Readying the NHS and social care for the COVID-19 peak

Public Accounts Committee Closed Inquiry
Opened: 4 Jun 2020 Closed: 2 Dec 2020 Parliament page
On Monday 22 June, in the next of our new series of work on NAO reports into the Government’s response to the Covid-19 pandemic, we will question the Permanent Secretary and Finance Director at the Department for Health and Social Care; the Chief Executive of the NHS; NHS England; Public … Read more
1 Recommendation
25 Conclusions
1 Report
1 Oral session
2 Letters
1 Event
Activity timeline 6 events
18 Nov
2020
Report published
16 Oct
2020
Correspondence
29 Jul
2020
Report published
21 Jul
2020
Correspondence
22 Jun
2020
Oral evidence
22 Jun
2020
Formal meeting (oral evidence session) · The Wilson Room, Portcullis House
Oral evidence sessions 1 session
22 Jun 2020
View on parliament.uk
Reading the NHS and social care for the COVID-19 peak
Amanda Pritchard · NHS England Catherine Frances · Department for Levelling Up, Housing and Communities Professor Paul Johnstone · Public Health England Rosamond Roughton · Department for Health and Social Care Sir Chris Wormald · Department of Health and Social Care Sir Simon Stevens · NHS England and NHS Improvement Steve Powis · NHS England
Title HC No. Published Items Response
Fourteenth Report: Readying the NHS and social care for the COVI… HC 405 29 Jul 2020 26 Responded
Recommendations & Conclusions
26 results
2 Recommendation
Fourteenth Report: Readying the NH…
Discharging patients from hospital into social care without first testing them for COVID-19 was an...
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 … Read more
HM Treasury
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3 Conclusion
Fourteenth Report: Readying the NH…
This pandemic has shown the tragic impact of delaying much needed social care reform, 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, … Read more
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 … Read more
HM Treasury
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4 Conclusion
Fourteenth Report: Readying the NH…
Public confidence is likely to be further undermined without an open and honest debate about...
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 … Read more
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 … Read more
HM Treasury
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5 Conclusion
Fourteenth Report: Readying the NH…
Staff in health and social care cannot be expected to be ready to cope with...
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 … Read more
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 … Read more
HM Treasury
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6 Conclusion
Fourteenth Report: Readying the NH…
Policies designed to create additional capacity quickly, while necessary, have resulted in a lack of...
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 … Read more
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 … Read more
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1 Conclusion
Fourteenth Report: Readying the NH…
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 & Social Care (the Department), NHS England & NHS Improvement (NHSE&I), the Ministry of Housing, Communities & Local Government (the … Read more
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. … Read more
HM Treasury
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7 Conclusion
Fourteenth Report: Readying the NH…
There have been serious and widespread concerns about the lack of timely testing for both...
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 … Read more
HM Treasury
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8 Conclusion
Fourteenth Report: Readying the NH…
Similarly, procuring and distributing PPE involved a range of bodies, including the Department, Public Health...
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 … Read more
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9 Conclusion
Fourteenth Report: Readying the NH…
On 17 March the NHS told trusts to discharge urgently all medically fit hospital patients...
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 … Read more
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 … Read more
HM Treasury
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10 Conclusion
Fourteenth Report: Readying the NH…
Some organisations such as Care England highlighted to us the flawed nature of this policy...
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 … Read more
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
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11 Conclusion
Fourteenth Report: Readying the NH…
We remained concerned that the Department had continued its policy of discharging people untested into...
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 … Read more
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
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12 Conclusion
Fourteenth Report: Readying the NH…
This Committee has warned before that the Department lacked an effective overall strategy or plan...
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 … Read more
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
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13 Conclusion
Fourteenth Report: Readying the NH…
We heard how frequently social care had taken second place to the NHS’s needs, particularly...
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 … Read more
HM Treasury
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14 Conclusion
Fourteenth Report: Readying the NH…
This Committee has also challenged the Department before over not delivering on its overarching responsibilities...
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 … Read more
HM Treasury
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15 Conclusion
Fourteenth Report: Readying the NH…
The Department stressed that it had to respond quickly to the COVID-19 pandemic often with...
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 … Read more
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 … Read more
HM Treasury
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16 Conclusion
Fourteenth Report: Readying the NH…
By comparison, because testing capacity was limited during the earlier stages of the pandemic, the...
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 … Read more
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 … Read more
HM Treasury
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17 Conclusion
Fourteenth Report: Readying the NH…
Concerns about the transparency of Government’s reporting about the measures it has taken, particularly around...
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 … Read more
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 … Read more
HM Treasury
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18 Conclusion
Fourteenth Report: Readying the NH…
Testing for COVID-19 is fundamental to controlling the virus, and to informing and reassuring the...
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 … Read more
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 … Read more
HM Treasury
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19 Conclusion
Fourteenth Report: Readying the NH…
We were keen to know how the Department would ensure sufficient stockpiles of PPE 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 … Read more
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 … Read more
HM Treasury
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20 Conclusion
Fourteenth Report: Readying the NH…
NHSE&I explained that the NHS was carrying 100,000 staff vacancies going into the pandemic.58 It...
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, … Read more
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, … Read more
HM Treasury
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21 Conclusion
Fourteenth Report: Readying the NH…
There have been numerous media reports of PPE shortages for health and social care staff...
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 … Read more
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 … Read more
HM Treasury
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22 Conclusion
Fourteenth Report: Readying the NH…
Testing for NHS workers (with symptoms) only began from 27 March, with eligibility extended to...
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 … Read more
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 … Read more
HM Treasury
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23 Conclusion
Fourteenth Report: Readying the NH…
We were concerned about the NHS needing to call on the same staff who have...
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 … Read more
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, … Read more
HM Treasury
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24 Conclusion
Fourteenth Report: Readying the NH…
Under its reasonable worst-case scenario, the Government expected over 4% of the population might require...
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 … Read more
HM Treasury
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25 Conclusion
Fourteenth Report: Readying the NH…
Between mid-March and mid-April, the NHS and armed forces are to be commended for increasing...
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 … Read more
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26 Conclusion
Fourteenth Report: Readying the NH…
Access to NHS services has reduced significantly during the COVID crisis, potentially creating huge pent-up...
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 … Read more
HM Treasury
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Correspondence 2 letters
16 Oct 2020 Correspondence from Julian Kelly, NHS Chief Financial Officer, re Readying the NHS and social care for COVID-19, dated 18 September 2020
Parliament page
21 Jul 2020 Correspondence from Public Health England in relation to the Committee's inquiry Readying the NHS and social care for the COVID-19 peak, dated 2 July 2020
Parliament page