COVID-19 Inquiry: List of Issues

The basic characteristics and epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) and Coronavirus disease (COVID-19). (a) Pathogens: i. History of infectious disease pandemics/epidemics in the UK and factors relevant to their impact. ii. High Consequence Infectious Diseases (HCID). iii. Zoonotic pathogens. iv. Influenza virus; types and outline of previous flu pandemics/epidemics. v. Coronaviruses: general characteristics; 2002/2003 SARS CoV-1 China; 2012 MERS Saudi Arabia; 2015 MERS South Korea; the discovery of other novel coronaviruses: locations, emergence, transmission and control. vi. Other major pathogens of concern. (b) Characteristics of SARS CoV-2: i. Virology. ii. Background to its emergence in 2019. iii. Epidemiology: transmission, incubation period and severity. iv. Early development of epidemiology. v. Differences between SARS CoV-2 and other viruses, including influenza. vi. Reproductive number (R0). vii. Probability of mutation and the effects of any mutations.

UK Government and devolved administrations structures and specialist bodies concerned with risk management and civil emergency planning, and their adequacy; historical changes to such structures and bodies as well as the structures in place as at January 2020; inter-organisational processes and cooperation. (a) History of the structures and specialist bodies concerned with risk management and civil emergency planning. (b) The Civil Contingencies Act 2004 and the associated framework in England, Wales, Scotland and Northern Ireland. (c) Pandemic preparedness bodies and structures. (d) Scientific Advisory Group on Emergencies (SAGE) and other scientific and advisory bodies and groups, their membership and diversity of expertise. (e) Funding of risk management and civil emergency structures. (f) The identification of Emergency Preparedness, Resilience and Response (‘EPRR’) as an expert specialism; capabilities within government and training. (g) Allocation of responsibility for EPRR between government departments, including at Ministerial level. (h) Did all key government departments have an effective system for receiving a range of internal advice in relevant expert disciplines? (i) Did the systems and culture of government properly allow for external advice and thinking? (j) To what extent were there adequate networks and links between government and wider civil society, including the private and voluntary sectors? (k) Did the UK government, the devolved administrations and local government have in place suitable risk management and resilience systems for a non-influenza pandemic, such as a coronavirus pandemic? (l) Did the specialist structures concerned with risk management and civil emergency planning allow for proper consideration of societal, economic and health impacts in light of pre-existing inequalities? (m) What are the lessons which have been learnt in respect of the preparedness and resilience structures in the UK and in the devolved administrations? (n) What was the extent of the UK’s data readiness, including the adequacy of national data governance structures, digital and data infrastructure, data availability and quality, analytical capability and skills? (o) To what extent were there adequate systems for information and data sharing in civil emergencies between: local government and both the UK Government and devolved administrations; between Northern Ireland and the Republic of Ireland; and the international community?

The planning for a pandemic, including forecasting, resources, and the learning from past simulation exercises (including coronaviruses, new and emerging high-consequence infectious diseases and influenza pandemic/epidemic exercises); the emergency plans that were in place; international comparisons and the history of, and learning from, past policy-related investigations. (a) Were pandemic plans clear, resilient, adaptable and effective? (b) The UK Government’s approach to risk assessment, including the systems and processes concerning the National Risk Assessment (NRA) and National Security Risk Assessment (NSRA) (including the National Resilience Planning Assumptions) and the public-facing National Risk Register (NRR). (c) The approaches of the Welsh Government, the Scottish Government and the Northern Ireland Executive to risk assessment, risk registers and relevant policies. (d) Was the system of subsidiarity effective in relation to risk assessment and emergency planning? (e) To what extent was the national pandemic planning overly focused on a novel influenza virus pandemic and/or insufficiently focused on a ‘disease X’ scenario? To what extent did the UK Government and devolved administrations plan for a coronavirus pandemic? (f) Learning lessons from past high consequence infectious diseases, epidemics and pandemics in the UK and overseas as well as simulation exercises and training conducted across the UK. In particular: i. What lessons were learnt from past high consequence infectious diseases, epidemics and pandemics in the UK and overseas and to what extent were they acted upon, including SARS, MERS and the 2009-2010 Swine Flu pandemic? ii. To what extent were simulation exercises adequate in terms of scope, frequency and those responders invited to participate? iii. To what extent were pre-existing inequalities considered? iv. To what extent were lessons acted upon and incorporated into pandemic planning? (g) To what extent was the level of UK emergency planning and preparedness for a pandemic impacted by the decision to exit the EU? (h) To what extent was the level of Northern Ireland emergency planning and preparedness for a pandemic impacted by the collapses of the power sharing agreement? (i) To what extent did the UK Government and devolved administrations engage sufficiently with external professional bodies in the development of national pandemic policy, planning and guidance. (j) Was there sufficient consultation and training in respect of the draft Pandemic Flu Bill? (k) What provisions were in place to ensure effective surge diagnostic testing capacity and capabilities in terms of: clinical testing and mass public testing? (l) Did the pandemic planning include adequate consideration of border and port controls or restrictions on international travel? (m) How did the UK Government and the devolved administrations assess and define pre-existing inequalities and vulnerabilities of different groups in the UK? (n) To what extent were pre-existing inequalities and vulnerabilities considered and accounted for as part of the UK Government’s, and regional, local and devolved administrations’, risk assessment processes? (o) To what extent were pre-existing inequalities and vulnerabilities considered and accounted for as part of the UK Government’s, and regional, local and devolved administrations’, emergency planning procedures? (p) To what extent did those involved with emergency planning engage sufficiently with the voluntary and community sectors in developing and communicating emergency plans?

