UK COVID-19 Inquiry

The UK government and devolved administrations should ensure, within 12 months of the publication of this Report, that the pandemic stockpiles:

retain stock that is better aligned with the range and severity of pandemic risks identified in the National Security Risk Assessment;
maintain a minimum three-month supply of PPE for the entire health and social care system in the UK;
retain close-to-zero tolerance for expired stock;
better reflect the composition of the UK’s health and social care workforce, aligned with fit-testing and other sizing requirements;
maintain a simple and streamlined system of management and oversight; and
are stored in a wide range of accessible locations.

To demonstrate continued compliance with the above, inspection reports should be submitted to health and social care ministers at least annually. Any issues identified should be resolved within three months.

The inspection reports should be published with the preparedness and resilience reports (Module 1, Recommendation 8).

The UK government, Scottish Government, Welsh Government and Northern Ireland Executive, within 12 months of the publication of this Report, should each have ready systems for the emergency procurement and distribution of healthcare equipment.

These new systems must:

integrate procurement and distribution;
have the ability rapidly to scale up efficient operations, including through integrated emergency procurement teams and automating the triaging and processing of offers of supply; and
be able to use market research, modelling and price benchmarking to ensure value for money.

The UK government and devolved administrations should publish simplified regulations for emergency healthcare equipment that are aligned with and cover the range and severity of pandemic risks identified in the National Security Risk Assessment.

The simplified regulations should:

establish the minimum technical specifications of healthcare equipment specifically for use in a pandemic, including international standards that are recognised in the UK;
clearly identify the regulator responsible for coordinating regulation, inspection and enforcement for each type of equipment; and
be accompanied by a buyer’s guide that is easily understood by procurement officials, suppliers and end-users in the health and social care sectors.

The emergency healthcare equipment regulations and the buyer’s guide should be kept under review and updated in line with relevant changes to the National Security Risk Assessment.

UK regulators, including the Health and Safety Executive, the Health and Safety Executive for Northern Ireland, the Office for Product Safety and Standards and the Medicines and Healthcare products Regulatory Agency, should establish an emergency healthcare equipment cross-regulator plan for future pandemics.

The plan must include arrangements for:

coordination of written guidance from regulators to ensure that it is clear, concise and updated when required; and
increasing testing house capacity and the deployment of suitable inspection regimes both to reduce the quantity of non-compliant equipment entering the system and to improve enforcement.

The UK government and devolved administrations should jointly commission a group of experts to develop blueprints for rapidly scalable critical care medical technology, aligned with the range and severity of pandemic risks identified in the National Security Risk Assessment, within 12 months of the publication of this Report.

The blueprints should be issued in accordance with the emergency healthcare equipment regulations and buyer’s guide (see Recommendation 4 of this Report) and regularly reviewed to ensure that they reflect technological advances.

The UK-wide whole-system civil emergency strategy, which the Inquiry has recommended should be developed by the UK government and devolved administrations (see the Inquiry’s Module 1 Report, Recommendation 4), should include specific objectives for international trade and domestic industry during a pandemic.

These must include:

the establishment of trading alliances in advance of the next pandemic, to diversify overseas sources of raw materials and healthcare equipment;
contractual arrangements with domestic and international suppliers of raw materials and healthcare equipment manufacturers which activate when a pandemic is declared;
a robust plan to enable domestic manufacturers rapidly to retool and repurpose facilities for the production of healthcare equipment; and
supporting investment for research and development into advanced manufacturing of healthcare equipment in the UK.

The UK government and devolved administrations should each establish a pool of officials who are trained in the emergency procurement and distribution of healthcare equipment.

Completion of the training should be mandatory for at least 20% of the workforce of each nation’s central healthcare equipment procurement bodies and kept up to date through annual refresher courses.

The UK government and devolved administrations should collaborate to establish a UK-wide commercial framework agreement of pre-approved external specialists in the emergency procurement and distribution of healthcare equipment.

The framework should be refreshed every three years.

The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should improve transparency, governance and accountability for procurement in an emergency.

As a minimum, these improvements should include the following:

Enhancing transparency

Any central digital platform used for procurement must allow for the automated collation of contract information and must reduce the administrative burden involved in publishing contract information.
Contracting authorities across the UK should be required to publish contract award notices (in Scotland) and contract details notices in addition to contract award notices (in England, Wales and Northern Ireland) irrespective of the country in which the supplier is based.

Governance: Fairness in emergency procurement

There should be no high priority lane.
All offers to supply healthcare equipment during a pandemic should be assessed according to the application of objective criteria.

Accountability: Approval process for emergency spending on healthcare equipment

In advance of a pandemic, each health and social care department in each government should agree, with their respective treasuries or finance departments, a process to scrutinise and approve emergency spending on healthcare equipment to ensure that there is a balance between accountability and timely spending decisions.

Within three years of the publication of this Report, the systems for the procurement and distribution of healthcare equipment should be digitalised and interoperable across the UK government and devolved administrations.

As a minimum, these systems should be able to use technology to collect, share and analyse data across the UK in real time on:

pandemic stockpiles, health and social care sector inventories and usage rates;
offers of supply, enabling automated comparison, triaging and processing;
non-compliant healthcare equipment entering the market;
supply chains, including international delivery times and domestic logistics and distribution data;
procurement and distribution workforce capacity; and
spending – automatically identifying, collecting and collating key contract data for publication.