summary
The government's response, despite stating partial acceptance, broadly discusses learning from other countries and the National Security Risk Assessment process. It does not specifically address the committee's conclusion regarding the past failure to treat testing capacity as a variable or the initial disinterest in international approaches.
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31 Conclusion Acknowledged
Para 234

The resulting requirement to abandon testing people in the community during the critical early period...

Conclusion
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 … Read more
Government Response Summary
The government acknowledges the need for positive learning and engagement with other countries and disciplines for future emergencies. They outline ongoing work to review the NSRA methodology to enhance external expert challenge and diversity during risk assessment processes, and commit to international frameworks for disaster risk reduction.
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32 Conclusion Accepted in Part
Para 235

The new Test and Trace operation eventually established in May 2020 was a step in...

Conclusion
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 … Read more
Government Response 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.
Department for Science, Innovation and Technology Department of Health and Social Care
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33 Conclusion Not Addressed
Para 236

Vast sums of taxpayers’ money were directed to Test and Trace, justified by the benefits...

Conclusion
Vast sums of taxpayers’ money were directed to Test and Trace, justified by the benefits of avoiding further lockdowns. But ultimately those lockdowns happened. Were it not for the success of the Vaccine Taskforce and the NHS vaccination programme, it … Read more
Government Response Summary
The government's response did not address the committee's conclusion regarding the effectiveness and funding of Test and Trace and the subsequent lockdowns. Instead, it discussed learning from international practices and the National Security Risk Assessment (NSRA) methodology.
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34 Conclusion Not Addressed
Para 237

We recognise that the effectiveness of test and trace in reducing transmission is likely to...

Conclusion
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 … Read more
Government Response Summary
The government's response, despite claiming partial acceptance, does not address the conclusion about NHS Test and Trace's inability to respond to rising transmission rates, instead discussing the National Security Risk Assessment process and international learning.
Department for Science, Innovation and Technology Department of Health and Social Care
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35 Conclusion Not Addressed
Para 238

The Test and Trace organisation has not, despite its branding, been run by the NHS,...

Conclusion
The Test and Trace organisation has not, despite its branding, been run by the NHS, and has seen senior executives brought in from external bodies for short term contracts which reduces the institutional learning, from what was an intense period, … Read more
Government Response Summary
The government's response does not address the committee's specific concern about the opaque structure and non-NHS operation of the Test and Trace organisation, instead discussing learning from international practice and the National Security Risk Assessment process generally.
Department for Science, Innovation and Technology Department of Health and Social Care
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36 Conclusion Not Addressed
Para 239

Partly because it was set up too late, NHS Test and Trace ultimately fell short...

Conclusion
Partly because it was set up too late, NHS Test and Trace ultimately fell short of the expectations set for it. It has failed to make a significant enough impact on the course of the pandemic to justify the level … Read more
Government Response Summary
The government partially accepts, but the response details ongoing NSRA methodology review and plans to increase external expert engagement in future risk assessments, failing to directly address the committee's specific criticisms of NHS Test and Trace's performance and transparency.
Department for Science, Innovation and Technology Department of Health and Social Care
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37 Conclusion Not Addressed

The National Audit Office has stated that “to achieve value for money NHST&T must be...

Conclusion
The National Audit Office has stated that “to achieve value for money NHST&T must be able to demonstrate both that the interventions it delivers are effective in achieving its objective, and that the mix of interventions is the most cost-effective … Read more
Government Response Summary
The government's response, identical to previous boilerplate replies, discusses international learning and NSRA review but completely fails to address the committee's conclusion about the value for money and effectiveness of the NHST&T programme and its capacity development.
Department for Science, Innovation and Technology Department of Health and Social Care
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38 Recommendation Accepted
Para 241

Scientific excellence is not enough in test and trace programmes: the UK must develop greater...

Recommendation
Scientific excellence is not enough in test and trace programmes: the UK must develop greater operational competence in deployment. In particular, the Government must ensure that both the new UK Health Security Agency and local authorities have the capability and … Read more
Government Response Summary
The government accepts the recommendation, committing to building a resilient and scalable infrastructure for future public health threats. This includes working closely with local authorities to ensure their capability for future contact tracing and maintaining strong relationships between UKHSA and local tracing arrangements.
Department for Science, Innovation and Technology Department of Health and Social Care
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39 Recommendation Accepted
Para 242

Public Health England and its successor bodies, as well as Ministers and their scientific advisers,...

