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Third 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 (51 recs)
Government Response
AI assessment · 170 of 200 classified
Accepted 37
Accepted in Part 32
Acknowledged 24
Not Addressed 72
Rejected 5
Government response
Government Response to the Health and Social Care Committee and Science and Technology Committee joint report: Coronavirus: lessons  learned  to date · published 16 Jun 2022
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Recommendations & Conclusions

200 items
58 Conclusion Accepted in Part

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 partially accepts the observation, committing to improve the NSRA methodology through an external review by RAEng and exploring ways to increase accessibility for external experts and diversify challenge in risk assessment.
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, acknowledging that lessons from previous pandemic exercises should have been better identified and implemented, and commits to improving future preparedness by developing a new pandemic strategy, investing in R&D, and strengthening international partnerships.
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 rejected the committee's assessment, disagreeing that COBR was ill-suited for pandemic response or that its confidentiality culture was unreliable. They defended COBR's role and ongoing review processes.
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 observation that the Civil Contingencies Secretariat lacked adequate resources and reach. It states that a range of existing capabilities, including near-term horizon scanning, the Joint Intelligence Organisation, and the National Situation Centre, already identify and assess risks.
Department for Science, Innovation and Technology Department of Health and Social Care
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62 Conclusion Not Addressed

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
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 slow data sharing protocols between national and local government.
Department for Science, Innovation and Technology Department of Health and Social Care
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63 Conclusion Accepted

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 acknowledges the NHS's limited surge capacity and states this experience should lead to more explicit, monitored surge capacity in long-term NHS organisation and funding. It also commits to developing new IPC protocols for pandemics and conducting comprehensive analysis of current latent capacity in critical care units.
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 the recommendation, agreeing on learning from diverse international expertise and detailing how the National Risk Register methodology is being reviewed by the Royal Academy of Engineering to increase external challenge and accessibility.
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 to establish a new standing capability for horizon scanning, stating that a range of existing complementary capabilities already address this need, including the Civil Contingencies Secretariat, the Joint Intelligence Organisation, and the National Situation Centre.
Department for Science, Innovation and Technology Department of Health and Social Care
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66 Recommendation Accepted in Part

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, agreeing on positive learning and engagement with international partners and disciplines, and is considering ways to increase external expert accessibility and challenge in the National Risk Assessment process.
Department for Science, Innovation and Technology Department of Health and Social Care
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67 Recommendation Accepted in Part

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 partially accepts, highlighting ongoing engagement with international practices and efforts to improve the National Risk Assessment (NSRA) methodology and external challenge, though it does not explicitly commit to increasing CCS resourcing or reporting specific stress test results.
Department for Science, Innovation and Technology Department of Health and Social Care
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68 Recommendation Not Addressed

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 partially accepts, agreeing on general learning and engagement, but the response focuses on the National Risk Assessment (NSRA) process and international cooperation, without committing to specific arrangements for immediate data flows or dispute resolution mechanisms between emergency response bodies.
Department for Science, Innovation and Technology Department of Health and Social Care
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69 Recommendation Not Addressed

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, but the response details ongoing NSRA methodology review and plans to increase external expert engagement in future risk assessments, failing to address the recommendation regarding a more central role for the Armed Forces in emergency response.
Department for Science, Innovation and Technology Department of Health and Social Care
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70 Recommendation Not Addressed

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 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 call to establish a volunteer reserve database.
Department for Science, Innovation and Technology Department of Health and Social Care
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71 Recommendation Not Addressed

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's response does not address the recommendation; instead, it merely reproduces the committee's own text, including the original recommendation and other unrelated recommendations from the report.
Department for Science, Innovation and Technology Department of Health and Social Care
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72 Recommendation Not Addressed

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's response is a verbatim restatement of the committee's recommendation, indicating no actual government response was provided for this item.
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 by explicitly restating it, indicating that comprehensive analysis will be carried out to assess the safety of the NHS's limited latent capacity, particularly in critical care units.
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 that NHS England has commissioned Health Education England to develop proposals enabling NHS staff to change clinical specialty mid-career and train in sub-specialties, alongside other initiatives to support flexible working and staff deployment.
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 uncertainty of early crisis situations, stating that scientific advice may be uncertain and rapid, precautionary action may be appropriate.
Department for Science, Innovation and Technology Department of Health and Social Care
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76 Recommendation Accepted

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

Recommendation
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 accepted the recommendation, stating that Public Health England, its successors, ministers, and scientific advisers should be more willing to study and emulate practices from other countries, and a culture of proactive collaboration should be established.
Department for Science, Innovation and Technology Department of Health and Social Care
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77 Conclusion Accepted

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 commits that future policy development will be characterised by greater questioning and challenge, with Ministers taking a more robust approach to scientific advice, and SAGE facilitating strong external challenge from diverse experts globally.
Department for Science, Innovation and Technology Department of Health and Social Care
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78 Recommendation Accepted in Part