Public health services, including the structure of national, regional and local public health bodies, their development over time and readiness; public health capacity, resources and levels of funding; any impact arising from the UK’s departure from the European Union; the way in which relevant bodies monitored and communicated about emerging disease. (a) The history and pre-pandemic structure of the public health bodies of the UK and devolved nations, including public laboratories. (b) To what extent, if at all, did changes in those structures affect the UK’s state of pandemic readiness and preparedness? (c) In practice, what was the state of pandemic readiness and preparedness of the UK’s public health bodies, in particular was there adequate surge capacity in terms of resources and personnel? (d) Were pandemic plans for the public health sector clear, resilient, adaptable and effective? (e) Did the UK and devolved public health bodies plan adequately for a novel high- consequence infectious disease pandemic? (f) To what extent did the levels of resources and funding of public health bodies affect their state of readiness and preparedness for a pandemic? (g) To what extent did preparations for exit from the EU impact on pandemic preparations and the readiness in practice of public health bodies? (h) What was the state of preparedness of the availability of PPE and clinical countermeasures, including by way of stockpiling and surge capacity? (i) What was the state of preparedness of surveillance, microbiology and research services? (j) To what extent were pre-existing inequalities and vulnerabilities considered and accounted for by public health bodies as part of their pandemic planning? (k) To what extent were there adequate systems for the standardisation of data concerning infections, fatalities and casualties across the UK?

Economic planning by relevant Government bodies, including capacity and spending commitments, and efficiency and anti-fraud controls, in the context of emergency planning. (a) To what extent was funding ring-fenced for civil contingencies within the UK Government and devolved administrations? (b) How, and to what extent, were the specific economic and fiscal consequences of a new and emerging infectious disease pandemic considered by the UK Government and devolved administrations in the context of emergency planning? (c) To what extent did UK Government departments and devolved administrations have regard to the need for anti-fraud provisions as part of their emergency planning? (d) To what extent did pandemic planning have regard to the economic consequences of a pandemic and the UK Government and devolved administration's response?

Planning for future pandemics; international surveillance and alert systems; the risks of new variants of Covid 19 and other viruses of concern including of a zoonotic origin. (a) What are the current surveillance, alert and response systems of international structures in respect of pandemics? (b) What are the current surveillance and alert systems in the UK in respect of pandemics? (c) What are the risks of new variants of concern relating to SARS CoV-2? (d) What are the risks of a pandemic affecting the UK in the foreseeable future? (e) What recommendations can be made, at this stage, in relation to the issues above?

The central government structures and bodies concerned with the UK response to the pandemic and their relationships and communications with the devolved administrations in Scotland, Wales and Northern Ireland and regional and local authorities. a. General nature of UK Government structures and core decision-making i. What were the central UK Government structures and bodies involved in the core decision-making and management of the UK response to Covid-19 in January 2020? Particular consideration will be given to the role of the Prime Minister, the Cabinet, COBR, Cabinet sub-committees, Ministerial groups, the Ministerial ‘quad’ committee, and to their links with SAGE, other expert advisory groups, senior civil servants, special advisers, the Department for Health and Social Care, NHS England and Public Health England. ii. How did the role of these structures and bodies develop between January 2020 and February 2022? What were the reasons for those developments? iii. Did the UK central government structure for dealing with emergencies enable key decisions to be taken efficiently and speedily? iv. Did the UK central government structures and processes at Prime Minister, Cabinet, Cabinet Office and Ministerial levels work effectively? Who made the key strategic decisions? v. Was there adequate access to clear and sustainable advice and relevant expertise generally? vi. Were key decisions taken in a timely way and after a proper process of advice/consultation? vii. Did decision-makers follow advice from SAGE and other relevant advisory groups when key decisions were taken? If not, what were their reasons for rejecting that advice and was this properly documented? viii. To what extent did informal communication (such as WhatsApp messaging) contribute to key strategic decision-making? Were the mechanisms and safeguards for considering and recording key decisions adequate or appropriate? ix. Was the SAGE structure appropriate for dealing with a pandemic of this nature? x. Did the composition and diversity of SAGE and its sub-groups sufficiently reflect experience from past epidemics and outbreak management, the experiences of other countries and real-time events, and was the membership of those groups properly revised to meet evolving understanding of the virus? xi. Was the advice from SAGE and its sub-groups transparent, clear and open to challenge both by Ministers and also within the group(s)? xii. What structures and core-decision making processes did the UK Government have and use to consult those it identified as vulnerable and at risk groups? How effective were they? b. How did the UK central government work with the devolved administrations, regional and local authorities? i. How did the UK Government liaise with devolved administrations, regional and local authorities over UK core decision-making between January 2020 and February 2022? ii. Was there proper communication with the devolved administrations and regional and local authorities by the UK Government on its decision-making? iii. Were key decisions taken by the UK Government after a proper process of advice/consultation with the devolved administrations, regional and local authorities?

