Reports & recommendations
55 recommendations from 5 reports, each with the government response on the record. Filter by government response, report, nation or delivery status.
Reports (15)
| Title | Volume | Publication Date | Recommendations | Links |
|---|---|---|---|---|
| Module 1: Resilience and Preparedness | 1 | 18 Jul 2024 | 10 | |
| Module 2: Core Decision-Making | 2 | 20 Nov 2025 | 19 | |
|
Module 3: Impact on Healthcare Systems
Original edition: Version 1 — NO-COMMENTS original
Report page first published 19 March 2026.
Version 1.1 — current corrected edition (Corrslip-2)
Correction slip dated 13 May 2026; page metadata modified 14 May 2026. The page modification is not a formal republication date.
Open current edition
· Search this held text
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3 | 19 Mar 2026 | 10 | |
| Module 4: Vaccines and Therapeutics | 4 | 16 Apr 2026 | 5 | |
| Module 5: Procurement | 5 | 14 Jul 2026 | 11 | |
| Every Story Matters: Economic Response | Listening Exercise | 24 Nov 2025 | 0 | |
| Every Story Matters: Impact on Society - Key Workers | Listening Exercise | 16 Feb 2026 | 0 | |
| Every Story Matters: Test, Trace and Isolate | Listening Exercise | 12 May 2025 | 0 | |
| Every Story Matters: Impact on Society - Bereavement | Listening Exercise | 03 Mar 2026 | 0 | |
| Every Story Matters: Final Record | Listening Exercise | 05 Mar 2026 | 0 | |
| Every Story Matters: Impact on Society - Mental Health and Wellbeing | Listening Exercise | 16 Feb 2026 | 0 | |
| Every Story Matters: Adult Social Care Sector | Listening Exercise | 30 Jun 2025 | 0 | |
| Every Story Matters: Children and Young People | Listening Exercise | 29 Sep 2025 | 0 | |
| Every Story Matters: Healthcare | Listening Exercise | 09 Sep 2024 | 0 | |
| Every Story Matters: Vaccines and Therapeutics | Listening Exercise | 14 Jan 2025 | 0 |
Recommendations (55)
Simplify Emergency Preparedness Structures
The governments of the UK, Scotland, Wales and Northern Ireland should each simplify and reduce the number of structures with responsibility for preparing for and building resilience to whole-system civil emergencies.
The core structures should be:
a single Cabinet-level or equivalent ministerial committee (including the senior minister responsible for health and social care) responsible for whole-system civil emergency preparedness and resilience for each government, which meets regularly and is chaired by the leader or deputy leader of the relevant government; and
a single cross-departmental group of senior officials in each government (which reports regularly to the Cabinet-level or equivalent ministerial committee) to oversee and implement policy on civil emergency preparedness and resilience.
This should be put in place within 12 months of the publication of this Report.
Within 6 months of the creation of the group of senior officials, it should complete a review to simplify and reduce the number of structures responsible for whole-system civil emergency preparedness and resilience.
Subsequently, within 24 months of the publication of this Report, the ministerial committee should rationalise and streamline subordinate or supporting groups and committees responsible for whole-system civil emergency preparedness and resilience. Any groups and committees retained or created to support this core structure should have a clear purpose and should report regularly about progress with, and completion of, tasks assigned to them.
The Inquiry asked UK administrations to simplify and streamline civil emergency preparedness structures. The UK Government (Cabinet Office) stated in July 2025 that the recommendation was closed, having established the National Security Council (Resilience) and refreshed catastrophic risk governance (Cabinet Office, Jul 2025). In July 2026, the Scottish Government reported that its Crisis Preparation Oversight Programme continued to support preparedness work alongside regular Cabinet updates (Scottish Government, Jul 2026). The Northern Ireland Executive stated in January 2026 that options to review its civil contingencies landscape remained under consideration (Northern Ireland Executive, Jan 2026), while the First Minister of Wales, Eluned Morgan MS, reported in July 2025 that implementation in Wales was completed (Eluned Morgan MS, Jul 2025).
Cabinet Office Leadership for Emergencies
The UK government should:
abolish the lead government department model for whole-system civil emergency preparedness and resilience; and
require the Cabinet Office to lead on preparing for and building resilience to whole-system civil emergencies across UK government departments, including monitoring the preparedness and resilience of other departments, supporting departments to correct problems, and escalating issues to the UK Cabinet-level ministerial committee and group of senior officials in Recommendation 1.
