Recommendations & Conclusions
26 items
2
Recommendation
Fourteenth Report: Readying the NHS and…
Discharging patients from hospital into social care without first testing them for COVID-19 was an appalling error. Shockingly, Government policy up to and including 15 April was to not test all patients discharged from hospital for COVID-19. In the period up to 15 April, up to a maximum of five …
Government response. 2. 1 The government agrees with the Committee’s recommendation. Ta rget implementation date: Spring 2021 2.2 Although the department agrees with the Committee’s recommendation, it disagrees with the Committee’s conclusion. 2.3 The department provided an update to the Chair on …
HM Treasury
3
Conclusion
Fourteenth Report: Readying the NHS and…
This pandemic has shown the tragic impact of delaying much needed social care reform, and instead treating the sector as the NHS’s poor relation. This Committee has highlighted the need for change in the social care sector for many years, particularly around the interface between health and social care. Despite …
Government response. 3.1 The government agrees with the Committee’s recommendation. Target Implementation date: Outstanding (date to be confirmed in due course) 3.2 The department provided an update to the Committee on 7 October 2020. The government’s current priority for adult social care …
HM Treasury
4
Conclusion
Fourteenth Report: Readying the NHS and…
Public confidence is likely to be further undermined without an open and honest debate about current capacity and tangible plans to address gaps, for example, in testing and PPE. Government has had to and will continue to have to make quick decisions with sometimes imperfect information as the pandemic develops. …
Government response. 4.1 The government agrees with the Committee’s recommendation. Recommendation Implemented 4.2 The department is confident that it has secured enough supply for this (2020-21) winter period and that it has processes and logistics in place to distribute personal protective equipment …
HM Treasury
5
Conclusion
Fourteenth Report: Readying the NHS and…
Staff in health and social care cannot be expected to be ready to cope with future peaks and also deal with the enormous backlogs that have built up unless they are managed well. We are deeply concerned about the frontline workers and volunteers who have endured the strain and trauma …
Government response. 5.1 The government agrees with the Committee’s recommendation. Recommendation Implemented 5.2 The department has published wellbeing guidance for all those working in adult social care, providing key advice and resources on maintaining mental wellbeing and how employers can take care …
HM Treasury
6
Conclusion
Fourteenth Report: Readying the NHS and…
Policies designed to create additional capacity quickly, while necessary, have resulted in a lack of transparency about costs and value for money. The NHS boosted its potential maximum capacity for the peak in April by building Nightingale hospitals across the country and signing contracts with independent providers for 8,000 additional …
Government response. 19. Nineteenth Report of Session 2019-21 The Sponsor Body (for the Restoration and Renewal of the Palace of Westminster) Restoration and renewal of the Palace of Westminster Introduction from the Committee After over 20 years of discussion, in January 2018, …
HM Treasury
1
Conclusion
Fourteenth Report: Readying the NHS and…
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health & Social Care (the Department), NHS England & NHS Improvement (NHSE&I), the Ministry of Housing, Communities & Local Government (the Ministry) and Public Health England on Readying the NHS and …
Government response. 1. NHS resilience and recovery – Lee McDonough, DHSC; Ruth May, Chief Nursing Office for England 2. Social care resilience including workforce and minimising transmission – Michelle Dyson, DHSC 3. Supply and distribution of key products – Jonathan Marron, DHSC; …
HM Treasury
7
Conclusion
Fourteenth Report: Readying the NHS and…
There have been serious and widespread concerns about the lack of timely testing for both staff and the public and inadequate PPE provision particularly in social care.13 When we queried the arrangements for ensuring access to testing, we were told that several bodies were involved, including the Department, Public Health …
HM Treasury
8
Conclusion
Fourteenth Report: Readying the NHS and…
Similarly, procuring and distributing PPE involved a range of bodies, including the Department, Public Health England, local NHS providers and care homes, yet until the appointment of Lord Deighton in mid-April no one took the lead in making sure there was sufficient PPE.16 Public Health England told us that it …
HM Treasury
9
Conclusion
Fourteenth Report: Readying the NHS and…
On 17 March the NHS told trusts to discharge urgently all medically fit hospital patients with COVID-19 to maximise inpatient and critical care capacity. On 2 April, the Department told care homes that they needed to make their full capacity available and could admit patients with COVID-19 by isolating suspected …
Government response. 2.1 The government agrees with the Committee’s recommendation. Ta rget implementation date: Spring 2021 2.2 Although the department agrees with the Committee’s recommendation, it disagrees with the Committee’s conclusion. 2.3 The department provided an update to the Chair on 7 …
HM Treasury
10
Conclusion
Fourteenth Report: Readying the NHS and…
Some organisations such as Care England highlighted to us the flawed nature of this policy and reported that, given the absence of testing and inadequate PPE, social care felt abandoned.21 When we challenged the Department and the NHS on such a reckless and negligent policy, the Department told us that …
Government response. 2: PAC conclusion: Discharging patients from hospital into social care without first testing them for COVID-19 was an appalling error.
