Recommendations & Conclusions
22 items
2
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
It is not clear how the Department of Health and Social Care is assessing whether the NHS has enough critical care equipment for future demand. NHSE&I’s estimate of how many mechanical ventilators the NHS would need in a worst-case scenario has changed repeatedly: on 12 February initial estimates indicated a …
Government response. 2.1 The government agrees with this recommendation. Re commendation implemented 2.2 Given the exceptional circumstances of the pandemic, since March 2020, DHSC and NHS E/I have worked together to provide additional support to NHS trusts to help ensure sufficient medical …
HM Treasury
3
Recommendation
Twenty-seventh Report - Covid-19: Suppl…
Despite having to operate at speed, the Department of Health and Social Care still had a duty to carry out full due diligence for all parts of the supply chain. In early March, initial attempts by the Department to secure additional mechanical ventilators through its normal NHS supply chain routes …
Government response. 3.1 The government agrees with this recommendation. Recommendation implemented 3.2 The majority of devices purchased during this period were through framework agreements where NHS standard procurement processes had been followed. These include usual full due diligence checks. 3.3 Where devices …
HM Treasury
4
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
The ventilator challenge was an exceptional and far from traditional approach that offers some lessons for future programmes although they could not be applied wholesale under normal circumstances. The ventilator challenge was undoubtedly a significant achievement, involving a huge effort from industry across the UK. In total it produced around …
Government response. 2020. The department is revising the structures through which the contracts are managed to ensure that roles are more clearly defined and sufficiently resourced for all aspects of contract management to operate fully effectively. It is developing more robust operating …
HM Treasury
5
Recommendation
Twenty-seventh Report - Covid-19: Suppl…
Both programmes succeeded in part due to cross-government working and the expertise of key individuals involved. It is clear that both programmes were successful in part due to the involvement of different government departments that were best placed to carry out specific functions, and the involvement of people with the …
Government response. 5.1 The government agrees with this recommendation. Target implementation date: March 2023 5.2 The Government Commercial Function and associated central employment model of the Government Commercial Organisation enables the Cabinet Office to continue to optimise the skill development and deployment …
HM Treasury
6
Recommendation
Twenty-seventh Report - Covid-19: Suppl…
The ventilator challenge produced intellectual property that should be exploited to maximise value for the taxpayer. The ventilator challenge produced a number of designs in a very short space of time, even though many did not go on to be manufactured. This was in part due to the Cabinet Office’s …
Government response. 6.1 The government agrees with this recommendation. Re commendation implemented 6.2 As a result of the Ventilator Challenge, the government owns a number of designs for viable, emergency-use mechanical ventilators. It has standard licencing terms for licencing these designs and …
HM Treasury
1
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department), the Cabinet Office and NHS England and NHS Improvement (NHSE&I) on the government’s efforts to increase the number of ventilators in response to COVID-19.1
Government response. Introduction from the Committee Ventilators are medical devices that assist or replace a patient’s breathing. Patients with COVID-19 who are admitted to hospital often have problems breathing. On arrival in hospital a patient’s blood oxygen level is measured. If it …
HM Treasury
7
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
When we challenged the Department on why it did not begin its initial efforts to buy more ventilators until the 3 March, it explained that there was a “huge amount” of work done in February to understand the disease and to look at the capacity across the NHS in multiple …
HM Treasury
8
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
From February to April, NHSE&I’s estimate of how many mechanical ventilators the NHS would need in a worst-case scenario changed repeatedly. Its estimates were based on reasonable worst-case planning assumptions assured by the Scientific Advisory Group for Emergencies (SAGE), which provides scientific and technical advice to support government decision-makers during …
HM Treasury
9
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
However, when the programmes began in early-March, departments were looking at a potential need of up to 90,000 mechanical ventilators, far more than the 7,400 thought to be available. The Department acknowledged that it was never going to be able to increase capacity to this level, but aimed to raise …
HM Treasury
10
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
It is fortunate that the majority of the ventilators were not needed and that there is now additional capacity if they should be required in the future. Nevertheless, we are concerned that the Department was not able to give a clear explanation of how it now assesses whether the NHS …
Government response. 2: PAC conclusion: It is not clear how the Department of Health and Social Care is assessing whether the NHS has enough critical care equipment for future demand. 2: PAC recommendation: The Department of Health and Social Care should write …
HM Treasury
11
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
From 3 March, in response to the anticipated shortage of ventilators, the Department began to purchase as many ventilators as it could using existing NHS supply chain framework agreements, which are designed to ensure competitive pricing. It explained that as part of these initial efforts, it discussed the possibility of …
Government response. 3.2 The majority of devices purchased during this period were through framework agreements where NHS standard procurement processes had been followed. These include usual full due diligence checks.
HM Treasury
12
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
From 13 March the Department, therefore, stepped up its efforts to purchase ventilators directly from overseas with significant help from the Foreign and Commonwealth Office and the Department of International Trade in China.18 The Department told us that while it was somewhat ahead of other countries in moving to international …
Government response. 3.2 The majority of devices purchased during this period were through framework agreements where NHS standard procurement processes had been followed. These include usual full due diligence checks.