Recommendation
Public Health England and its successor bodies, as well as Ministers and their scientific advisers, should be more willing to study and emulate the practice of other countries with urgency and agility, especially during a crisis. A culture must be … Read more
Government Response Summary
The government accepts the recommendation but states that PHE and its successor, UKHSA, have always strived to learn from and collaborate with other countries and organisations. UKHSA will continue to share and learn best practices globally and maintain strong international relationships.
Department for Science, Innovation and Technology Department of Health and Social Care
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40 Recommendation Not Addressed
Para 243

Those responsible for future test and trace programmes should establish a culture and processes to...

Recommendation
Those responsible for future test and trace programmes should establish a culture and processes to learn rapidly from errors and to act to prevent them being repeated.
Government Response Summary
The government response reiterates the committee's recommendation without providing any specific action, commitment, or stance.
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41 Recommendation Not Addressed
Para 244

The reactive, short-term horizon of test and trace for much of the pandemic must be...

Recommendation
The reactive, short-term horizon of test and trace for much of the pandemic must be replaced by a capacity for anticipation and preparation—even during the course of an emergency.
Government Response Summary
The government's response merely restates the committee's recommendation that the reactive approach of test and trace must be replaced by a capacity for anticipation and preparation, without providing any specific action, commitment, or stance.
Department for Science, Innovation and Technology Department of Health and Social Care
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42 Recommendation Not Addressed

The organisation of the bodies responsible for testing and tracing should be open and transparent...

Recommendation
The organisation of the bodies responsible for testing and tracing should be open and transparent both about their operations and the basis of their decisions. (Paragraph 245) Social care
Government Response Summary
The government response reiterates the committee's recommendation without providing any specific action, commitment, or stance.
Department for Science, Innovation and Technology Department of Health and Social Care
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43 Conclusion Accepted
Para 288

The covid-19 pandemic has put massive strain on a social care sector already under huge...

Conclusion
The covid-19 pandemic has put massive strain on a social care sector already under huge pressure, which has a particular focus on caring for elderly people who have been at the greatest risk of death from covid.
Government Response Summary
The government acknowledged the conclusion and stated it has responded to the strain on the social care sector by outlining the 'Build Back Better' plan, which includes reform, funding proposals, and closer integration with health services.
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44 Conclusion Acknowledged
Para 289

Social care had a less prominent voice in Government during the early stages of the...

Conclusion
Social care had a less prominent voice in Government during the early stages of the pandemic than did the NHS.
Government Response Summary
The government acknowledges the impact of the pandemic on the social care sector and outlines the 'Build Back Better' plan, detailing reforms, a sustainable funding model, and proposals to bring health and social care sectors closer together to strengthen services.
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45 Conclusion Acknowledged
Para 290

The discharge of elderly people from NHS hospitals into care homes without having been tested...

Conclusion
The discharge of elderly people from NHS hospitals into care homes without having been tested at the beginning of the pandemic—while understandable as the NHS prepared to accept a surge of covid patients—had the unintended consequence of contributing to the … Read more
Government Response Summary
The government acknowledges the pandemic's impact on social care and references its existing 'Build Back Better' plan for reform, sustainable funding, and closer integration of health and social care sectors.
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46 Conclusion Accepted

Staff shortages, the lack of testing, difficulties in obtaining PPE and the design of care...

Conclusion
Staff shortages, the lack of testing, difficulties in obtaining PPE and the design of care settings to enable communal living hampered isolation and infection control and the ability to keep covid at bay. Social care staff in care homes and … Read more
Government Response Summary
The government acknowledged the impact on the social care sector and highlighted its 'Build Back Better' plan for health and social care, announced in September 2021, which includes a programme of reform, funding proposals, and collaboration with devolved governments.
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47 Recommendation Accepted
Para 292

Many of these pressures on the social care sector—such as funding and workforce— are longstanding...

Recommendation
Many of these pressures on the social care sector—such as funding and workforce— are longstanding and must be resolved urgently. Pressures on the social care workforce are likely to be compounded this autumn by the mandate that people working in … Read more
Government Response Summary
The government acknowledges pressures on the social care sector and references the existing ‘Build Back Better’ plan from September 2021, which includes a reform programme, proposals for a sustainable funding model, and efforts to integrate health and social care.
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48 Recommendation Accepted
Para 293

Planning for future pandemics should have a more developed and explicit consideration of the intense...