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

Recommendation
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, without directly acknowledging the "public health failures" conclusion, commits to reforming SAGE in the future to include more diverse and international representation, aiming to improve learning and preparedness.
Department for Science, Innovation and Technology Department of Health and Social Care
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79 Conclusion Not Addressed

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
Government Response Summary
The government's response provides an unrelated statement about the publication of SAGE advice and minutes, failing to address the committee's observation regarding the debate around 'herd immunity'.
Department for Science, Innovation and Technology Department of Health and Social Care
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80 Conclusion Not Addressed

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
Government Response Summary
The government's response is entirely unrelated to the committee's conclusion about non-pharmaceutical interventions and past statements on herd immunity, instead making a recommendation about international standards for reporting COVID-19 deaths.
Department for Science, Innovation and Technology Department of Health and Social Care
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81 Conclusion Not Addressed

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
Government Response Summary
The government's response details its commitment to developing greater operational competence in test and trace programs, including ensuring UKHSA and local authorities have capability and funding to establish surge capacity and contact tracing within seven days of an emergency, which does not address the committee's conclusion about past policy fatalism and an implicit herd immunity strategy.
Department for Science, Innovation and Technology Department of Health and Social Care
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82 Conclusion Not Addressed

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
Government Response Summary
The government's response outlines future actions regarding international collaboration and culture change but does not address the committee's observation about the UK's initial policy choice to moderate the virus's spread.
Department for Science, Innovation and Technology Department of Health and Social Care
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83 Conclusion Not Addressed

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
Government Response Summary
The government's response discusses the need for future test and trace programmes to learn from errors, which does not address the committee's historical observation about early pandemic strategy and herd immunity.
Department for Science, Innovation and Technology Department of Health and Social Care
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84 Conclusion Not Addressed

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
Government Response Summary
The government states that the reactive approach to test and trace must be replaced by anticipation and preparation for emergencies, without directly addressing the committee's specific points about early lockdown decisions and event impacts.
Department for Science, Innovation and Technology Department of Health and Social Care
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85 Conclusion Not Addressed

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
Government Response Summary
The government's response states that testing and tracing bodies should be transparent, which does not address the committee's conclusion regarding SAGE's explicitly gradual approach to non-pharmaceutical interventions.
Department for Science, Innovation and Technology Department of Health and Social Care
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86 Conclusion Not Addressed

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
Government Response Summary
The government's response outlines several future actions for pandemic planning and enhancing social care prominence, which does not address the committee's observation about the timeline and advice for NPIs in 2020.
Department for Science, Innovation and Technology Department of Health and Social Care
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87 Conclusion Not Addressed

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
Government Response Summary
The government's response concerns social care reform, which is entirely unrelated to the committee's conclusion about the flawed assumption of calibrated control over the virus and lack of data.
Department for Science, Innovation and Technology Department of Health and Social Care
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88 Conclusion Not Addressed

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
Government Response Summary
The government's response is entirely irrelevant to the conclusion, discussing social care funding instead of the UK's early gradualist approach to pandemic measures.
Department for Science, Innovation and Technology Department of Health and Social Care
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89 Conclusion Not Addressed

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
Government Response Summary
The government provides a generic welcome to the report, acknowledging the crisis and agreeing that lessons should be learned, without engaging with the specific details of the WHO advice cited in the conclusion.
Department for Science, Innovation and Technology Department of Health and Social Care
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90 Conclusion Not Addressed

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
Government Response Summary
The government provides a generic response welcoming the report and acknowledging the scale of the pandemic and the need to learn lessons, but does not address the specific conclusion about missed opportunities for preparedness in February 2020.
Department for Science, Innovation and Technology Department of Health and Social Care
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91 Conclusion Not Addressed

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
Government Response Summary
The government's response is a generic acknowledgement of the report and the need to learn lessons, but it does not specifically address the committee's conclusion about the abrupt policy change or internal recognition of an impending disaster.
Department for Science, Innovation and Technology Department of Health and Social Care
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92 Conclusion Not Addressed

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
Government Response Summary
The government provided a general statement about learning lessons from the pandemic and adapting for future crises, but did not specifically address the committee's detailed conclusion regarding SAGE's advice for lockdown dates.
Department for Science, Innovation and Technology Department of Health and Social Care
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93 Conclusion Not Addressed

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
Government Response Summary
The government provides a general introductory statement, acknowledging the crisis and the need to learn lessons, but it does not specifically address the committee's conclusion regarding the delay in the first lockdown despite available evidence and warnings.
Department for Science, Innovation and Technology Department of Health and Social Care
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94 Conclusion Not Addressed

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 acknowledges the crisis and the need to learn lessons, stating it has adapted and learned throughout the pandemic to inform preparedness for future crises, but offers no specific response to the observations on border controls.
Department for Science, Innovation and Technology Department of Health and Social Care
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95 Conclusion Not Addressed