HM Treasury
11
Conclusion
Fourteenth Report: Readying the NHS and…
We remained concerned that the Department had continued its policy of discharging people untested into care homes even once it was clear there was an emerging problem.26 The number of first-time outbreaks in individual care homes peaked at 1,009 in early April. Between 9 March and 17 May, around 5,900 …
Government response. 2: PAC conclusion: Discharging patients from hospital into social care without first testing them for COVID-19 was an appalling error.
HM Treasury
12
Conclusion
Fourteenth Report: Readying the NHS and…
This Committee has warned before that the Department lacked an effective overall strategy or plan to integrate health and care and that poor outcomes could arise as a result.29 As Care England told us, for too long “adult social care has been kicked into the long grass by governments of …
Government response. 3: PAC conclusion: This pandemic has shown the tragic impact of delaying much needed social care reform, and instead treating the sector as the NHS’s poor relation.
HM Treasury
13
Conclusion
Fourteenth Report: Readying the NHS and…
We heard how frequently social care had taken second place to the NHS’s needs, particularly in accessing test kits and results, and securing reliable PPE supply for care homes, which had been neither timely nor coordinated.33 When questioned, the Department denied that social care had been forgotten, citing the work …
HM Treasury
14
Conclusion
Fourteenth Report: Readying the NHS and…
This Committee has also challenged the Department before over not delivering on its overarching responsibilities towards the care market, and having no credible plans to ensure the sector was sustainably funded.38 We note it was not until June 2020 that the Department appointed a director general for adult social care …
HM Treasury
15
Conclusion
Fourteenth Report: Readying the NHS and…
The Department stressed that it had to respond quickly to the COVID-19 pandemic often with “imperfect knowledge”, which was why its approach had altered over time.43 But Care England told us that PPE guidance had changed no fewer than 40 times, causing confusion and anxiety to service providers and staff.44 …
Government response. 4.2 The department is confident that it has secured enough supply for this (2020-21) winter period and that it has processes and logistics in place to distribute personal protective equipment (PPE) to where it is needed. The government has now …
HM Treasury
16
Conclusion
Fourteenth Report: Readying the NHS and…
By comparison, because testing capacity was limited during the earlier stages of the pandemic, the Department said it had sought clinical advice on where that capacity was best deployed. Eligibility for tests changed as capacity increased and the Department noted that testing was the area which had evolved the most …
Government response. 4.3 The ability to test and trace for COVID-19 is critical to ending transmission in the community. The department will continue to grow capacity and resilience, including being prepared for winter when demand for testing is likely to increase. The …
HM Treasury
17
Conclusion
Fourteenth Report: Readying the NHS and…
Concerns about the transparency of Government’s reporting about the measures it has taken, particularly around PPE and testing, have been widely publicised.47 We heard from stakeholders in the health and social care sector who highlighted issues with inadequate and unreliable PPE supply.48 For example, despite the fanfare around a large …
Government response. 4.2 The department is confident that it has secured enough supply for this (2020-21) winter period and that it has processes and logistics in place to distribute personal protective equipment (PPE) to where it is needed. The government has now …
HM Treasury
18
Conclusion
Fourteenth Report: Readying the NHS and…
Testing for COVID-19 is fundamental to controlling the virus, and to informing and reassuring the public.50 Yet, while Government’s announcement of its 100,000 daily test target by the end of April had a galvanising effect to start with, NHS Providers reported that it had ended up being a distraction from …
Government response. 4.3 The ability to test and trace for COVID-19 is critical to ending transmission in the community. The department will continue to grow capacity and resilience, including being prepared for winter when demand for testing is likely to increase. The …