The Inquiry recommended replacing the lead department model with central government leadership for whole-system emergencies. In January 2026, the Cabinet Office described embedding its leadership role in updated emergency doctrine, but did not describe abolishing the lead department model, noting that guidance on departmental expectations was expected in spring 2026 (Cabinet Office, Jan 2026). The Northern Ireland Executive reported in January 2026 that whole-system risks remained central to its risk management strategy (Northern Ireland Executive, Jan 2026). In a written statement that month, Eluned Morgan MS, First Minister of Wales, stated that an alternative crisis management model was being developed for publication in autumn 2026 (Eluned Morgan MS, Jan 2026).
Improved Risk Assessment Approach
The UK government and devolved administrations should work together on developing a new approach to risk assessment that moves away from a reliance on single reasonable worst-case scenarios towards an approach that:
assesses a wider range of scenarios representative of the different risks and the range of each kind of risk;
considers the prevention and mitigation of an emergency in addition to dealing with its consequences;
provides a full analysis of the ways in which the combined impacts of different risks may complicate or worsen an emergency;
assesses long-term risks in addition to short-term risks and considers how they may interact with each other;
undertakes an assessment of the impact of each risk on vulnerable people; and
takes into account the capacity and capabilities of the UK.
In doing so, the UK government and devolved administrations should perform risk assessments that reflect the circumstances and characteristics particular to England, Wales, Scotland, Northern Ireland and the UK as a whole.
The Inquiry recommended creating a new multi-scenario approach to national risk assessment. In January 2026, the Cabinet Office reported that it had begun reviewing the National Security Risk Assessment methodology to reference varied scenarios, issued guidance on vulnerable groups, and continued developing a digital platform to analyse linked risks (Cabinet Office, Jan 2026). The department also noted progress on an alternative capability-based assessment pilot with the Royal Academy of Engineering, though joint work with devolved administrations was not mentioned (Cabinet Office, Jan 2026). It stated that the methodology review is scheduled to conclude in summer 2026 with changes implemented in 2027, alongside rollout of the digital platform and delivery of the pilot during 2026 (Cabinet Office, Jan 2026).
UK-wide Civil Emergency Strategy
The UK government and devolved administrations should together introduce a UK-wide whole-system civil emergency strategy (which includes pandemics) to prevent each emergency and also to reduce, control and mitigate its effects.
As a minimum, the strategy should:
be adaptable;
include sections dedicated to each potential whole-system civil emergency – for example, one on pandemics with a clear explanation of the roles and responsibilities of the UK government, devolved administrations and their departments/directorates as well as local responders;
consider a wide range of potential scenarios for each type of emergency;
identify the key issues and set out a range of potential responses;
identify how the strategy is to be applied to ensure that any potential responses are proportionate to the particular circumstances of the emergency;
include an assessment in the short, medium and long term, based on published modelling, of the potential health, social and economic impacts of the emergency and of potential responses to the emergency on the population and, in particular, on vulnerable people; and
include an assessment of the infrastructure, technology and skills the UK needs to respond effectively to the emergency and how those needs might change for different scenarios.
The strategy should be subject to a substantive reassessment at least every three years to ensure that it is up to date and effective, incorporating lessons learned between reassessments.
The Inquiry recommended a UK-wide civil emergency strategy covering pandemics and other major risks. In January 2026, the Cabinet Office reported that the Department for Health and Social Care was preparing a pandemic preparedness strategy for publication in early 2026 and updating a respiratory response plan (Cabinet Office, Jan 2026). It stated that adapting the plan to other transmission routes would continue throughout 2026, alongside work mapping cascading impacts of catastrophic risks (Cabinet Office, Jan 2026). It had earlier stated in July 2025 that its Resilience Action Plan and risk-specific operational plans addressed the recommendation, maintaining that a single UK-wide strategy would be "unwieldy" under devolution arrangements (Cabinet Office, Jul 2025).
Pandemic Data Systems and Research
The UK government, working with the devolved administrations, should establish mechanisms for the timely collection, analysis, secure sharing and use of reliable data for informing emergency responses, in advance of future pandemics. Data systems should be tested in pandemic exercises.
