Source · Select Committees · Public Accounts Committee
Recommendation 5
5
Government would have been better prepared for COVID-19 if it had applied learning from previous...
Conclusion
Government would have been better prepared for COVID-19 if it had applied learning from previous incidents and exercises. Government was unprepared for a pandemic with widespread asymptomatic transmission, but this was not unprecedented. The early spread of HIV, too, was partly caused by the fact that it was an asymptomatic condition that could take months before being diagnosed. While government took action following major simulation exercises such as Cygnus and Winter Willow, it did not act upon exercises Valverde, relating to novel coronavirus, and Alice, relating to Middle East respiratory syndrome (MERS). This resulted in a lot of PPE in the Governments strategic stocks which was not suitable for Covid, although the department said it was still able to use “a huge amount of it”. We are not convinced that government has learnt lessons from its lack of planning. For instance, it is unclear whether government would be able to reinstate the Coronavirus Jobs Retention Scheme at short notice without the implementation issues incurred when the scheme was first introduced. Recommendation: The Cabinet Office should set up a cross-government process to capture learning for emergency preparedness and resilience from exercises and actual incidents, including COVID-19, and to allocate clear accountabilities for applying learning. It should report annually on the implementation of each learning point.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. and the government has done extensive work to model a range of scenarios to better understand the levels of ‘bounce-back’ demand. Modelling estimates that there could be over 7 million patients who did not come forward for treatment so far during the pandemic, a significant proportion of whom may do so in the coming years. A number of tools have been made available to regions and systems to support the development of robust activity plans for the remainder of this year, as part of the formal activity planning process for the period. Since September 2020, NHSE&I have published analysis on the recovery of urgent cancer referrals and first treatments by age, sex, ethnicity, and deprivation. Support has been provided to address variation in a number of areas such as establishing regional and national cancer teams, collaborative work with Getting It Right First Time (GIRFT), a national programme designed to improve the treatment and care of patients through in-depth review of services, benchmarking, and presenting a data-driven evidence base to support change. Improvements across the NHS in planning and delivery of all services, such as addressing the 104+ week waiters are a key priority along with minimising urgent cancer backlogs. 6: PAC conclusion: For the next few years it is likely that waiting time performance for cancer and elective care will remain poor and the waiting list for elective care will continue to grow. 6a: PAC recommendation: The Department and NHSE&I must be realistic and transparent about what the NHS can achieve with the resources it has and the trade- offs that are needed to reduce waiting lists. In implementing its elective recovery plan, NHSE&I should set out clearly what patients can realistically expect in terms of waiting times for elective and cancer treatment. 6.1 The government agrees with the Committee’s recommendation. 6.2 The government has been clear that the overall NHS waiting list is likely to worsen prior to improvements and service recovery. 6.3 As set out in the response to recommendation 2, NHS England also published the Elective Recovery Plan in February 2022. This plan sets out a clear vision for how the NHS will recover and expand elective and cancer services over the next three years, and what patients can expect. There are also clear goals and objectives set on prioritisation within the Recovery Plan. This allows better understanding of future demand, with further updates to be provided later in the year. 6.4 All of the above however, is subject to demand and capacity levels similar to pre-covid, whilst also maintaining low levels of Covid across the NHS. 6b: PAC recommendation: By the time of the next Spending Review at the latest, the Department and NHSE&I should have a fully costed plan to enable legally binding elective and cancer care performance standards to be met once more. 6.5 The government agrees with the Committee’s recommendation. 6.6 The Elective Recovery Plan sets out goals for this Spending Review period to use the current funding settlement to maximise elective performance. 6.7 However, as referenced in the response to recommendation 2, there remains both short-term and long-term uncertainty around capacity and demand because of the pandemic and its impact. Ahead of the next Spending Review settlement process, the department will work closely with NHSE&I and other stakeholders to develop funding proposals for the next SR period to be submitted to HM Treasury, using the latest data available at the time. billion of UK trade in 2020.1 The Department for International Trade (the Department) has overall responsibility for convening these trade negotiations, while other departments provide expertise, lead aspects of the negotiations in their policy areas and provide diplomatic support overseas. For example, the Department for Environment, Food & Rural Affairs (Defra) leads on aspects of the negotiations covering agri-food, sanitary and phytosanitary and animal welfare. The Department is not responsible for the UK’s trade negotiations with the EU which were led by the Cabinet Office until December 2021 when responsibilities transferred to the Foreign, Commonwealth and Development Office (FCDO). Based on a report by the National Audit Office, the Committee took evidence on the 19 January 2022 from the Department for International Trade, The Department for Environment, Food and Rural Affairs and the Cabinet Office. The Committee published its report on the 18 March 2022. This is the government’s response to the Committee’s report. Relevant reports • NAO report: Progress with trade negotiations – Session 2021-22 (HC 862) • PAC report: Progress with trade negotiations – Session 2021-22 (HC 993) Government response to the Committee 1: PAC conclusion: The Department for International Trade faces significant challenges in meeting its target for 80% of UK trade to be covered by FTAs by the end of 2022. 1