HM Treasury
13
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
We recognise that given the circumstances the Department had to move quickly. However, regardless of the circumstances, government regulations require departments to carry out due diligence on the organisations that they buy from and exclude organisations that do not comply with various environmental, social and labour laws”.20 The Department told …
Government response. 3: PAC conclusion: Despite having to operate at speed, the Department of Health and Social Care still had a duty to carry out full due diligence for all parts of the supply chain. 3a: PAC recommendation: The Department of Health …
HM Treasury
14
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
The Cabinet Office’s ventilator challenge, which encouraged UK businesses to develop new ventilators from scratch and increase the production of existing products or modified designs, was undoubtedly a significant achievement. In total, it produced around 15,000 mechanical ventilators in the space of just four months, over 1.5 times the number …
Government response. 4.1 The government agrees with this recommendation. Ta rget implementation date: June 2021 4.2 The Government Commercial Function is in the process of updating the Outsourcing Playbook V2 which will be launched as a Sourcing Playbook in Spring/Summer 2021 and …
HM Treasury
15
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
However, it is important to remember that the challenge did not take place under normal circumstances. Ventilator Challenge UK, the consortium of businesses that worked together to produce the Penlon ES02 ventilators, described the process as “working against a backdrop of life or death urgency”.24 The Cabinet Office acknowledged that …
Government response. 4.1 The government agrees with this recommendation. Ta rget implementation date: June 2021 4.2 The Government Commercial Function is in the process of updating the Outsourcing Playbook V2 which will be launched as a Sourcing Playbook in Spring/Summer 2021 and …
HM Treasury
16
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
Nevertheless, there are clearly elements of the challenge which could be applied to future programmes. For example, the Cabinet Office told us that it took a number of steps to ensure that suppliers costs were reasonable, such as working on an open-book basis using the Ministry of Defence’s Cost Assurance …
Government response. 4: PAC conclusion: The ventilator challenge was an exceptional and far from traditional approach that offers some lessons for future programmes although they could not be applied wholesale under normal circumstances. 4: PAC recommendation: As part of its treasury minute …
HM Treasury
17
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
In any government programme, departments should aim to work collaboratively across government and to involve people with the right skills from the outset. Yet this is not something we always see in the programmes we report on.28 In this case, we heard how the departments’ efforts to involve government departments …
Government response. 5.1 The government agrees with this recommendation. Target implementation date: March 2023 5.2 The Government Commercial Function and associated central employment model of the Government Commercial Organisation enables the Cabinet Office to continue to optimise the skill development and deployment …
HM Treasury
18
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
For example, the Department explained that both the Department for International Trade and the Foreign and Commonwealth Office helped it to purchase ventilators directly from China, which it viewed as the largest untapped market for ventilators. Both departments played a substantial role in assessing offers, which meant that the Department …
Government response. 3.2 The majority of devices purchased during this period were through framework agreements where NHS standard procurement processes had been followed. These include usual full due diligence checks.
HM Treasury
19
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
The Cabinet Office also drew on external expertise where required. We heard that the Chief Commercial Officer happened to have a background in running engineering and product development companies that meant he was well placed to develop and initiate the programme. Additionally the Cabinet Office’s ‘technical design authority’, put in …
Government response. 5.1 The government agrees with this recommendation. Target implementation date: March 2023 5.2 The Government Commercial Function and associated central employment model of the Government Commercial Organisation enables the Cabinet Office to continue to optimise the skill development and deployment …
HM Treasury
20
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
From the outset, Cabinet Office’s strategy was to support a number of both new and existing designs. This was to provide it with insurance against new designs not meeting the regulatory standards on time and the likelihood of it facing global competition for parts and components used in existing designs. …
Government response. 6.1 The government agrees with this recommendation. Re commendation implemented 6.2 As a result of the Ventilator Challenge, the government owns a number of designs for viable, emergency-use mechanical ventilators. It has standard licencing terms for licencing these designs and …
HM Treasury
21
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
In total the Cabinet financed 18 devices from 17 challenge participants over the course of the challenge; the majority of which were either completely new designs or modifications of existing designs. Through its technical design process, which eliminated devices based on whether they met regulatory requirements or were needed to …
Government response. 6.1 The government agrees with this recommendation. Re commendation implemented 6.2 As a result of the Ventilator Challenge, the government owns a number of designs for viable, emergency-use mechanical ventilators. It has standard licencing terms for licencing these designs and …
HM Treasury
22
Conclusion
Twenty-seventh Report - Covid-19: Suppl…
Designs are a type of intellectual property (IP), which if protected, can provide value for the owner.36 The Cabinet Office told us that it owns the IP for the designs it paid for and that it either owns all or a “substantial chunk” of the IP for the majority of …
Government response. 6: PAC conclusion: The ventilator challenge produced intellectual property that should be exploited to maximise value for the taxpayer. 6: PAC recommendation: The Cabinet Office should set out, as part of its Treasury Minute response, how it plans to maximize …
HM Treasury