The UK government should also commission a wider range of research projects ready to commence in the event of a future pandemic. These could be ‘hibernated’ studies or existing studies that are designed to be rapidly adapted to a new outbreak. Better working with international partners should be encouraged. This should include projects to:
understand the prevalence of a new virus;
measure the effectiveness of a range of different public health measures; and
identify which groups of vulnerable people are hardest hit by the pandemic and why.
The Inquiry asked the UK government to establish pandemic data systems and adaptable research. The Cabinet Office reported in January 2026 that the Biothreats Radar platform was launched across government, the Risk Vulnerability Tool was made available during Exercise PEGASUS, and a chair was appointed for the Health Data Research Service (Cabinet Office, Jan 2026). The Northern Ireland Executive stated in January 2026 that legislative amendments to permit sharing health datasets remained scheduled for 2025 to 2026 (Northern Ireland Executive, Jan 2026). Eluned Morgan MS stated in January 2026 that full adoption of the Welsh Emergency Care Data Set remained targeted for autumn 2026 (Eluned Morgan MS, Jan 2026).
Triennial Pandemic Exercises
The UK government and devolved administrations should together hold a UK-wide pandemic response exercise at least every three years. The exercise should: test the UK-wide, cross-government, national and local response to a pandemic at all stages, from the initial outbreak to multiple waves over a number of years; include a broad range of those involved in pandemic preparedness and response; and consider how a broad range of vulnerable people will be helped in the event of a pandemic.
The Cabinet Office reported in January 2026 that live participation in Exercise Pegasus, a UK-wide pandemic exercise involving all government departments and devolved administrations, concluded in November 2025 (Cabinet Office, Jan 2026). It stated that a fourth tabletop phase focusing on recovery was planned for summer 2026 to examine the impact of response decisions (Cabinet Office, Jan 2026). The department aims to deliver an outstanding post-exercise report communicating the findings and lessons in winter 2026 (Cabinet Office, Jan 2026).
Publish Exercise Reports and Lessons
For all civil emergency exercises, the governments of the UK, Scotland, Wales and Northern Ireland should each (unless there are reasons of national security for not doing so): publish an exercise report summarising the findings, lessons and recommendations, within three months of the conclusion of the exercise; publish an action plan setting out the specific steps that will be taken in response to the report's findings, and by which entity, within six months of the conclusion of the exercise; and keep exercise reports, action plans, and emergency plans and guidance from across the UK in a single, UK-wide online archive, accessible to all involved in emergency preparedness, resilience and response.
The Cabinet Office reported in January 2026 that development was underway on a UK-wide online repository for civil emergency exercise information and a cross-government lessons management framework (Cabinet Office, Jan 2026). In the same January 2026 update, the department noted that repository scoping work was expected to conclude in 2026, while the publication schedule for the Exercise PEGASUS report remained to be confirmed with publication likely in winter 2026 (Cabinet Office, Jan 2026).
Triennial Parliamentary Resilience Reports
The governments of the UK, Scotland, Wales and Northern Ireland should each produce and publish reports to their respective legislatures at least every three years on whole-system civil emergency preparedness and resilience. The reports should include as a minimum: the risks that each government has identified are likely to result in whole-system civil emergencies; the recommendations that have been made to each government to mitigate those risks, and whether these recommendations have been accepted or rejected; a cost–benefit analysis setting out the economic and social costs of accepting the risks as against taking action to mitigate the risks; who may be vulnerable to the risks and what steps are being taken to mitigate those risks; a plan setting out the timescales for implementing the recommendations that have been accepted; and an update on the progress that has been made on implementing previously accepted recommendations.
The Cabinet Office reported in July 2025 that it considered the recommendation closed after delivering an annual statement to Parliament on risk and resilience (Cabinet Office, Jul 2025). The Scottish Government stated in July 2026 that the recommendation had been delivered and closed following the publication of its first preparedness report, while First Minister of Wales Eluned Morgan MS considered it completed in January 2026 (Eluned Morgan MS, Jan 2026; Scottish Government, Jul 2026). The Northern Ireland Executive stated in January 2026 that the recommendation remained open, with work ongoing to develop a position paper by July 2026 to inform its first report to the assembly (Northern Ireland Executive, Jan 2026).