Access to and use in decision-making of medical and scientific expertise, data collection and modelling relating to the spread of the virus, including the measuring and understanding of transmission, and infection, mutation, re-infection, morbidity and death rates, and long-term sequelae (long Covid); the certificate system and excess mortality; the relationship between and operation of systems for the collection, modelling and dissemination of data between government departments and between the government, the NHS and the care sector. a. What data and modelling did the core decision-makers rely upon? i. What were the key sources of data and modelling information? ii. Did key decision-makers have adequate access to reliable data, statistics and modelling information, including in relation to excess deaths, and on the potential long-term effects and chronic health impacts of Covid-19? iii. To what extent did data collection consider the impact of Covid-19 on vulnerable and at risk groups, in particular in relation to infection and mortality rates based on race/ethnicity and disability? iv. Did the systems for the collection and dissemination of data between UK government departments and between central government, the devolved administrations, the NHS and the care sector work effectively? v. Was there sufficient coordination and communication about data collection, dissemination and analysis between the UK Government and devolved nations? vi. Was the mathematical modelling of epidemiological outcomes sufficiently reliable? Was its purpose and capacity properly understood? vii. To what extent were other factors, such as economic, societal, educational and mental health impacts, modelled? viii. What was the role of the Behavioural Insights Team?

The initial understanding of, and response to, the nature and spread of Covid-19 in light of information received from the World Health Organization and other relevant international and national bodies, advice from scientific, medical and other advisers and the response of other countries. This will include the government’s initial strategies relating to community testing, surveillance, the movement from ‘contain’ to ‘delay’ and guidance and advice to health and social care providers. a. Basic understanding of the virus and the disease i. Methodology for calculating rates of infection, hospitalisation. ii. The UK initially classified Covid-19 as a High Consequences Infectious Disease. When and why was it declassified? b. UK Government core decisions from January 2020 i. Did the UK Government react appropriately to the news of the epidemic in China? ii. Were the essential features of the virus and disease (especially its asymptomatic nature, means of transmission, severity, reinfection rates, antibodies and long-term health impacts) properly understood? What was the timeline for this information being available? iii. Did the UK Government properly appreciate the seriousness of the position concerning the spread of the virus? iv. What regard did the UK Government have to the structures utilised and decisions made in other countries to limit the spread of the virus? v. What initial decisions were taken in relation to the test and trace of infected persons? c. UK Government core decisions from February 2020 i. Did the UK Government appreciate the degree to which the virus was spreading through the UK? ii. What key strategies did the UK Government adopt in response to the spread of the virus? iii. In light of the spread of the virus beyond China, did the UK Government take adequate precautionary measures? iv. What was the concept of ‘herd immunity’? To what extent did it form part of the UK Government’s strategy (for example, as part of a belief that it would prevent a second wave following the lifting of social restrictions)? To what extent was the concept of ‘herd immunity’ founded upon scientific or academic research?

