Select Committee · Public Accounts Committee

COVID-19: Supply of ventilators

Status: Closed Opened: 24 Sep 2020 Closed: 25 Mar 2021 10 recommendations 12 conclusions 1 report

This inquiry continues our work on the government’s response to the Covid-19 pandemic, focussing on the NAO’s investigation into the supply chains and procurement of ventilators. The NAO report will set out the facts about the government’s spending on efforts to rapidly increase the number of ventilators available to the NHS in response to COVID-19. … Show more

Reports

1 report
Title HC No. Published Items Response
Twenty-seventh Report - Covid-19: Supply of ventilators HC 685 25 Nov 2020 22 Responded

Recommendations & Conclusions

22 items
2 Recommendation Twenty-seventh Report - Covid-19: Suppl… Not Addressed

It is not clear how the Department of Health and Social Care is assessing whether...

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 … Read more

Government response AI summary
The government claims to agree with the recommendation and states it has implemented measures by purchasing and distributing medical equipment and establishing a national loan process, asserting the NHS has sufficient stock and processes. However, it does not explicitly explain its current methodology for assessing …
Read full response →
HM Treasury
3 Recommendation Twenty-seventh Report - Covid-19: Suppl… Acknowledged

Despite having to operate at speed, the Department of Health and Social Care still had...

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 … Read more

Government response AI summary
The government agreed, explaining that due diligence for most purchases followed standard processes, but was limited during the emergency. It stated confidence that increased capacity and improved horizon scanning will reduce the future need for rapid, less thorough procurement.
Read full response →
HM Treasury
4 Recommendation Twenty-seventh Report - Covid-19: Suppl… Not Addressed

The ventilator challenge was an exceptional and far from traditional approach that offers some lessons...

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 … Read more

Government response AI summary
The government's response focuses on revising contract management structures and improving operating procedures generally, rather than specifically addressing how it will learn, publicise, and disseminate lessons from the ventilator challenge.
Read full response →
HM Treasury
5 Recommendation Twenty-seventh Report - Covid-19: Suppl… Accepted

Both programmes succeeded in part due to cross-government working and the expertise of key individuals...

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 … Read more

Government response AI summary
The government accepts the recommendation and states that the Government Commercial Function is optimising skill development and deployment, with further activity underway to build commercial capability across government departments and the wider public sector, aiming to scale by March 2023.
Read full response →
HM Treasury
6 Recommendation Twenty-seventh Report - Covid-19: Suppl… Accepted

The ventilator challenge produced intellectual property that should be exploited to maximise value for the...

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 … Read more

Government response AI summary
The government accepts the recommendation, stating it has standard licensing terms for the ventilator designs it owns, though no revenue has been generated yet. It has also developed and shared a document outlining key innovation lessons from the Ventilator Challenge.
Read full response →
HM Treasury
1 Conclusion Twenty-seventh Report - Covid-19: Suppl… Not Addressed

On the basis of a report by the Comptroller and Auditor General, we took evidence...

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 Read more

Government response AI summary
The government response provides an introduction to ventilators and the context of the pandemic, rather than engaging with the committee's concluding statement about taking evidence.
Read full response →
HM Treasury
7 Conclusion Twenty-seventh Report - Covid-19: Suppl… Deferred

When we challenged the Department on why it did not begin its initial efforts to...

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 … Read more

Government response AI summary
The government agreed to consider standardising local asset register information in the longer term, including promoting standardised taxonomies and information exchange, with a broader target implementation date of Summer 2021.
Read full response →
HM Treasury
8 Conclusion Twenty-seventh Report - Covid-19: Suppl… Accepted

From February to April, NHSE&I’s estimate of how many mechanical ventilators the NHS would need...

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 … Read more

Government response AI summary
The government agreed, outlining its purchase of thousands of ventilators and other equipment, and the implementation of a national loan process, asserting that sufficient stock and processes are now in place for trusts.
Read full response →
HM Treasury
9 Conclusion Twenty-seventh Report - Covid-19: Suppl… Accepted

However, when the programmes began in early-March, departments were looking at a potential need of...

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 … Read more

Government response AI summary
Although the committee's item was a conclusion, the government states it agrees with a recommendation (which was not present) and that it has already implemented measures, detailing past purchases of ventilators and other equipment, and the establishment of a national loan process to ensure sufficient …
Read full response →
HM Treasury
10 Recommendation Twenty-seventh Report - Covid-19: Suppl… Accepted

It is fortunate that the majority of the ventilators were not needed and that there...

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 … Read more

Government response AI summary
The government agrees with the recommendation and states it has implemented it, assuring themselves that the NHS has the right processes and sufficient stock of medical equipment to respond to the pandemic, through direct purchases and a national loan process.
Read full response →
HM Treasury
11 Conclusion Twenty-seventh Report - Covid-19: Suppl… Not Addressed

From 3 March, in response to the anticipated shortage of ventilators, the Department began to...

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 … Read more

Government response AI summary
The government reiterated that most devices were purchased through standard framework agreements with due diligence, without addressing the committee's observations on the challenges of increasing manufacturing speed or the initial 'huge deficit' in supply.
Read full response →
HM Treasury
12 Conclusion Twenty-seventh Report - Covid-19: Suppl… Not Addressed

From 13 March the Department, therefore, stepped up its efforts to purchase ventilators directly from...