External Red Teams for Resilience
The governments of the UK, Scotland, Wales and Northern Ireland should each introduce the use of red teams in the Civil Service to scrutinise and challenge the principles, evidence, policies and advice relating to preparedness for and resilience to whole-system civil emergencies. The red teams should be brought in from outside of government and the Civil Service.
The Cabinet Office reported in January 2026 that an October 2025 pilot was being applied to incorporate red teaming into the ongoing 2026 Capabilities Assessment, the Government Office for Science had established a resilience red teaming function, and remaining expert advisory groups were being stood up to review risks throughout the year (Cabinet Office, Jan 2026). The department previously stated in July 2025 that a broader red teaming capability to test departmental risk planning is due in autumn 2026 (Cabinet Office, Jul 2025).
Independent Statutory Resilience Body
The UK government should, in consultation with the devolved administrations, create a statutory independent body for whole-system civil emergency preparedness and resilience.
The new body should be given responsibility for:
providing independent, strategic advice to the UK government and devolved administrations on their planning for, preparedness for and building resilience to whole-system civil emergencies;
consulting with the voluntary, community and social enterprise sector at a national and local level and directors of public health on the protection of vulnerable people in whole-system civil emergencies;
assessing the state of planning for, preparedness for and resilience to whole-system civil emergencies across the UK; and
making recommendations on the capacity and capabilities that will be required to prepare for and build resilience to whole-system civil emergencies.
As an interim measure, the new body should be established on a non-statutory basis within 12 months of this Report, so that it may begin its work in advance of legislation being passed.
The Inquiry recommended creating an independent statutory resilience body for civil emergencies. In April 2026, Dan Jarvis, for the Cabinet Office, stated that convening independent panels to scrutinise whole-system risks forms the government's response, though the Minister did not mention creating a statutory body (Dan Jarvis, Apr 2026). In March 2026, the National Preparedness Commission stated that the recommendation had been rejected and questioned whether ad hoc panels would adequately substitute for an independent scrutinising body (House of Lords National Resilience Committee, Mar 2026; House of Lords National Resilience Committee, Mar 2026). The department had previously stated in July 2025 that a statutory body was not necessary because it could not outsource responsibility for response plans (Cabinet Office, Jul 2025; Cabinet Office, Jul 2025).
NI CMO Independence
The Department of Health (Northern Ireland) should reconstitute the role of the Chief Medical Officer for Northern Ireland as an independent advisory role. The Chief Medical Officer for Northern Ireland should not have managerial responsibilities within the Department of Health (Northern Ireland).
In March 2026, the Northern Ireland Executive accepted the recommendation, stating that following departmental restructuring the Chief Medical Officer no longer held managerial responsibility for departmental directorates, though further options to safeguard the role's independent advisory status were being developed before establishing an implementation timeframe (Northern Ireland Executive response, Mar 2026). The record holds no update since the Northern Ireland Executive's response of March 2026 (Northern Ireland Executive response, Mar 2026).
Devolved Nations SAGE Attendance
The Government Office for Science (GO-Science) should invite the governments of Scotland, Wales and Northern Ireland to nominate a small number of representatives to attend meetings of the Scientific Advisory Group for Emergencies (SAGE) from the outset of any future emergency. The status of those representatives as either 'participant' or 'observer' should depend upon their expertise and should be a matter for SAGE to determine.
In March 2026, the Cabinet Office stated that the Government Office for Science had already made the required changes to ensure devolved Chief Scientific Advisers are invited to observe meetings from the outset of an emergency, with participant status decided by the Government Chief Scientific Adviser (Cabinet Office response, Mar 2026). Earlier that month, the Northern Ireland Executive accepted the recommendation, while the Scottish Government and Welsh Government noted it and confirmed ongoing work to agree devolved attendance arrangements (Welsh Government response, Mar 2026; Scottish Government response, Mar 2026; Northern Ireland Executive response, Mar 2026). The record holds no update since the UK Government's response of March 2026 (Cabinet Office response, Mar 2026).
UK-wide Expert Register
The Government Office for Science (GO-Science) should develop and maintain a register of experts across the four nations of the UK who would be willing to participate in scientific advisory groups, covering a broad range of potential civil emergencies.
The register should be regularly refreshed through open calls for applications.