The core decision-making relating to the imposition of UK-wide and, later, England-wide non-pharmaceutical interventions (NPIs), including the national lockdowns in March-July 2020, November-December 2020 and January-April 2021, local and regional restrictions, circuit breakers, working from home, reduction of person to person contact, social-distancing, the use of face-coverings, school closures, and border controls; the timeliness and reasonableness of such NPIs, including the likely effects had decisions to intervene been taken earlier, or differently; the development of the approach to NPIs in light of the understanding of their impact on transmission, infection and death; the identification of at risk and other vulnerable groups and the assessment of the likely impact of the contemplated NPIs on such groups in light of existing inequalities. a. The use of Non-Pharmaceutical Interventions (NPIs) i. How did medical, scientific and economic advice and data, including expertise on the potential impact of the NPIs, inform the UK Government core decision-making in relation to NPIs? ii. Did the UK Government consider in a timely fashion the use of NPIs to limit the spread of the virus? iii. Were appropriate NPIs considered in the period from January to March 2020? iv. Did the UK Government coordinate effectively with the devolved administrations, and regional and local authorities, on the use of NPIs? v. To what extent was it considered that the UK’s border should be closed (ie a general travel ban), and/or that restrictions should be imposed on travel in and out of the four nations? b. March 2020/first lockdown i. Did the UK Government act fast enough to minimise the transmission of Covid-19 prior to the first lockdown, for example, in relation to mass gatherings held in England in early March 2020? ii. Did the UK Government adopt the most appropriate strategy in initially seeking to manage rather than suppress the virus, by ‘flattening the curve’, and by imposing restrictions incrementally? Why did the strategy change? iii. Was a lockdown necessary? iv. Should the decision to impose a lockdown have been taken before 23 March 2020? If so, when? v. Is it possible to say what the likely effects of earlier or different decisions to intervene would have been (the counter-factual position)? vi. To what extent was the closure of schools considered separately from the imposition of a lockdown? c. Events during and after the first lockdown 23 March 2020 (legally in force 26 March) to 4 July 2020 i. Was the first lockdown effective in controlling the transmission of Covid-19 in England? ii. Was the lockdown lifted at the most appropriate time and communicated in the most appropriate way? iii. Should national restrictions of any kind have been maintained after the first lockdown was lifted? iv. What lessons were learned from the first lockdown in terms of the impacts on vulnerable and at risk groups, four-nation working, communication about the virus, and compliance with enforcement laws? v. In what ways did the UK Government seek to promote the opening up of the economy after the lifting of the first lockdown? vi. Were the economic schemes (such as ‘Eat Out to Help Out’) based on scientific advice? Did they contribute to the spread of the virus? To what extent did the government weigh up the risks of such schemes? d. Local restrictions and UK-divergence i. How effective were the local restrictions that were introduced in England after the first national lockdown? ii. Were the local restrictions and the differences between them the most effective and fairest way to manage the virus? iii. Why did the UK Government take a different approach from the devolved nations following the first national lockdown? e. Second lockdown (5 November 2020 to 2 December 2020) i. Should the UK Government have imposed a ‘circuit breaker’ or other lockdown in mid-September, or thereafter? ii. How effective were the ‘tier’ restrictions that were imposed on 12 October 2020? iii. Was a second national lockdown necessary? iv. Should the decision to impose a lockdown from 5 November 2020 have been taken before 31 October 2020? If so, when? v. Is it possible to say what the likely effects of an earlier decision to lockdown would have been (the counter-factual position). vi. Did the second lockdown achieve its purpose? vii. Was it lifted at the most appropriate time? viii. How effective were the ‘tier’ restrictions that were maintained thereafter? f. Events during and after the third lockdown (5 January 2021 to February 2022) i. To what extent did the availability of vaccines inform government decision making on the use of NPIs? ii. Was a third national lockdown necessary? To what extent were lessons learned from the first and second lockdowns? iii. Should the decision to impose a lockdown from 5 January 2021 have been taken before 4 January 2021? If so, when? iv. Is it possible to say what the outcome would have been if the decision had been taken earlier? v. Was it lifted at the most appropriate time? vi. Following the emergence of the Omicron variant in or around December 2021 and the implementation of ‘Plan B’ restrictions, should a fourth national lockdown or any other stringent restrictions have been imposed? vii. Was the decision to end all Covid restrictions on 24 February 2022 taken at the right time? g. Vulnerable and at risk groups i. To what extent did the UK Government recognise and define "vulnerable and at risk groups" throughout the course of the pandemic, and take appropriate account of pre-existing inequalities when considering the imposition of NPIs? ii. To what extent was the Public Sector Equality Duty complied with? iii. To what extent did the UK Government assess the likely impacts of contemplated NPIs upon people and communities falling within such groups, and seek to mitigate them? iv. To what extent was the possibility of serious long term health consequences arising from the imposition of NPIs foreseen and addressed? v. How was the danger to health posed by the virus weighed up against the perceived danger of societal and economic damage (to include risks of increased mental-health issues, domestic abuse and the impact on children’s wellbeing, development and educational attainment) caused by the imposition of social restrictions?

Public health communications in relation to steps being taken to control the spread of the virus; transparency of government messaging; the use of behavioural management and the maintenance of public confidence in the UK government, including the impact of alleged breaches of rules and standards by Ministers, officials and advisers. a. How did the UK Government communicate? i. How effective were the key public health communications in relation to the steps taken to control the spread of the virus in the UK between January 2020 and February 2022? ii. To what extent was there a four-nation approach to communication? Was this effective? iii. Was the messaging accessible to vulnerable and at risk groups? Was this effective? iv. To what extent did breaches by UK Ministers, officials and advisers of social restrictions and lockdown rules and guidance, and the associated public debate at that time, damage public confidence and the maintenance of observance of those rules by the public?

The public health and coronavirus legislation and regulations that were proposed and enacted: their proportionality and enforcement. a. Public health and coronavirus legislation and regulations i. What processes were adopted for the review and scrutiny of the Coronavirus laws and regulations? Were they sufficient? ii. To what extent were equality impact assessments carried out appropriate and sufficient? Were their conclusions taken into account when passing laws and regulations? b. Enforcement With a focus on civil liberties: i. Why were criminal sanctions considered necessary and proportionate? In general terms, was the enforcement of the Coronavirus laws and regulations proportionate and effective?

What lessons can be learnt and what possible recommendations can be identified at this stage to support appropriate and effective decision-making in the event of a future pandemic?

The impact of Covid-19 on people’s experience of healthcare.

Core decision-making and leadership within healthcare systems during the pandemic.

Staffing levels and critical care capacity, the establishment and use of Nightingale hospitals and the use of private hospitals.

111, 999 and ambulance services, GP surgeries and hospitals and cross- sectional co-operation between services.