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 provides a generic introductory statement acknowledging the report and its own efforts during the pandemic, without specifically addressing the conclusion regarding more rigorous border controls or a precautionary approach.
Department for Science, Innovation and Technology Department of Health and Social Care
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96 Conclusion Not Addressed

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

Conclusion
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 provides a generic welcome to the report, acknowledging the crisis and agreeing that lessons should be learned, without engaging with the specific conclusion about initial lockdown decision-making.
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 provides a generic introductory response, welcoming the report and acknowledging the importance of learning lessons from the pandemic without addressing the specific conclusion about SAGE's transparency evolution.
Department for Science, Innovation and Technology Department of Health and Social Care
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98 Conclusion Not Addressed

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
Government Response Summary
The government provides a generic response welcoming the report and acknowledging the scale of the pandemic and the need to learn lessons, but does not address the specific conclusion regarding SAGE advice and government decision-making.
Department for Science, Innovation and Technology Department of Health and Social Care
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99 Conclusion Acknowledged

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 acknowledges the report and agrees that lessons should be learned from the COVID-19 experience to inform preparedness for future crises, without committing to specific new actions regarding scientific advice challenge.
Department for Science, Innovation and Technology Department of Health and Social Care
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100 Conclusion Accepted

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 committed to adopting an approach of greater questioning and challenge in future policy development, stating ministers should be more robust and that SAGE should facilitate strong 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 Accepted

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 committed to adopting an approach of greater questioning and challenge in future policy development, stating ministers should be more robust and that SAGE should facilitate strong external and structured challenge to scientific advice.
Department for Science, Innovation and Technology Department of Health and Social Care
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102 Recommendation Accepted

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

Recommendation
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 directly accepted the recommendation, stating that a more robust approach to questioning and challenging scientific advice should characterise future policy development, and that ministers, government, and SAGE should facilitate structured external challenge.
Department for Science, Innovation and Technology Department of Health and Social Care
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103 Conclusion Accepted

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 accepts the underlying concern, stating that future policy development will involve greater questioning and challenge from ministers, and SAGE will 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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104 Conclusion Acknowledged

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's response outlines an aspirational approach for the future, stating that policy development should feature greater questioning and challenge, and that ministers should be more robust in challenging advice.
Department for Science, Innovation and Technology Department of Health and Social Care
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105 Conclusion Accepted

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 accepts the underlying concern, stating that future policy development will involve greater questioning and challenge from ministers, and SAGE will 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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106 Conclusion Not Addressed

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's response does not address Professor Whitty's observation about advice being based on observed data. Instead, it makes its own recommendation that future policy development should involve greater questioning and challenge of scientific advice by Ministers, the government, and SAGE.
Department for Science, Innovation and Technology Department of Health and Social Care
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107 Conclusion Accepted

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 accepts that future policy development should be characterised by greater questioning and challenge, urging Ministers to robustly scrutinise advice and for the government and SAGE to facilitate strong external challenge to scientific advice.
Department for Science, Innovation and Technology Department of Health and Social Care
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108 Conclusion Acknowledged

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's response outlines an aspirational approach for the future, stating that policy development should feature greater questioning and challenge, and that ministers should be more robust in challenging advice.
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 commits to a future approach characterized by greater questioning and challenge in policy development. Ministers will robustly challenge scientific advice, and the government and SAGE will facilitate strong external challenge from diverse 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 response does not address the committee's conclusion regarding public compliance with lockdown measures, instead discussing the need for greater questioning and challenge in future policy development and scientific advice.
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 adopting a future approach of greater questioning and challenge in policy development, encouraging ministers to challenge advice and facilitating strong external and international expert challenge to scientific advice.
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112 Conclusion Accepted in Part

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 partially accepts, stating it agrees on the importance of learning and engagement with other countries and is considering ways to increase external expert access and diversity of challenge, especially for the National Risk Assessment.
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113 Conclusion Acknowledged

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 partially accepts 'this recommendation' (despite it being a conclusion), agreeing on the importance of learning from other countries and stating it will do so flexibly. It also outlines efforts to review and improve the National Security Risk Assessment (NSRA) methodology and increase expert challenge and international practice sharing, partially addressing the theme of international engagement.
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114 Conclusion Not Addressed

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 claims to partially accept an unspecified recommendation, but its response focuses on improving scientific challenge and international learning related to the NSRA process, rather than directly addressing the committee's conclusion about SAGE's early evidence base.
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115 Conclusion

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
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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 Accepted in Part

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
Government Response Summary
The government partially accepts the recommendation, stating it has published scientific evidence and advice, including SAGE papers, within 10 days of meetings, arguing this strikes a reasonable balance for transparency. They commit to continuing to publish advice and note this will be considered by the COVID-19 Public Inquiry.
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123 Conclusion Accepted in Part