The Inquiry recommended creating a UK-wide emergency expert register refreshed through open calls. In March 2026, the UK Government (Cabinet Office) stated that the Government Office for Science (GO-Science) already maintains an expert register for the Scientific Advisory Group for Emergencies (SAGE), is refreshing selection processes during 2026, and is working with devolved governments (Cabinet Office response, Mar 2026). The department explained in March 2026 that exploring options for open calls is a longer-term ambition due to resource requirements and the need for operational flexibility (Cabinet Office response, Mar 2026). It added in March 2026 that the register cannot be relied upon exclusively and that agile processes will continue to identify emergency expertise at pace (Cabinet Office response, Mar 2026). The record holds nothing dated later than the response of March 2026 (Cabinet Office response, Mar 2026).
Publish Technical Advice During Emergencies
During a whole-system civil emergency, the UK government and devolved administrations should each routinely publish technical advice on scientific, economic and social matters at the earliest opportunity, as well as the minutes of expert advisory groups – except where there are good reasons that prevent publication, such as commercial confidentiality, personal safety or national security, or because legal advice privilege applies.
The Cabinet Office accepted the recommendation in March 2026, stating that advisory papers and minutes will be published as and when appropriate and that it will continue reviewing guidance to define publication roles during emergencies (Cabinet Office response, Mar 2026). The Northern Ireland Executive, the Scottish Government, and the Welsh Government also accepted the recommendation in March 2026, committing to transparency and early publication in future civil emergencies (Welsh Government response, Mar 2026; Scottish Government response, Mar 2026; Northern Ireland Executive response, Mar 2026). The record holds no update since the Cabinet Office's response of March 2026 (Cabinet Office response, Mar 2026).
Advisory Group Terms of Appointment
The Government Office for Science (GO-Science), the Scottish Government, the Welsh Government and the Department of Health (Northern Ireland) should each develop standard terms of appointment for all participants in scientific advisory groups. These terms should include: clarity around the nature of an individual's role and the extent of their responsibility, as well as the likely time commitment; payment where their time commitment means that they have to spend time away from their substantive role; access to support services; and access to advice on personal and online security, with procedures for escalating specific concerns.
The UK Government (Cabinet Office) stated in March 2026 that the Government Office for Science will review and update terms, conditions, and support for advisory group participants by 2027, including developing guidance on institutional compensation (Cabinet Office response, Mar 2026). Earlier that month, the Northern Ireland Executive, the Scottish Government, and the Welsh Government also accepted the recommendation to establish standard terms of appointment (Welsh Government response, Mar 2026; Scottish Government response, Mar 2026; Northern Ireland Executive response, Mar 2026). The record holds no update since the UK Government (Cabinet Office)'s response of March 2026 (Cabinet Office response, Mar 2026).
Enact Socio-economic Duty
The UK government should bring into force in England section 1 of the Equality Act 2010, implementing the socio-economic duty. The Northern Ireland Assembly and Northern Ireland Executive should consider an equivalent provision within section 75 of the Northern Ireland Act 1998.
The Inquiry recommended enacting the socio-economic duty in England and Northern Ireland. In September 2026, Satvir Kaur, answering for Women and Equalities, stated that work continues towards commencing the duty, which includes drafting statutory guidance, and that a list of subject public authorities will be published upon commencement (Satvir Kaur, Sep 2026). In March 2026, the Northern Ireland Executive stated that exploring an equivalent provision remained under consideration while officials engaged with the Equality Commission for Northern Ireland and other stakeholders (Northern Ireland Executive response, Mar 2026).
Statutory Child Rights Impact Assessments
The UK government should introduce legislation to place child rights impact assessments on a statutory footing in England. The Northern Ireland Executive should consider an equivalent provision.
The Inquiry recommended statutory child rights impact assessments for England and Northern Ireland. In June 2026, Josh MacAlister, answering for the Department for Education, stated that the government does not intend to introduce legislation to make Child’s Rights Impact Assessments (CRIAs) a statutory requirement at this time (Josh MacAlister, Jun 2026). In March 2026, the UK Government (Cabinet Office) stated that it would consider Module 8 report findings the following year while working to incorporate children's interests into risk planning (Cabinet Office response, Mar 2026). Earlier in March 2026, the Northern Ireland Executive stated that it did not propose to legislate for CRIAs at that time, though it could review this position following Module 8 (Northern Ireland Executive response, Mar 2026).
