Twenty-seventh Report - Covid-19: Supply of ventilators

Select Committee
Public Accounts Committee HC 685 25 November 2020
Report Status Government responded
Conclusions & Recommendations 22 items (10 recs)
Government Response (AI assessment · 22 of 22 classified)
Government response
Treasury minutes: Government response to the Committee of Public Accounts on the Twenty seventh report from Session 2019-21 · published 25 Mar 2021

Recommendations & Conclusions

22 results
2 Recommendation Not Addressed
It is not clear how the Department of Health and Social Care is assessing whether...
Recommendation
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 … Read more
Government Response 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 equipment needs or confirm it has written to the committee as requested.
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3 Recommendation Acknowledged
Despite having to operate at speed, the Department of Health and Social Care still had...
Recommendation
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 … Read more
Government Response 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.
HM Treasury
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4 Recommendation Not Addressed
The ventilator challenge was an exceptional and far from traditional approach that offers some lessons...
Recommendation
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 … Read more
Government Response 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.
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5 Recommendation Accepted
Both programmes succeeded in part due to cross-government working and the expertise of key individuals...
Recommendation
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 … Read more
Government Response 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.
HM Treasury
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6 Recommendation Accepted
The ventilator challenge produced intellectual property that should be exploited to maximise value for the...
Recommendation
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 … Read more
Government Response 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.
HM Treasury
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1 Conclusion Not Addressed
On the basis of a report by the Comptroller and Auditor General, we took evidence...
Conclusion
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 … Read more
Government Response 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.
HM Treasury
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7 Conclusion Deferred
When we challenged the Department on why it did not begin its initial efforts to...
Conclusion
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 … Read more
Government Response 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.
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8 Conclusion Accepted
From February to April, NHSE&I’s estimate of how many mechanical ventilators the NHS would need...
Conclusion
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 … Read more
Government Response 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.
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9 Conclusion Accepted
However, when the programmes began in early-March, departments were looking at a potential need of...
Conclusion
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 … Read more
Government Response 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 stock for the NHS.
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10 Recommendation Accepted
It is fortunate that the majority of the ventilators were not needed and that there...
Recommendation
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 … Read more
Government Response 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.
HM Treasury
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11 Conclusion Not Addressed
From 3 March, in response to the anticipated shortage of ventilators, the Department began to...
Conclusion
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 … Read more
Government Response 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.
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12 Conclusion Not Addressed
From 13 March the Department, therefore, stepped up its efforts to purchase ventilators directly from...
Conclusion
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 … Read more
Government Response 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.
HM Treasury
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13 Recommendation Accepted
We recognise that given the circumstances the Department had to move quickly.
Recommendation
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 … Read more
Government Response 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 scanning, reaffirming its commitment to high ethical standards and combating modern slavery.
HM Treasury
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14 Conclusion Accepted
The Cabinet Office’s ventilator challenge, which encouraged UK businesses to develop new ventilators from scratch...
Conclusion
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 … Read more
Government Response 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.
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15 Conclusion Accepted
However, it is important to remember that the challenge did not take place under normal...
Conclusion
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 … Read more
Government Response 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 training, and disseminate them through knowledge sharing sessions.
HM Treasury
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16 Recommendation Accepted
Nevertheless, there are clearly elements of the challenge which could be applied to future programmes.
Recommendation
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 … Read more
Government Response 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.
HM Treasury
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17 Recommendation Accepted
In any government programme, departments should aim to work collaboratively across government and to involve...
Recommendation
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, … Read more
Government Response 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.
HM Treasury
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18 Conclusion Not Addressed
For example, the Department explained that both the Department for International Trade and the Foreign...
Conclusion
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 … Read more
Government Response 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.
HM Treasury
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19 Conclusion Accepted
The Cabinet Office also drew on external expertise where required.
Conclusion
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 … Read more
Government Response 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.
HM Treasury
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20 Conclusion Acknowledged
From the outset, Cabinet Office’s strategy was to support a number of both new and...
Conclusion
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 … Read more
Government Response 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.
HM Treasury
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21 Conclusion Acknowledged
In total the Cabinet financed 18 devices from 17 challenge participants over the course of...
Conclusion
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 … Read more
Government Response 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.
HM Treasury
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22 Recommendation Accepted
Designs are a type of intellectual property (IP), which if protected, can provide value for...
Recommendation
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 … Read more
Government Response 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.
HM Treasury
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