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
Government Response Summary
The government partially accepts the recommendation, stating it has published scientific evidence and advice, including SAGE papers, within 10 days of meetings, arguing this strikes a reasonable balance for transparency. They commit to continuing to publish advice and note this will be considered by the COVID-19 Public Inquiry.
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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

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
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131 Conclusion

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
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132 Conclusion

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
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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 discusses learning from other countries and reviewing the National Security Risk Assessment (NSRA) methodology to increase external expert challenge, which does not address the committee's specific conclusion about the difficulty of judging the second lockdown.
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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
The government's response discusses learning from other countries and reviewing the National Security Risk Assessment (NSRA) methodology to increase external expert challenge, which does not address the committee's conclusion about the Alpha variant's emergence and impact.
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135 Conclusion Accepted in Part

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 partially accepts, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
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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, despite claiming partial acceptance, fails to address the conclusion regarding the nature and impact of the second wave of the pandemic and the Alpha variant, instead focusing on the National Security Risk Assessment process.
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137 Conclusion Accepted in Part

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 partially accepts, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
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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
The government response is identical to its response to a different recommendation, focusing on expert diversity and international learning in risk assessment, and does not address the committee's conclusion about the difficulty of decision-making during a pandemic.
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139 Conclusion Acknowledged

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

Conclusion
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 acknowledges the importance of public health communications for compliance, asserting that its messaging early in the pandemic was strong and effective in contributing to public understanding and adherence.
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140 Conclusion Acknowledged

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 acknowledges the committee's observation, agreeing that early government messaging was strong, effective, and crucial for public understanding and compliance with pandemic measures.
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141 Conclusion Acknowledged

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 acknowledges the report's point about the importance of public health communications and affirms its early pandemic messaging was strong, effective, and contributed to public compliance.
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142 Conclusion Acknowledged

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 acknowledges the report's finding, agreeing that early messaging was strong and effective, contributing to public understanding and compliance.
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143 Conclusion Not Addressed

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's response generally praises the strength and effectiveness of its early public health messaging, but it does not address the specific criticisms regarding confusion over guidance or the lack of BSL interpreters.
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144 Conclusion Acknowledged

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 acknowledges the importance of public health communications and states that its early pandemic messaging was strong and effective.
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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 its response focuses only on the early, strong messaging, failing to address the committee's specific concerns about later inconsistent messaging across the four nations and resulting 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, but its response only addresses the effectiveness of early messaging, without engaging with the committee's conclusion about the deteriorating public understanding and compliance due to the complexity of the three-tier system.
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147 Conclusion Not Addressed

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 highlights the effectiveness of its *early* pandemic messaging but does not address the committee's conclusion regarding inconsistent messaging *after* the first wave or the impact of rule breaches on public trust.
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148 Conclusion Accepted

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 agrees on the importance of public health communications but highlights its past messaging as strong and effective, without committing to new actions or a revised strategy to address current issues with trust and misinformation.
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149 Conclusion

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
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150 Conclusion Accepted

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 states it will, via the World Health Organisation, advocate for an international standard for reporting COVID-19 deaths and a framework for reporting disease-related deaths in future pandemics.
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151 Conclusion

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
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152 Conclusion Acknowledged

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 acknowledges that scientific advice may be uncertain in early crises, suggesting a precautionary approach might be appropriate, but does not specifically address the committee's criticism of past policy or groupthink.
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153 Conclusion Not Addressed

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 states that in early crises, scientific advice is uncertain, and acting quickly on a precautionary basis may be appropriate, but does not address the committee's critique of the 'flattening the curve' policy.
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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 offers a general statement about scientific advice in early crises but does not address the committee's specific explanations for early policy errors.
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155 Conclusion Not Addressed

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's response explains the nature of scientific advice during a crisis, stating that it may be uncertain and require quick, precautionary action. It does not address the committee's concern about ministers finding it difficult to challenge scientific advice or the lack of sufficient challenge that took place.
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156 Conclusion Accepted in Part

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, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
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157 Conclusion Not Addressed

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 affirms its early pandemic messaging was strong and effective, but does not address the committee's concerns regarding later communication complexity and inconsistency.
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158 Conclusion Acknowledged

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 acknowledges the conclusion verbatim, agreeing that in early crisis situations with scientific uncertainty, it may be appropriate to act quickly on a precautionary basis rather than waiting for more scientific certainty.
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159 Recommendation Accepted

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 accepts the recommendation, reiterating that a greater questioning and challenging approach should characterize policy development, with Ministers taking a robust approach to scientific advice and facilitating external and structured challenge from diverse global experts.
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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 response is a verbatim repetition of the committee's recommendation and does not provide any specific commitment or stance on the proposed action.
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161 Recommendation Accepted