Vulnerable People Framework
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should each agree a framework that identifies people who would be most at risk of becoming infected by and dying from a disease and those who are most likely to be negatively impacted by any steps taken to respond to a future pandemic. The framework should set out the specific steps that could be taken to mitigate the risks to these people.
Equality impact assessments should form part of this framework. Where they cannot be undertaken in a national crisis, they should be reinstated as soon as possible.
Each government should agree and publish in its response to this Report how it will ensure that this framework is embedded into emergency decision-making and who will be responsible for ensuring these issues remain under consideration throughout a national crisis.
The Inquiry recommended that UK governments agree frameworks mitigating pandemic risks for vulnerable populations. In March 2026, the UK Government accepted the recommendation, stating that the Department of Health and Social Care (DHSC) will review existing guidance to identify gaps and embed frameworks into emergency decision-making (Cabinet Office response, Mar 2026). The response described plans to evaluate community measures and consult people with lived experience, but it did not mention equality impact assessments or who would be responsible for these issues during a crisis (Cabinet Office response, Mar 2026). Earlier that month, the Northern Ireland Executive, Scottish Government, and Welsh Government also accepted the recommendation in full or in principle, detailing updates to their respective emergency frameworks (Welsh Government response, Mar 2026; Scottish Government response, Mar 2026; Northern Ireland Executive response, Mar 2026). The record holds nothing dated later than the response of March 2026 (Cabinet Office response, Mar 2026).
NI Emergency Powers Review
The Northern Ireland Executive and UK government (in consultation with the Irish government where necessary) should review the structures and delegated powers of government in Northern Ireland to consider: the empowerment of the First Minister and deputy First Minister jointly to direct the work of other ministers and departments during an emergency; the empowerment of the Head of the Northern Ireland Civil Service in relation to the allocation of civil servants to departments or to civil contingency structures during an emergency; and how decisions that would usually be subject to ministerial approval would be taken should an emergency occur during the suspension of power-sharing arrangements.
The Northern Ireland Executive stated in March 2026 that the recommendation remained under consideration, explaining that it was working to enhance civil service redeployment powers while engaging with an Assembly committee on ministerial emergency powers (Northern Ireland Executive response, Mar 2026). The UK Government (Cabinet Office) stated in March 2026 that local parties should consider any institutional changes, though it stood ready to discuss proposals and consult the Irish government (Cabinet Office response, Mar 2026). The record holds no update since the UK Government (Cabinet Office)'s response of March 2026 (Cabinet Office response, Mar 2026).
Pandemic Decision-Making Framework
The UK government and devolved administrations should set out in future pandemic preparedness strategies (see the Inquiry’s Module 1 Report, Recommendation 4) how decision-making will work in a future pandemic.
This should include provision for COBR to be used as the initial response structure and set out how the UK government and devolved administrations will transition from managing a pandemic through COBR to managing it through separate arrangements in each nation when it becomes clear that the emergency will be longer-term.
It should include provision for longer-term decision-making structures in the UK government which consist of:
a strategy group to set the overall approach to each stage of the pandemic and take decisions on major interventions (eg entering and exiting lockdown); and
an operational group to take decisions on the implementation of the agreed strategy throughout the pandemic.
The design of these structures should include an outline of decision-making procedures for each group.
The strategy should make express provision for the involvement of the UK Cabinet in the decision-making of the strategy and operational groups.
It should also provide that longer-term decision-making should be conducted primarily by the UK, Scottish and Welsh Cabinets and the Northern Ireland Executive.
Decision-making groups in each nation should include a minister with responsibility for representing the interests of vulnerable groups. In the UK government, the Minister for Women and Equalities may be the most appropriate minister in this regard.
The Inquiry asked governments to set out pandemic decision-making structures in preparedness strategies. In March 2026, the UK Government (Cabinet Office) stated that initial crisis responses would use Cabinet Office Briefing Rooms (COBR) before transitioning to strategy and operational committees, with the Minister for Women and Equalities representing vulnerable groups (Cabinet Office response, Mar 2026). The Northern Ireland Executive stated in March 2026 that the design of an enduring response structure remained under consideration (Northern Ireland Executive response, Mar 2026). The Scottish Government confirmed in March 2026 that its governance outline established strategic and operational structures, while the Welsh Government stated in March 2026 that decisions on devolved matters must remain with Welsh Ministers from the outset (Welsh Government response, Mar 2026; Scottish Government response, Mar 2026). The record holds nothing dated later than the response of March 2026 (Cabinet Office response, Mar 2026).
