Fourteenth Report: Readying the NHS and social care for the COVID-19 peak

Select Committee

Public Accounts Committee HC 405 29 July 2020

Report Status Government responded

Conclusions & Recommendations 26 items (6 recs)

Source View on Parliament website

Government Response (AI assessment · 24 of 26 classified)

Accepted 11

Accepted in Part 1

Acknowledged 6

Deferred 1

Not Addressed 5

Government response

Treasury minutes: Government response to the Committee of Public Accounts on the Fourteenth report from Session 2019-21 · published 18 Nov 2020

Read the government response ↗ Response on the tracker

Recommendations & Conclusions

11 results

4 Recommendation Accepted

Public confidence is likely to be further undermined without an open and honest debate about...

Recommendation

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 Summary

The government agreed with the recommendation, stating it has secured sufficient PPE for winter, building four-month stockpiles, and has significantly increased daily COVID-19 testing capacity to over 500,000 by October 2020.

HM Treasury

View Details

5 Recommendation Accepted

Staff in health and social care cannot be expected to be ready to cope with...

Recommendation

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 Summary

The government agrees with the recommendation and states it has implemented several measures, including publishing wellbeing guidance for social care, supporting "Our Frontline", and launching the NHS People Plan 2020-21 which focuses on staff recovery and was developed with professional bodies. Existing NHS COVID-19 support programs offering 1:1 support, apps, and helplines are also mentioned.

HM Treasury

View Details

7 Conclusion Accepted

There have been serious and widespread concerns about the lack of timely testing for both...

Conclusion

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

Government Response Summary

The government agrees with the committee's observation and states it has secured enough PPE for winter 2020-21, strengthened supply chains, and built stockpiles. It also significantly increased daily COVID-19 testing capacity to over 500,000 by October 2020 through lab expansion and new technologies.

HM Treasury

View Details

8 Conclusion Accepted

Similarly, procuring and distributing PPE involved a range of bodies, including the Department, Public Health...

Conclusion

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

Government Response Summary

The government states the recommendation has been implemented, having regularly reviewed leadership structures during the pandemic and clarified Senior Responsible Officers for various workstreams of the COVID-19 Battle Plan.

HM Treasury

View Details

9 Conclusion Accepted

On 17 March the NHS told trusts to discharge urgently all medically fit hospital patients...

Conclusion

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 Summary

The government agrees with the committee's implicit recommendation regarding patient discharge safety, despite disagreeing with the committee's historical conclusion. It states that since April and September 2020, all individuals are required to be tested prior to discharge to a care home, and no provider can be forced to admit residents if they cannot cope safely. The SAGE Care Homes Working Group will keep evidence on discharge under review.

HM Treasury

View Details

16 Conclusion Accepted

By comparison, because testing capacity was limited during the earlier stages of the pandemic, the...

Conclusion

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 Summary

The government states that it has significantly increased UK daily swab test capacity to over 500,000 by October 2020 through various measures like expanding labs and introducing new technologies.

HM Treasury

View Details

17 Conclusion Accepted

Concerns about the transparency of Government’s reporting about the measures it has taken, particularly around...

Conclusion

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 Summary

The government states it is confident in its PPE supply for winter 2020-21, having strengthened and diversified supply chains, ordered over 32 billion items, and built stockpiles. It has also established a distribution system, including expanding the PPE portal for social and primary care, to ensure access.

HM Treasury

View Details

18 Conclusion Accepted

Testing for COVID-19 is fundamental to controlling the virus, and to informing and reassuring the...

Conclusion

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 Summary

The government states it has significantly increased UK daily swab test capacity from 2,000 in March 2020 to over 500,000 by October 2020, through lab expansion, new partnerships, additional staff, and cutting-edge technologies.

HM Treasury

View Details

21 Conclusion Accepted

There have been numerous media reports of PPE shortages for health and social care staff...

Conclusion

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 Summary

The government expresses confidence in having secured sufficient PPE for winter 2020-21, detailing strengthened and diversified supply chains, 32 billion items ordered, and the establishment of a robust distribution system including an expanded PPE portal for social and primary care.

HM Treasury

View Details

22 Conclusion Accepted

Testing for NHS workers (with symptoms) only began from 27 March, with eligibility extended to...

Conclusion

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 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 a maximum of five symptomatic residents in each care home would be tested, and from the 28th April all symptomatic care home residents were offered testing but this was capped at 30,000 tests per day between residents and staff. From 28 April, all social care workers were eligible for tests, but the Department capped the daily amount of care home tests at 30,000 (to be shared between 54 Qq 51–52, 56–57, 78–79 55 Qq 25, 27 56 Qq 49–50; Public Health England letter from Professor Paul Johnstone to PAC Chair, 2 July 2020 57 Qq 76, 78, 79 58 Q 109 59 Qq 5, 94 60 Qq 96–97 61 Qq 21,23, 26–27; Committee of Public Accounts, NHS capital expenditure and financial management, Eighth Report of Session 2019–21, HC 344, 8 July 2020; RSC0010 NHS Confederation submission; RSC0001 Care England submission; RSC0002 Local Government Association submission; RSC0004 NHS Providers submission 62 C&AG’s Report, para 4.28 16 Readying the NHS and social care for the COVID-19 peak staff and residents).63 Stakeholders told us that failures in testing had also led to increased anxiety and frustration as well as increased absence due to unnecessary isolation. For example, the NHS Confederation told us that the NHS had had an unprecedented level of absence during the first weeks of April.64 When asked about testing staff, the Department said it had made this available in care homes as capacity increased and there were now around 70,000 tests a day available to all care home staff as well as residents. NHSE&I told us it had now started testing asymptomatic staff and referenced Public Health England’s large-scale study testing staff to see if they had COVID-19 now, or had previously had it, which would provide more information on how and when it was best to test.65 Show less

Government Response Summary

The government states it will continue to grow testing capacity and resilience, having already increased UK daily swab test capacity from 2,000 in March to over 500,000 by October 2020 through lab expansion, new partnerships, additional staff, and new technologies.

HM Treasury

View Details

23 Conclusion Accepted

We were concerned about the NHS needing to call on the same staff who have...

Conclusion

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 Summary

The government states that the NHS People Plan for 2020-21, published in July 2020, outlines actions by NHS England, Health Education England, and NHS employers to support staff recovery from the pandemic's first peak and ensure their well-being.

HM Treasury

View Details