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 accepts the recommendation and commits to publishing scientific advice from SAGE co-chairs within 24 hours of being given or policy being decided, and SAGE minutes and papers within 48 hours of meetings.
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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 repeats the committee's recommendation verbatim without stating whether it accepts it or committing to any specific action.
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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 mixed record of test, trace and isolate, committing to building a resilient and scalable infrastructure for future public health threats by working closely with local authorities and maintaining UKHSA 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 lessons learned, stating it will build a resilient test, trace, and isolate infrastructure, work with local authorities, and ensure UKHSA maintains local tracing relationships to protect against future health threats.
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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 states it will build on the legacy of the pandemic's test, trace, and isolate response, ensuring resilient infrastructure and continued collaboration with local authorities through UKHSA for future public health threats.
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166 Conclusion Acknowledged

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 acknowledges the test, trace, and isolate legacy by outlining plans to build a resilient and scalable infrastructure, work with local authorities, and maintain UKHSA's relationships for future public health emergencies.
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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 commits to building a resilient and scalable test, trace, and isolate infrastructure for future threats, working with local authorities to ensure future contact tracing capabilities, and leveraging UKHSA's established relationships.
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168 Conclusion Not Addressed

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 partially accepts the recommendation but offers a generic response about learning from international practices and improving the National Security Risk Assessment (NSRA) methodology, without addressing the specific issue of global constraints in equipment and consumables for testing.
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169 Conclusion Acknowledged

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's response, phrased as a directive, states that Public Health England and its successors, Ministers, and advisers should be more willing to study and emulate international practices with urgency and agility during crises.
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170 Conclusion Rejected

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 partially accepts the recommendation by agreeing it is important to learn from other countries and detailing how UKHSA will facilitate this. However, it explicitly rejects the committee's specific conclusion that a negligent omission occurred or that a culture of rejecting assistance was established regarding the South Korean approach.
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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, agreeing to learn from international engagement and committing to review the National Risk Assessment (NSRA) methodology to increase external expert challenge and diversity.
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172 Conclusion Not Addressed

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, but the response details ongoing NSRA methodology review and plans to increase external expert engagement in future risk assessments, rather than directly addressing the committee's observation on past failures in testing strategy and capacity.
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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
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 the profound failure of testing and monitoring capabilities early in the pandemic.
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174 Conclusion Accepted in Part

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, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
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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's response partially accepts a 'recommendation' and describes ongoing work related to international learning and the review of the National Risk Assessment (NSRA) methodology. However, this response does not address the committee's specific concern about scientific advisors being too passive in accepting assurances about Public Health England's capacity.
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176 Conclusion Accepted in Part

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 partially accepts the recommendation, agreeing on the importance of learning and engagement, and highlighting efforts to improve expert challenge to the National Security Risk Assessment (NSRA) methodology, including an external review by the Royal Academy of Engineering.
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177 Conclusion Not Addressed

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's response, despite claiming partial acceptance, fails to address the conclusion regarding the lack of early testing capacity and the decision to halt community test and trace, instead discussing the National Security Risk Assessment process.
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178 Conclusion Accepted in Part

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 partially accepts, agreeing on positive learning and engagement with other countries. It details ongoing reviews of the National Security Risk Assessment (NSRA) methodology, including commissioning an external group and considering ways to increase external expert accessibility.
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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's response discusses learning from other countries and reviewing the National Security Risk Assessment (NSRA) methodology to increase external expert challenge, which does not address the committee's specific conclusion about testing capacity limitations and nosocomial infections in hospitals.
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180 Conclusion Not Addressed

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's response, despite claiming partial acceptance, does not address the conclusion about the damaging lack of testing for social care and hospital discharges, instead discussing the National Security Risk Assessment process.
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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, despite claiming partial acceptance, fails to address the conclusion regarding the impact of insufficient testing for social care staff and disease transmission in care homes, instead discussing the National Security Risk Assessment process.
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182 Conclusion Not Addressed

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
Government Response Summary
The government states it partially accepts the recommendation but its response discusses the National Risk Register Assessment (NSRA) methodology and external expert challenge, which does not address the conclusion about testing capacity and targets.
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183 Conclusion Not Addressed

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
Government Response Summary
The government's response, despite claiming partial acceptance, does not address the conclusion about the 100,000 daily testing target and its contested achievement, instead discussing the National Security Risk Assessment process.
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184 Conclusion Acknowledged

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
Government Response Summary
The government partially accepts the recommendation, generally agreeing on the importance of learning from other countries and disciplines, and describes ongoing efforts to review and improve the methodology of the National Security Risk Assessment (NSRA).
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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

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
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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 Recommendation Accepted

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

Recommendation
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
Government Response Summary
The government accepts the recommendation to ensure robust plans for rapidly scaling up test, trace, and isolate programmes in future health emergencies. It highlights UKHSA's existing capacity for PCR and LFD testing, its ability to scale up within 72 hours, and its commitment to continuing to develop these capabilities and ensure resilient infrastructure.
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195 Conclusion Accepted