Healthcare provision and treatment for patients with Covid-19, healthcare systems’ response to clinical trials and research during the pandemic. The allocation of staff and resources. The impact on those requiring care for reasons other than Covid-19. Quality of treatment for Covid-19 and non- Covid-19 patients, delays in treatment, waiting lists and people not seeking or receiving treatment. Palliative care. The discharge of patients from hospital.

Decision-making about the nature of healthcare to be provided for patients with Covid-19, its escalation and the provision of cardiopulmonary resuscitation, including the use of do not attempt cardiopulmonary resuscitation instructions (DNACPRs).

The impact of the pandemic on doctors, nurses and other healthcare staff, including on those in training and specific groups of healthcare workers (for example by reference to ethnic background). Availability of healthcare staff. The NHS surcharge for non-UK healthcare staff and the decision to remove the surcharge.

Preventing the spread of Covid-19 within healthcare settings, including infection control, the adequacy of PPE and rules about visiting those in hospital.

Communication with patients with Covid-19 and their loved ones about patients’ condition and treatment, including discussions about DNACPRs.

Deaths caused by the Covid-19 pandemic, in terms of the numbers, classification and recording of deaths, including the impact on specific groups of healthcare workers, for example by reference to ethnic background and geographical location.

Shielding and the impact on the clinically vulnerable (including those referred to as “clinically extremely vulnerable”).

Characterisation and identification of Post-Covid Condition (including the condition referred to as long Covid) and its diagnosis and treatment.

The development, procurement, manufacture and approval of vaccines during the pandemic, including the effectiveness of UK-wide decision-making, in particular, the role of the UK Vaccine Taskforce. What lessons can we learn from innovative practices that were successfully introduced during the pandemic for future pandemic preparedness?

The development, trials and steps taken to enable the use of new therapeutics and repurposed medications during the pandemic.

Vaccine delivery in England, Wales, Scotland and Northern Ireland, including roll-out procedures such as: arrangements on the ground and public messaging; Joint Committee on Vaccination and Immunisation recommendations on eligibility / prioritisation and decisions taken by policy makers; the ethics of prioritisation decisions and impact on particular groups such as those with comorbidities. Vaccine as a Condition of Deployment, in particular its effectiveness in limiting transmission and impact on vaccine hesitancy.

Barriers to vaccine uptake, including vaccine confidence and access issues and the effectiveness, timeliness and adequacy of Government planning for and response to inequalities relevant to vaccine uptake.

Vaccine safety issues including post marketing surveillance, such as the Yellow Card monitoring and reporting system and a suggested correlation between Covid-19 vaccines and cardiovascular issues.

Whether any reforms to the UK Vaccine Damage Payment Scheme are necessary.

Were the stockpiles of key healthcare equipment and supplies adequate to respond to the Covid-19 pandemic? If not, in what sense were they inadequate? How long did they last? How long should future PPE stockpiles aim to last?

Were the systems for the storage, monitoring, review, management and administration of PPE stockpiles adequate and effective? If not, in what sense were they inadequate and/or ineffective and what lessons can be learned for future pandemics?

Was account taken of the range of physical characteristics of the health and social care workforce when stockpiling PPE? If not, why not?

Which institutions were responsible for the procurement and distribution of key healthcare and equipment and supplies during the pandemic? What were the systems and tools for procuring key health care equipment and supplies and how effective were they?

Were the institutions, structures, systems and tools in the UK and devolved administrations adequate, adaptable and effective for the procurement and distribution of key healthcare equipment and supplies during the pandemic?

What were the institutions, structures, systems and tools that needed to be created by the governments of the UK and devolved administrations during the pandemic? Why did they need to be created? Were they effective at meeting the demands of the pandemic? In particular, did the system achieve an adequate balance between the speed of the response, value for money and quality in the award of contracts?

What were the systems in the UK and devolved administrations for the: a. collection, transmission and analysis of inventory data of key healthcare equipment and supplies? b. analysis of market data on the types, prices and quantities of key healthcare equipment and supplies available to those in charge of procurement? c. modelling and forecasting of the distribution, demand and supply of key healthcare equipment? How did these adapt during the pandemic and were they effective?

What are the strengths and weaknesses of a system of contracting out functions such as procurement of key healthcare equipment and supplies for the NHS and storage and distribution of those items?

What lessons can and should the UK and devolved administrations learn from each other’s and international approaches to stockpiling, procurement and distribution?

What is the role of technology, such as automation and artificial intelligence, in public procurement? How should the decisions of ministers and officials be assisted by automation and artificial intelligence?

Why was the High Priority (also known as the ‘VIP’) Lane established? What were its aims and objectives? Did it achieve them? If not, why not?

What were the key features of the High Priority Lane, including its advantages and disadvantages? How did its operation differ, if at all, from the approach adopted to other offers to supply key healthcare equipment and supplies?

In what circumstances might a prioritisation system assist in the procurement of key healthcare equipment and supplies in an emergency? What, if any, were the countervailing disadvantages of such a system? Was any comparable system established by Devolved Nations? How might any risks associated with a High Priority Lane be mitigated in future?

Which entities in the UK and devolved administrations were responsible for the distribution of key healthcare equipment and supplies during the pandemic?