Leadership Succession Arrangements
The UK government and devolved administrations should each establish formal arrangements for covering the roles of Prime Minister and First Minister (and in Northern Ireland, deputy First Minister) as applicable during a whole-system civil emergency, should the incumbent be unable to undertake their duties for any reason.
The Inquiry recommended formal leadership succession arrangements for UK and devolved leaders. In September 2026, Mr Hamish Falconer, answering for the Cabinet Office, stated that the Cabinet list on GOV.UK provides the current order of precedence of ministers (Mr Hamish Falconer, Sep 2026). In March 2026, the department accepted the recommendation and stated that the Prime Minister would put appropriate arrangements in place (Cabinet Office response, Mar 2026). Also in March 2026, the Northern Ireland Executive, Scottish Government, and Welsh Government accepted the measure, though the Executive stated that deciding pre-agreed succession arrangements remained under consideration (Welsh Government response, Mar 2026; Scottish Government response, Mar 2026; Northern Ireland Executive response, Mar 2026).
Central Emergency Taskforces
The response to a future whole-system civil emergency should be coordinated via central taskforces in each of the UK, Scotland, Wales and Northern Ireland, with responsibility for the commissioning and synthesis of advice, coordination of a single data picture and facilitation of decision-making processes. In preparation, the UK government and devolved administrations should each design the operating procedures for these taskforces, including, but not limited to, identifying the key roles needed to run the taskforces and how those roles would be appointed.
The UK government should also identify the role of its taskforce in supporting decision-making procedures within the strategy and operational decision-making structures.
These arrangements should be incorporated into future pandemic preparedness strategies (see the Inquiry’s Module 1 Report, Recommendation 4).
The Inquiry recommended establishing central emergency taskforces across the UK and devolved administrations. In March 2026, the UK Government (Cabinet Office) stated that operational plans for a pandemic taskforce were drafted in its Pandemic Concept of Operations, to coordinate cross-government strategy and data (Cabinet Office response, Mar 2026). The Northern Ireland Executive stated in March 2026 that it supported an enduring response structure, though its precise composition remained under consideration (Northern Ireland Executive response, Mar 2026). Earlier in March 2026, the Scottish Government accepted the recommendation in principle while formalising its operational approach, and the Welsh Government stated that it would incorporate an enduring taskforce into guidance published in early summer 2026 (Welsh Government response, Mar 2026; Scottish Government response, Mar 2026). The record holds nothing dated later than the response of March 2026 (Cabinet Office response, Mar 2026).
NI Executive Confidentiality Duty
The Executive Office should amend the Ministerial Code to impose a duty of confidentiality on ministers that prohibits the disclosure of the individual views of ministers expressed during meetings of the Northern Ireland Executive Committee.
The Northern Ireland Executive stated in March 2026 that the recommendation remained under consideration, noting that The Executive Office would consider proposals to amend the Ministerial Code, though any change would require agreement by the Executive Committee and Assembly (Northern Ireland Executive response, Mar 2026). The UK Government (Cabinet Office) stated in March 2026 that the recommendation was not for it to respond to (Cabinet Office response, Mar 2026). The record holds no update since the Northern Ireland Executive's response of March 2026 (Northern Ireland Executive response, Mar 2026).
Accessible Emergency Communications
The UK government and devolved administrations should each develop action plans for how government communications will be made more accessible during a pandemic.
As a minimum, these should include making provision for the translation of government press conferences into British Sign Language (and Irish Sign Language in Northern Ireland) and the translation of key announcements into the most frequently spoken languages in the UK.