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
Government Response Summary
The government accepts the recommendation, affirming the importance of rapidly scaling up test, trace, and isolate programmes. It highlights UKHSA's current capacity (700k-800k PCR tests/day and 2.5m LFD tests/day) and commits to continue developing capacity and ensuring a resilient infrastructure for future health threats.
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196 Conclusion Accepted

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
Government Response Summary
The government accepts the recommendation, agreeing on the importance of robust plans and capabilities to rapidly scale up test, trace, and isolate programmes in future emergencies. It details UKHSA's current surge capacity (700k-800k PCR tests/day and 2.5m LFD tests/day) and commits to continuing capacity development and ensuring a resilient, scalable infrastructure.
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197 Conclusion Accepted

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
Government Response Summary
The government accepts the recommendation, affirming the importance of rapidly scaling up test, trace, and isolate programmes in future health emergencies. It details UKHSA's current surge capacity (700k-800k PCR tests/day and 2.5m LFD tests/day) and commits to continuing capacity development and ensuring a resilient, scalable infrastructure.
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198 Recommendation Accepted

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

Recommendation
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 accepts the recommendation to ensure robust plans for rapidly scaling up test, trace, and isolate programmes in future health emergencies. It states UKHSA already has significant PCR and LFD testing capacity and commits to continuing to develop capabilities and ensure resilient infrastructure.
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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 partially accepts a 'recommendation' and describes ongoing work related to international learning and the review of the National Risk Assessment (NSRA) methodology. However, this response does not address the committee's specific concern about NHS Test and Trace being unprepared for surges in testing demand.
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200 Recommendation Not Addressed

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 accepts the recommendation but primarily details its past efforts during the pandemic to provide accessible health advice and testing services to diverse communities, rather than committing to a dependable future organisation for testing capacity and demand.
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1 Recommendation Accepted in Part
Para 58

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

Recommendation
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 partially accepts the implicit recommendation, agreeing to learn from and engage with other countries. It details ongoing improvements to the National Risk Assessment (NSRA) methodology, including increasing expert challenge and international learning, to better prepare for a broader range of risks.
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2 Conclusion Accepted in Part
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 partially accepts, agreeing to learn from international engagement and committing to review the National Risk Assessment (NSRA) methodology to increase external expert challenge and diversity.
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3 Conclusion Not Addressed
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 partially accepts, agreeing on the importance of learning, but the response focuses on the National Risk Assessment (NSRA) process and its external review, without directly addressing the committee's conclusion about COBR's operational suitability or confidentiality issues.
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4 Conclusion Accepted
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 states it accepts the recommendation and details that the resourcing and capabilities of the Civil Contingencies Secretariat (CCS) have already been improved, with additional staff, a restructured secretariat, and transferred functions.
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5 Conclusion Accepted in Part
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 partially accepts the observation, acknowledging that more needs to be done to improve data sharing and interoperability. It cites numerous ongoing programs and initiatives, including the Data Standards Authority and the NHS Data Sharing Service, and commits to making further progress in this area.
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6 Conclusion Accepted
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 accepts the conclusion that the NHS runs hot with little spare capacity, outlining existing steps taken to increase capacity, including beds and staff, and committing to future investment in additional capacity and improved management.
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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, agreeing on the importance of diverse expertise and international learning, which it says it already does flexibly. It highlights commissioning an external review of the National Risk Assessment (NSRA) methodology and is considering ways to increase external expert accessibility and challenge.
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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 rejects the recommendation, stating that a range of complementary standing capabilities already exist across various departments and organisations to identify and assess current and future risks.
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9 Recommendation Not Addressed
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 response is a verbatim repetition of the committee's recommendation and does not provide any specific commitment or stance on the proposed action.
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10 Recommendation Accepted in Part
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 partially accepts the recommendation, stating improvements to CCS resourcing are being considered following a review. It claims CCS already conducts stress tests and is considering how to report exercise outcomes in the annual report, balanced against security.
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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 and is actively working to improve data sharing arrangements, including developing a data strategy via the Civil Contingencies Secretariat, and affirms existing mechanisms are in place for dispute resolution.
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12 Recommendation Accepted
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 accepts the recommendation, highlighting the existing established role of the Armed Forces in supporting UK resilience and the collaborative work between the MoD, CCS, and civil authorities, and commits to continuing to improve this collaboration.
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13 Recommendation Accepted in Part
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 partially accepts the recommendation, highlighting existing partnerships with St John Ambulance and Royal Voluntary Service for volunteer deployment in specific programmes like vaccinations, and states NHS England is continuing to consider improvements to the volunteer model.
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14 Recommendation Not Addressed
Para 71