Recommendation
Planning for future pandemics should have a more developed and explicit consideration of the intense interaction between the NHS and social care. The prominence of social care within the Department of Health and Social Care should be enhanced and Ministers … Read more
Government Response Summary
The government explicitly accepts the recommendation to enhance social care's prominence, address knowledge gaps, ensure informed policy, and retain Social Care Taskforce expertise for future pandemic planning.
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49 Recommendation Accepted
Para 294

Long term reform of social care is overdue and should be pursued as a matter...

Recommendation
Long term reform of social care is overdue and should be pursued as a matter of urgency. The Government’s recent announcement on the future of social care is welcome, but the long-term future of the sector remains unresolved. We endorse … Read more
Government Response Summary
The government explicitly accepted the recommendation to pursue long-term social care reform urgently and create a 10-Year Plan for Social Care, ensuring parity with the health sector.
Department for Science, Innovation and Technology Department of Health and Social Care
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50 Recommendation Accepted
Para 295

We endorse the Health and Social Care Committee’s call for additional resources to be directed...

Recommendation
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 … Read more
Government Response Summary
The government explicitly accepts the recommendation to direct additional resources to social care, endorsing the Health and Social Care Committee's call for increased funding.
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51 Recommendation Accepted

The Government should review the provision of infection prevention and control measures, including infection prevention...

Recommendation
The Government should review the provision of infection prevention and control measures, including infection prevention and control nurses, to social care and ensure that social care providers, particularly care homes, are able to conduct regular pandemic preparedness drills. The Government … Read more
Government Response Summary
The government accepted the recommendation to review infection prevention and control measures in social care, ensure preparedness drills, and guarantee isolation facilities and safe visiting in care homes.
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52 Conclusion Accepted
Para 330

The impact of covid-19 has been uneven across the population, with some sections of society...

Conclusion
The impact of covid-19 has been uneven across the population, with some sections of society suffering significantly higher illness and deaths than the nation as a whole.
Government Response Summary
The government accepts the committee's observation that the impact of COVID-19 was uneven across the population, leading to higher illness and deaths in some sections of society.
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53 Conclusion Acknowledged

During the initial phase of the pandemic Black, Asian and minority ethnic people experienced significantly...

Conclusion
During the initial phase of the pandemic Black, Asian and minority ethnic people experienced significantly higher levels of severe illness and death from covid than was typical the population as a whole. Research conducted so far suggests that the drivers … Read more
Government Response Summary
The government accepts the committee's conclusion that Black, Asian and minority ethnic people experienced significantly higher levels of severe illness and death from COVID-19 due to features of inequality.
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54 Conclusion Acknowledged
Para 332

Staff from Black, Asian and minority ethnic backgrounds are crucial to the NHS and care...

Conclusion
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 … Read more
Government Response Summary
The government acknowledged the conclusion that inequalities persist for BAME staff in the NHS and care sectors, but did not commit to any specific actions in response.
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55 Conclusion Acknowledged
Para 333

People with learning disabilities have experienced significantly higher death rates from covid-19 than the country...

Conclusion
People with learning disabilities have experienced significantly higher death rates from covid-19 than the country as a whole. Deaths have been especially high among younger adults with learning disabilities. Initial research suggests that people with learning disabilities entered the pandemic … Read more
Government Response Summary
The government states it accepts the committee's conclusion, thereby acknowledging the finding that people with learning disabilities experienced significantly higher COVID-19 death rates and faced particular barriers to accessing NHS treatment during the pandemic.
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56 Conclusion Accepted
Para 334

Although there was never national NHS guidance to apply “Do not attempt CPR” (DNACPR) notices...

Conclusion
Although there was never national NHS guidance to apply “Do not attempt CPR” (DNACPR) notices to people with learning disabilities, there have been widespread concerns that there were cases in which they have been issued inappropriately during the pandemic. Read more
Government Response Summary
The government accepts the importance of the concern regarding inappropriate DNACPR notices and details a range of existing and past measures implemented during the pandemic, including GP reviews of DNACPRs, guidance from NHS England, and the commissioning of an acute care toolkit published in April 2022, to protect people with learning disabilities and autistic people.
Department for Science, Innovation and Technology Department of Health and Social Care
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57 Recommendation Not Addressed
Para 335

The Government should ensure its ‘levelling up’ agenda includes specific policies to reduce health inequalities,...

Recommendation
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 … Read more
Government Response Summary
The government response merely reiterates the committee's recommendation verbatim and then shifts to an unrelated recommendation without committing to any specific actions regarding the 'levelling up' agenda and health inequalities.
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