What were the systems in the UK and devolved administrations for the distribution of key healthcare equipment and supplies during the pandemic? What systems were in place to ensure that there was fair and effective distribution of key healthcare equipment and supplies?

What were the principal issues encountered in distributing PPE? Did the governments of the UK and devolved administrations respond to the issues effectively?

What role did the Ministry of Defence have in organising procurement, logistics and distribution during the pandemic? What was the role of the private sector? What are the alternatives to deploying the resources of the Ministry of Defence during a pandemic? What can be learned from the methods used by the Ministry of Defence to improve distribution during a pandemic?

How did systems for distribution and procurement meet the needs of the care sector and of contractors who delivered NHS services?

Was the system of mutual aid for the distribution of PPE between the UK and devolved administrations effective?

What are the skills, expertise and experience necessary for effective procurement in a pandemic? Did the UK and devolved administrations possess and deploy them in sufficient numbers, breadth and depth?

What are the areas in which the UK government and devolved administrations relied on the private sector and consultants to assist them in procurement during the pandemic? Why was such reliance necessary?

How should the government approach training and retaining experts in emergency procurement? What should the role of private sector consultants and contractors be in providing advice and engaging in procurement and distribution during an emergency such as a pandemic?

What were the UK government and devolved administrations’ approaches to the domestic manufacture and international procurement of key healthcare equipment and supplies? How did ‘UK Make’, ‘China Buy’ and other routes for the procurement of key healthcare equipment and supplies compare in terms of speed, quality and price during the pandemic?

What were the advantages and disadvantages of the ‘Calls to Arms’ in the Ventilator Challenge, Operation Moonshot and the domestic manufacture of PPE? How should the government approach industry in responding to a pandemic emergency?

Did the UK and devolved administrations have an effective strategy for the international and domestic supply of key healthcare equipment and supplies during a pandemic? If not, why not? How did the UK and devolved administrations approach reliance on global free trade, international supply chains and domestic industrial capacity to respond effectively to the pandemic? Was this an effective approach?

To what extent did the strategy for the procurement of key healthcare equipment and supplies complement and support other aspects of the pandemic response?

What are the key elements of foreign and international trade policy which the UK should adopt to build long-term resilience in its supply chains?

What role, if any, should a domestic industrial strategy play in preparing to respond to emergencies such as pandemics?

What are the pros and cons of relying on the global market and global supply chains for key healthcare equipment and supplies during a pandemic? How should any such risks be mitigated? Should the UK diversify its sources of supply to include greater domestic manufacturing?

Is it possible and/or desirable to control pricing and thus the profits of suppliers of key healthcare equipment and supplies during a pandemic? What lessons can be drawn from international comparisons in this regard?

Are there any strategic industries necessary for the manufacture of key healthcare and equipment in the event of a pandemic? If so, what are they? How may they be supported prior to and during an emergency?

What was the system in the UK and devolved administrations by which technical specifications for key healthcare equipment and supplies were set, disseminated and kept under review by technical and clinical experts? Was the overall system adequate and effective?

Were the systems for the inspection of the key healthcare equipment and supplies adequate?

What action was taken to ensure that PPE provided during the pandemic was safe for use?

What are the best methods of achieving a balance in procurement of key healthcare equipment and supplies between such factors as speed, cost, quality and fairness in the award of contracts? Was such a balance struck through the use of framework agreements, open competition, dynamic purchasing systems and direct awards and what lessons can be drawn from the experience?

What is the best way to approach spending controls on procurement during a pandemic?

What is the appropriate role of transparency in procurement during a pandemic? How should this be balanced with responding to the demands of the emergency?

Were there adequate systems to identify and mitigate against potential fraud, bribery and corruption in procurement of key healthcare equipment and supplies? To what extent were the UK government and devolved administrations using expertise in data analytics, due diligence and fraud detection to mitigate risk?

How should record-keeping and publication of key decisions in the context of emergency procurement be improved? Was the balance between the expeditious awarding of contracts and transparency, for example, by the publication of contract award notices? How much information should be published and when?

Did the government collect and analyse in real-time the data about the contracts were entered into during the pandemic? If not, why not? What conclusions may be drawn about the system from an analysis of contract data? Do they reveal anything which contradicts official accounts of procurement?

To what extent did and should procurement during an emergency such as a pandemic take into account wider environmental, social and governance policy? Was there an effective disposal strategy? Was there sufficient consideration of reusable PPE and its pros and cons? Was account taken of the risk of modern slavery in supply chains?

How does the waste caused by emergency purchasing during the pandemic compare to waste in the governments of the UK and devolved administrations more generally?

What are the plans of the UK governments and devolved administrations for the disposal of key medical equipment and supplies purchased in excess?

The impact of the pandemic on people’s experience of the Care Sector. This will focus on recipients of care and their loved ones and those working within the Care Sector and will include consideration of the unequal impacts on them.

The structure of the Care Sector and the key bodies involved in the UK and Devolved Administrations at the start of and during the pandemic. This will include staffing levels and bed capacity immediately prior to the pandemic.