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 … Read more

Government response AI summary
The government stated that most devices were purchased through standard framework agreements with due diligence, which did not address the committee's observation regarding intense competition and price volatility in overseas procurement.
Read full response →
HM Treasury
13 Recommendation Twenty-seventh Report - Covid-19: Suppl… Accepted

We recognise that given the circumstances the Department had to move quickly.

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 … Read more

Government response AI summary
The government accepts the recommendation, stating that while urgent circumstances limited due diligence in some cases, most purchases used standard processes. It assures that past checks were appropriate and future needs for rapid emergency procurement will be reduced due to increased capacity and improved horizon …
Read full response →
HM Treasury
14 Conclusion Twenty-seventh Report - Covid-19: Suppl… Accepted

The Cabinet Office’s ventilator challenge, which encouraged UK businesses to develop new ventilators from scratch...

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 … Read more

Government response AI summary
The government agreed and committed to updating the Sourcing Playbook by Spring/Summer 2021 to incorporate Ventilator Challenge lessons, which will also be captured as a case study for risk training and knowledge sharing sessions.
Read full response →
HM Treasury
15 Conclusion Twenty-seventh Report - Covid-19: Suppl… Accepted

However, it is important to remember that the challenge did not take place under normal...

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 … Read more

Government response AI summary
Although the committee's item was a conclusion, the government states agreement with a recommendation (which was not present in this item) and outlines a plan to update the Outsourcing Playbook by Spring/Summer 2021 to incorporate ventilator challenge lessons, capture them as a case study for …
Read full response →
HM Treasury
16 Recommendation Twenty-seventh Report - Covid-19: Suppl… Accepted

Nevertheless, there are clearly elements of the challenge which could be applied to future programmes.

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 … Read more

Government response AI summary
The government accepts the recommendation and aims to update the Outsourcing Playbook by Spring/Summer 2021 to incorporate ventilator challenge lessons as a case study for risk training, ensuring these lessons are disseminated to government departments.
Read full response →
HM Treasury
17 Recommendation Twenty-seventh Report - Covid-19: Suppl… Accepted

In any government programme, departments should aim to work collaboratively across government and to involve...

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 … Read more

Government response AI summary
The government agreed and committed to optimising skill development and deployment within the Government Commercial Function, with a target of March 2023 for scaling up capability building and assessment across the wider public sector.
Read full response →
HM Treasury
18 Conclusion Twenty-seventh Report - Covid-19: Suppl… Not Addressed

For example, the Department explained that both the Department for International Trade and the Foreign...

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 … Read more

Government response AI summary
The government stated that most devices were purchased through NHS standard framework agreements with full due diligence checks, without addressing the committee's observations on successful inter-departmental collaboration or effective cost assurance.
Read full response →
HM Treasury
19 Conclusion Twenty-seventh Report - Covid-19: Suppl… Accepted

The Cabinet Office also drew on external expertise where required.

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 … Read more

Government response AI summary
The government agrees with the recommendation (which it interpreted from the conclusion) and commits to optimising skill development and capability building in the commercial space across government, with a target date of March 2023 for achieving scale.
Read full response →
HM Treasury
20 Conclusion Twenty-seventh Report - Covid-19: Suppl… Acknowledged

From the outset, Cabinet Office’s strategy was to support a number of both new and...

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. … Read more

Government response AI summary
The government agreed, stating it owns viable emergency ventilator designs with standard licensing terms (though no revenue generated yet), and has developed and shared a document on lessons learned from the Ventilator Challenge.
Read full response →
HM Treasury
21 Conclusion Twenty-seventh Report - Covid-19: Suppl… Acknowledged

In total the Cabinet financed 18 devices from 17 challenge participants over the course of...

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 … Read more

Government response AI summary
The government agreed, stating it owns viable emergency ventilator designs with standard licensing terms (though no revenue generated yet), and has developed and shared a document on lessons learned from the Ventilator Challenge.
Read full response →
HM Treasury
22 Recommendation Twenty-seventh Report - Covid-19: Suppl… Accepted

Designs are a type of intellectual property (IP), which if protected, can provide value for...

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 … Read more

Government response AI summary
The government accepts the recommendation, stating it owns ventilator designs and has standard licensing terms, although this has not yet generated revenue. It has also developed and shared a document outlining key innovation lessons from the challenge.
Read full response →
HM Treasury

Oral evidence sessions

1 session
Date Witnesses
12 Oct 2020 Alex Chisholm · Cabinet Office, David Williams · Daily Mail, Emily Lawson · NHS England and NHS Improvement, Gareth Rhys Williams · Crown Commercial Service, Sir Chris Wormald · Department of Health and Social Care View ↗

Who gave evidence

5 witnesses
WitnessOrganisationSessions
Alex Chisholm · Chief Operating Officer Civil Service and Permane… Cabinet Office 1
David Williams · Journalist Daily Mail 1
Emily Lawson · Chief Commercial Officer NHS England and NHS Improvement 1
Gareth Rhys Williams · Government Chief Commercial Officer and Non-Execu… Crown Commercial Service 1
Sir Chris Wormald · Permanent Secretary Department of Health and Social Care 1

Correspondence

1 letter
DateDirectionTitle
16 Mar 2021 Correspondence from Alex Chisholm, Civil Service Chief Operating Officer and Ca…