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 response repeats the committee's statement verbatim without committing to any specific actions or plan to achieve surge capacity.
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15 Recommendation Not Addressed
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's response merely restates the committee's recommendation verbatim without indicating acceptance, rejection, or any action being taken.
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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 response is identical to the committee's recommendation, providing no specific stance or commitment to action.
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17 Recommendation Not Addressed

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 response simply restates the committee's recommendation for NHS England and Health Education England to develop proposals for more flexible staff specialty changes mid-career, without providing its own stance or committed actions.
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18 Conclusion Not Addressed
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 is a generic statement about acting quickly on a precautionary basis and does not address the committee's specific conclusion regarding past policy decisions and groupthink during the COVID-19 pandemic.
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19 Conclusion
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
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20 Conclusion Accepted

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 accepts the recommendation, committing to ensuring future policy is developed through robust questioning, drawing on diverse expertise, and continuously learning lessons. It notes the Cabinet Office and Government Office for Science are leading work to strengthen government's futures capability, including external challenge and international engagement.
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21 Conclusion Accepted in Part
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
The government partially accepts the recommendation, agreeing on learning from diverse international expertise and detailing how the National Risk Register methodology is being reviewed by the Royal Academy of Engineering to improve expert challenge and accessibility.
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22 Conclusion
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
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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 agrees that early pandemic messaging was strong and effective, but does not address the conclusion's point about later complexity and inconsistency in guidance.
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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 and does not provide any specific stance or commentary.
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25 Recommendation Accepted in Part
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 partially accepts, agreeing to learn from other countries and disciplines. It describes how the Cabinet Office is reviewing the NSRA methodology to increase expert and diverse challenge during and after the process.
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26 Recommendation Accepted in Part

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 partially accepts the recommendation, agreeing to learn from international engagement and committing to review the National Risk Assessment (NSRA) methodology to increase external expert challenge and diversity.
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27 Recommendation Not Addressed
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
Despite stating partial acceptance, the government's response completely deviates from the recommendation regarding the timely publication of SAGE advice, minutes, and papers, instead discussing the National Risk Assessment (NSRA) process and international engagement.
Department for Science, Innovation and Technology Department of Health and Social Care
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28 Recommendation Accepted in Part

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 partially accepts, agreeing on positive learning and engagement with other countries, but the response largely details ongoing reviews of the National Security Risk Assessment (NSRA) methodology and increasing external expert accessibility, rather than committing to making the case for international death reporting standards via WHO.
Department for Science, Innovation and Technology Department of Health and Social Care
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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, agreeing on positive learning and engagement, but the response details the National Risk Assessment (NSRA) process and its external review, without directly addressing the committee's conclusion about past operational failures in test and trace or Public Health England's performance.
Department for Science, Innovation and Technology Department of Health and Social Care
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30 Conclusion Accepted in Part
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 partially accepts the conclusion, agreeing on the importance of learning from other countries and enhancing challenge. It notes an ongoing review by the Royal Academy of Engineering of the National Security Risk Assessment methodology, and the Cabinet Office is considering ways to increase external expert input.
Department for Science, Innovation and Technology Department of Health and Social Care
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31 Conclusion Accepted in Part
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 partially accepts the committee's findings, agreeing on the vital need for operational competence to rapidly scale up test, trace, and isolate programmes in future emergencies. It highlights UKHSA's current surge capacity (700-800k PCR, 2.5m LFD daily) and commits to working with local authorities and maintaining local relationships to build resilient and scalable infrastructure.
Department for Science, Innovation and Technology Department of Health and Social Care
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32 Conclusion Accepted
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 accepts the observation, committing to strengthening proactive collaboration and confirming that UKHSA will maintain established relationships with local tracing arrangements.
Department for Science, Innovation and Technology Department of Health and Social Care
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33 Conclusion
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
Department for Science, Innovation and Technology Department of Health and Social Care
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34 Conclusion Accepted in Part
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 partially accepts the recommendation, agreeing on the vital need for operational competence to scale up test and trace. It details UKHSA's current surge capacity (700-800k PCR, 2.5m LFD daily) and commits to working with local authorities and maintaining local relationships to build resilient and scalable infrastructure for future emergencies.
Department for Science, Innovation and Technology Department of Health and Social Care
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35 Recommendation Accepted
Para 238

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

Recommendation
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 accepts the recommendation for transparency, stating that UKHSA already operates within transparency guidance, publishes a wide range of operational data, and releases contracts over £10,000 within 90 days. It also reaffirms its commitment to using lessons learned for future public health planning.
Department for Science, Innovation and Technology Department of Health and Social Care
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36 Recommendation Accepted
Para 239