The key decisions made by the UK Government and the Devolved Administrations in respect of the Care Sector, including the decisions relating to the discharge of people from hospitals into adult care and residential homes in the early stages of the pandemic.

The management of the pandemic in adult care and residential homes. This will include the measures preventing the spread of Covid-19, such as infection prevention and control measures, testing for Covid-19, the availability and adequacy of personal protective equipment (PPE), restrictions on access by/to healthcare professionals and visits from loved ones.

The use of Do Not Attempt Cardiopulmonary Resuscitation (DNACPRs) and communication with recipients of care and their loved ones about the recipient of care’s condition and treatment including discussions and decisions about DNACPRs.

The changes to the regulatory inspection regimes within the Care Sector.

Deaths related to the infection of Covid-19 including deaths of recipients of care and staff.

Infection prevention and control measures for those providing care in the home, including by unpaid carers.

The test, trace and isolate policies and strategies developed and deployed, taking into account modelling, capacity of the systems throughout the pandemic and the rationale, appropriateness and data available for the decisions of the UK and devolved administrations and wider border policy considerations.

The availability, use and effectiveness of different test, trace and isolate technologies, policies and strategies including lateral flow and PCR tests, testing for variants, digital contact tracing and other testing techniques.

The structure of the test, trace and isolate system and the key bodies involved in decision making in the UK and Devolved Administrations. It will include the efficacy and impact of the models adopted, the use of the private sector and other institutions and the cost.

Enforcement of testing, tracing and isolation procedures and factors influencing compliance, such as the adequacy of and trust in messaging, financial and practical support to those required to isolate and the availability and use of data in decision making.

The preservation of infrastructure, capacity and research to improve and develop test, trace and isolate schemes for future pandemics.

The extent to which children and young people were considered as part of any preparedness and planning for a pandemic.

The extent to which children and young people were considered by the UK Government and the Devolved Administrations in respect of the application of non-pharmaceutical Interventions (NPIs) and the impact of those decisions.

The impact of the pandemic on the education of, and the early years provision for, children and young people (including further and/or higher education, apprenticeships).

The impact of the pandemic on children and young people’s physical and mental health, wellbeing, development, family lives and on their access to healthcare services.

The impact of the pandemic on children and young people in relation to access to and engagement with social care services and other agencies with a role in supporting the safety of children. This will include children at risk, children whose families receive support from social services, young carers, those in the care of local authorities,care and care leavers.

The impact of the pandemic on children and young people in contact with the criminal justice system including those in the youth custody estate, youth defendants and offenders and those whose parents or primary carers were in custody during the pandemic.

The impact of the pandemic on children and young people in contact with the immigration system.

The impact of the pandemic on children and young people in relation to their access to and use of the internet, social media and online resources.

What steps did the UK Government and the Devolved Administrations take to assess the nature and extent of the economic shocks facing the UK economy at the outset of the pandemic? Did they accurately assess the economic risks to individuals, businesses and to the economies of the UK and devolved nations?

Did the UK Government and the Devolved Administrations take into account an appropriate range of economic considerations when formulating the initial economic response, including uncertainty regarding the duration and severity of the pandemic and its potential longer term impact on the labour market?

What range of policy interventions were available to the UK Government and the Devolved Administrations when formulating the initial economic response to the pandemic? On what basis did they decide on the initial interventions?

Did the UK Government and Devolved Administrations have sufficiently in mind the potential for a novel virus to cause long term health issues that might affect the economic activity of large numbers of people?

Whether economic decision making structures and processes within the UK Government and the Devolved Administrations were effective in the response to the pandemic.

Whether intergovernmental structures for economic decision making were effective.

Were structures between government and local authorities for economic decision making effective?

Whether the economic decision making of the UK Government and Devolved Administrations adequately took into account the likely duration and severity of the public health crisis throughout the pandemic.

Were decisions regarding the overarching economic response taken in an effective way? Were decisions made by the appropriate people in the UK Government and Devolved Administrations through appropriate structures and with adequate checks and balances?

Did the UK Government and the Devolved Administrations make effective use of advice, analysis and expertise in the economic response to the pandemic?

Whether the Bank of England made an accurate assessment of the nature and extent of the economic crisis facing the UK.

What monetary policy interventions were available to the Bank of England for the kind of economic crisis caused by the pandemic?

Whether quantitative easing was an appropriate policy response?

Did the relationship between His Majesty’s Treasury and the Bank of England operate effectively in the economic response to the pandemic?

Did the funding framework affect the ability of the Devolved Administrations to make economic policy? Was the Barnett Guarantee an effective adaptation to the usual funding framework? Should other adaptations to the usual funding framework have been considered in an economic emergency such as this?

Did the UK Government involve the Devolved Administrations in decisions about funding appropriately?

Was the process for deciding on the amount and timing of funding provided to local authorities adequate? Did the UK Government and Devolved Administrations involve local authorities in decisions about funding effectively? Was there sufficient certainty to enable local authorities to plan strategically? Was monitoring by the UK Government and Devolved Administrations of the use to which funding was put adequate?