HM Treasury
19
Conclusion
Fourteenth Report: Readying the NHS and…
We were keen to know how the Department would ensure sufficient stockpiles of PPE and testing capacity as it rolls out its ambitious ‘track and trace’ programme and the NHS resumes routine services while continuing to deal with COVID-19 this autumn and winter.54 It reiterated that testing capacity had now …
Government response. 4.3 The ability to test and trace for COVID-19 is critical to ending transmission in the community. The department will continue to grow capacity and resilience, including being prepared for winter when demand for testing is likely to increase. The …
HM Treasury
20
Conclusion
Fourteenth Report: Readying the NHS and…
NHSE&I explained that the NHS was carrying 100,000 staff vacancies going into the pandemic.58 It said the workforce had been boosted by around 20,000 students; retired NHS staff; and a further 600,000 volunteers (working across a range of public services, including the NHS) who stepped forward to work on the …
Government response. 5.4 The NHS People Plan for 2020- 21: action for us all was published on 30 July 2020. The People Plan sets out action that NHS England and NHS Improvement, Health Education England and NHS employers will take over the …
HM Treasury
21
Conclusion
Fourteenth Report: Readying the NHS and…
There have been numerous media reports of PPE shortages for health and social care staff and stakeholders have told us how the failure to provide adequate and timely PPE has impacted staff morale, trust and confidence.61 In the period from 6 April to 19 May, more than 80% of local …
Government response. 4.2 The department is confident that it has secured enough supply for this (2020-21) winter period and that it has processes and logistics in place to distribute personal protective equipment (PPE) to where it is needed. The government has now …
HM Treasury
22
Conclusion
Fourteenth Report: Readying the NHS and…
Testing for NHS workers (with symptoms) only began from 27 March, with eligibility extended to social care workers (with symptoms) from 15 April, after the pandemic had passed its first peak. In the period up to 15th April up to a maximum of five symptomatic residents in each care home …
Government response. 4.3 The ability to test and trace for COVID-19 is critical to ending transmission in the community. The department will continue to grow capacity and resilience, including being prepared for winter when demand for testing is likely to increase. The …
HM Treasury
23
Conclusion
Fourteenth Report: Readying the NHS and…
We were concerned about the NHS needing to call on the same staff who have already worked exceptionally long hours during the first peak in order to deal with the backlogs of treatment, while also standing ready for a potential second peak.66 NHSE&I explained that it was “encouraging people to …
Government response. 5.4 The NHS People Plan for 2020- 21: action for us all was published on 30 July 2020. The People Plan sets out action that NHS England and NHS Improvement, Health Education England and NHS employers will take over the …
HM Treasury
24
Conclusion
Fourteenth Report: Readying the NHS and…
Under its reasonable worst-case scenario, the Government expected over 4% of the population might require hospital admission for COVID-19 and 30% of those would require critical care. NHSE&I told us that the number of COVID-19 patients admitted to hospital had risen from a few hundred in mid-March to 18,000 two …
HM Treasury
25
Conclusion
Fourteenth Report: Readying the NHS and…
Between mid-March and mid-April, the NHS and armed forces are to be commended for increasing the number of beds available for Covid-19 patients from 12,600 to 53,700 in 63 C&AG’s Report, para 3.16 64 RSC0012 National Institute for Health Research (NIHR) Health Protection Research Unit in Merging and Zoonotic Infections; …
HM Treasury
26
Conclusion
Fourteenth Report: Readying the NHS and…
Access to NHS services has reduced significantly during the COVID crisis, potentially creating huge pent-up demand, which will add to the substantial waiting lists that existed before the pandemic.77 NHSE&I told us that access to emergency and critical services, such as cancer, has been maintained throughout the crisis although use …
HM Treasury