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

Recommendation
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 accepts the recommendation to ensure robust and scalable test, trace, and isolate programmes for future health emergencies. It highlights UKHSA's current capacity to conduct and scale up PCR and LFD testing within 72 hours, and commits to continuing to develop its capabilities and ensure resilient infrastructure.
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 advocates for developing greater operational competence in future test and trace programmes, ensuring relevant agencies have surge capacity within seven days of an emergency, but does not address the committee's conclusion on past testing capacity.
Department for Science, Innovation and Technology Department of Health and Social Care
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38 Recommendation Not Addressed
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 response repeats the committee's recommendation verbatim without committing to any specific actions or plans to achieve greater operational competence or surge capacity.
Department for Science, Innovation and Technology Department of Health and Social Care
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39 Recommendation Not Addressed
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 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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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 merely restates the committee's recommendation verbatim, without providing any specific commitment, action plan, or official stance.
Department for Science, Innovation and Technology Department of Health and Social Care
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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 response reiterates the committee's recommendation verbatim, without providing any specific commitment, acceptance, or alternative action.
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 merely repeats the committee's recommendation verbatim, without committing to specific actions or explaining how the transparency of testing and tracing bodies will be achieved.
Department for Science, Innovation and Technology Department of Health and Social Care
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43 Conclusion Acknowledged
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 recognises the pandemic's impact on the social care sector, referencing the 'Build Back Better' plan from September 2021 for reform, funding, and closer integration of health and social care.
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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 social care and references the 'Build Back Better' plan for health and social care reform, which aims to strengthen adult social care and foster closer ties between sectors.
Department for Science, Innovation and Technology Department of Health and Social Care
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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 recognises the pandemic's impact on social care, referencing the 'Build Back Better' plan from September 2021 for reform, sustainable funding, and closer integration of health and social care.
Department for Science, Innovation and Technology Department of Health and Social Care
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46 Conclusion Acknowledged

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 acknowledges the impact of the pandemic on the social care sector, pointing to the 'Build Back Better' plan as its response to strengthen services through reform, a sustainable funding model, and closer integration with health.
Department for Science, Innovation and Technology Department of Health and Social Care
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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 the longstanding pressures on the social care sector and states its 'Build Back Better' plan addresses these through a clear programme of reform, proposals for a sustainable funding model, and initiatives to integrate health and social care.
Department for Science, Innovation and Technology Department of 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 accepts the recommendation, stating it is committed to better preparing the social care sector and has acted to enhance social care's prominence within DHSC and NHS. It outlines plans to retain Social Care Taskforce expertise and details specific funding and initiatives from the 'Build Back Better' plan, including £500m for workforce support and £300m for housing integration.
Department for Science, Innovation and Technology Department of Health and Social Care
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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 accepts the recommendation and commits to publishing a white paper that will set out a 10-year vision for social care reform, addressing the call for urgency and parity with the NHS.
Department for Science, Innovation and Technology Department of Health and Social Care
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50 Recommendation Accepted in Part
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 partially accepts, detailing a commitment of £5.4 billion over three years for social care reforms and an additional £1.7 billion for the charging system, with more details to be announced later.
Department for Science, Innovation and Technology Department of Health and Social Care
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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 accepts the recommendation and is funding IPC training for social care staff, providing free PPE until March 2023, has launched an Infection Control Fund, and provides updated guidance on care home visiting.
Department for Science, Innovation and Technology Department of Health and Social Care
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52 Conclusion Acknowledged
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 acknowledges the uneven impact of COVID-19, particularly on ethnic minority groups, highlighting actions already taken and proposals made in the 'Levelling Up the United Kingdom' white paper.
Department for Science, Innovation and Technology Department of Health and Social Care
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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 recognises the disproportionate impact on ethnic minority groups, stating it has taken action to support them and that socio-economic factors are addressed in the 'Levelling Up the United Kingdom' white paper.
Department for Science, Innovation and Technology Department of Health and Social Care
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54 Conclusion Accepted in Part
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 accepts the recommendation to develop a strategy for securing appropriate PPE for all NHS and care staff, including those from BAME backgrounds, acknowledging the committee's concerns about inequalities. It highlights existing efforts to ensure good fit-test performance for masks and engagement with BAME staff, while asserting that fit-test rates are not generally low.
Department for Science, Innovation and Technology Department of Health and Social Care
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55 Conclusion Accepted
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 recommendation and details a range of measures already implemented throughout the pandemic, including increased testing, new guidance, blended annual health checks, and a newly published acute care toolkit.
Department for Science, Innovation and Technology Department of Health and Social Care
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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 states it accepts the importance of clear DNACPR guidance, noting it aligns with ongoing work by the Ministerial Oversight Group. It highlights the publication of Universal Principles for Advance Care Planning and patient-facing guidance on nhs.uk as existing actions addressing the concern.
Department for Science, Innovation and Technology Department of Health and Social Care
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57 Recommendation Accepted in Part
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 accepts the recommendation, stating it will consider how to reduce health inequalities as part of the levelling up agenda and commits to continued action including developing a Staff Network Maturity Framework and Staff Network Chair development programme through NHS England.
Department for Science, Innovation and Technology Department of Health and Social Care
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