Were decisions made by the UK Government about providing funding to other relevant public services, including the transport sector, effective?

The basis for the UK Government’s decision to protect jobs via the Coronavirus Job Retention Scheme (‘CJRS’) and the Self-Employment Income Support Scheme (‘SEISS’)? Were those schemes designed and delivered effectively? Were risks to the UK labour market appropriately assessed and balanced?

Was there effective and adequate consultation during the design of the scheme? To what extent did any such consultation inform the design of the scheme?

Did those schemes adequately mitigate against the risk of fraud and error?

Did the schemes have an unequal impact or otherwise fail to protect economically vulnerable groups? How, if at all, was the potential risk of long term sequelae taken into account in the design of the scheme?

Was monitoring of the impact of the schemes adequate?

Were appropriate amendments made throughout the lifetime of the schemes? Could and should the schemes have been more targeted? Were decisions about the continuation or amendment of the schemes made in a timely and effective manner?

Was communication with the public about the schemes clear, accessible and effective?

Did the schemes achieve their intended aims? Did the schemes operate effectively alongside other economic interventions in the UK and in each of the Devolved Nations?

Were the schemes ended at the right time and following appropriate consultation?

Were schemes intended to promote the recovery of the labour market effective? Did they appropriately address long term risks to the labour market?

What strategies did the UK Government and the Devolved Administrations use to protect businesses and were they effective?

Were UK-wide business loan schemes designed and delivered effectively?

Were business grant schemes designed and delivered effectively in all four nations of the UK?

Was there effective and adequate consultation during the design of the scheme? Were those responsible for delivering loan and grant schemes involved in the design of the schemes effectively or at all? To what extent did any such consultation inform the design of the scheme?

Did loan and grant schemes adequately target businesses in need of support? Were certain businesses unduly excluded from support?

Did loan and grant schemes adequately mitigate against the risk of fraud and error?

Did loan and grant schemes support economically vulnerable groups effectively?

Was monitoring of the impact of loan and grant schemes adequate?

Were appropriate amendments made throughout the lifetime of the schemes? Were decisions about the continuation or amendment of the schemes made in a timely and effective manner?

Was communication with the public about loan and grant schemes clear, accessible and effective?

Did loan and grant schemes achieve their intended aims? Did the schemes operate effectively alongside other economic interventions in the UK and in each of the Devolved Nations?

Were loan and grant schemes ended at the right time and following appropriate consultation?

Were other significant economic interventions to support businesses in the UK and the Devolved Nations designed and delivered effectively? Did they achieve their intended aims?

What measures did the UK Government and the Devolved Administrations introduce which were capable of alleviating economic hardship including uplifts to Universal Credit and working tax credit and changes to Statutory Sick Pay? What were the objectives of those schemes and who were the intended beneficiaries?

Were those schemes designed and delivered effectively?

Did the uplifts to Universal Credit and Working Tax Credit and the changes to Statutory Sick Pay eligibility adequately target those identified by government as being in need of economic support?

Did those schemes adequately mitigate against the risk of fraud and error?

Was there effective and adequate consultation during the design of the scheme? To what extent did any such consultation inform the design of the scheme?

Did those schemes support economically vulnerable groups effectively? How, if at all, was the potential risk of long term sequelae taken into account in the design of the schemes?

Was monitoring of the impact of those schemes adequate?

Were appropriate amendments made throughout the lifetime of the schemes? Were decisions about the continuation or amendment of the schemes made in a timely and effective manner?

Was communication with the public about those schemes clear, accessible and effective?

Did those schemes achieve their intended aims? Did the schemes operate effectively alongside other economic interventions in the UK and in the Devolved Nations?

Were those schemes ended at the right time and following appropriate consultation?

Was economic support provided to the voluntary and community sector, including the £750 million package for Voluntary, Community and Social Enterprise organisations, designed and delivered effectively?

Were other significant economic interventions to alleviate economic hardship in the UK and the Devolved Nations designed and delivered effectively? Did they achieve their intended aims?

The general population of the UK including the impact on mental health and wellbeing of the population. This will include the community level impact on sport and leisure and cultural institutions and the societal impact of the closure and reopening restrictions imposed on the hospitality, retail, travel and tourism industries. It will also cover the impact of restrictions on worship resulting from the closure and reopening of places of worship.

Key workers, excluding health and social care workers, but including those working in the police service, fire and rescue workers, teachers, cleaners, transport workers, taxi and delivery drivers, funeral workers, security guards and public facing sales and retail workers. It will cover: ● The impact of implementing government decisions ● Any inequality in the impact of interventions, including lockdown, testing and workplace safety ● Any inequality in the impact on health outcomes, such as infections, mortality and mental and physical wellbeing.

The most vulnerable, including those outlined in the Inquiry's Equalities Statement as well as the clinically vulnerable and clinically extremely vulnerable. It will include the following topics: ● Housing and homelessness ● Safeguarding and support for victims of domestic abuse ● Those within the immigration and asylum system ● Those within prisons and other places of detention ● Those affected by the operation of the justice system.

The bereaved, including restrictions on arrangements for funeral and burials and post-bereavement support.