The Inquiry asked UK administrations to develop action plans for accessible pandemic communications. In March 2026, the UK Government (Cabinet Office) stated that it had established a British Sign Language protocol for emergency announcements and updated crisis planning guidance, though translating announcements into the UK's most frequently spoken languages was not mentioned (Cabinet Office response, Mar 2026). Also that month, the Northern Ireland Executive committed to drafting accessible communications guidance by September 2026 and highlighted its use of sign language interpreters (Northern Ireland Executive response, Mar 2026). Earlier in March 2026, the Scottish Government agreed to develop an action plan including sign language and spoken language translations, and the Welsh Government pledged to add crisis advice to its inclusive communications guide (Welsh Government response, Mar 2026; Scottish Government response, Mar 2026). The record holds nothing dated later than the response of March 2026 (Cabinet Office response, Mar 2026).
Parliamentary Scrutiny of Emergency Powers
The UK government and devolved administrations should ensure that the draft affirmative procedure is the standard process for enacting substantial and wide-ranging powers in a civil emergency, such as a pandemic, under primary public health legislation.
Any departure from this procedure should be the exception, with clear criteria and safeguards in place to prevent the bypassing of parliamentary scrutiny. These safeguards should include:
‘sunset clauses’ for regulations made using the made affirmative procedure, specifying a clear expiration date, typically within two months; and
a duty on ministers to report to their respective legislatures every two months on the exercise of emergency powers.
The Inquiry recommended making the draft affirmative procedure standard for emergency public health powers. In March 2026, the UK Government (Cabinet Office) stated that sunset clauses and reporting duties can be useful, but legislative approaches must be decided case by case (Cabinet Office response, Mar 2026). The Northern Ireland Executive accepted the recommendation in March 2026, noting that further discussion with Assembly colleagues is required (Northern Ireland Executive response, Mar 2026). The Scottish Government accepted the recommendation in March 2026, agreeing that made affirmative regulations should typically expire within two months (Scottish Government response, Mar 2026). The Welsh Government accepted the recommendation in principle in March 2026, noting that different emergencies require different legislative approaches (Welsh Government response, Mar 2026). The record holds nothing dated later than the response of March 2026 (Cabinet Office response, Mar 2026).
Civil Contingencies Act Review
The UK government should undertake a review of the Civil Contingencies Act 2004 to assess its potential role in managing future civil emergencies, including pandemics, and whether it could be employed as an interim emergency framework until more specific legislation with appropriate parliamentary safeguards is passed.
The review should:
examine the conditions under which the Civil Contingencies Act 2004 may be invoked in a public health emergency;
consider any adjustments to the Act’s safeguards, such as the triple lock test or time limits, that would make it more adaptable to pandemics; and
produce clear guidance on the Act’s application for use in civil emergencies, including pandemics, to support its use as an emergency measure in advance of specific legislation – such as a dedicated pandemic bill – being passed.
The Inquiry recommended reviewing the Civil Contingencies Act 2004 to assess its role in pandemics. In September 2026, Dan Jarvis, answering for the Cabinet Office, stated that a review assessing changes to the legislation and guidance was underway and due before Parliament by March 2027 (Dan Jarvis, Sep 2026). The department had launched a call for views in July 2026 seeking evidence on safeguards for using emergency powers in pandemics (Cabinet Office, Jul 2026). The UK Government accepted the recommendation in March 2026, agreeing to review emergency powers, safeguards, and guidance in collaboration with devolved administrations (Cabinet Office response, Mar 2026).
Public Emergency Information Portal
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should develop an online portal for use in future civil emergencies, where members of the public can access information on the legal restrictions that apply in their area and any associated guidance.
This portal should be easily accessible and its content should be written in straightforward and unambiguous language.
The Inquiry recommended creating an online portal detailing local civil emergency restrictions and guidance. In March 2026, the UK Government (Cabinet Office) stated that existing tools such as GOV.UK would be used rather than a single portal, but committed to co-producing shared emergency communication principles with devolved administrations during 2026 (Cabinet Office response, Mar 2026). The Northern Ireland Executive stated in March 2026 that its NI Direct website could host emergency guidance if required (Northern Ireland Executive response, Mar 2026). Earlier that month, the Scottish Government and Welsh Government similarly favoured relying on their established national websites rather than a unified portal, while agreeing to develop the joint 2026 principles (Welsh Government response, Mar 2026; Scottish Government response, Mar 2026). The record holds nothing dated later than the response of March 2026 (Cabinet Office response, Mar 2026).
Devolved Nations COBR Attendance
The UK government should invite the devolved administrations, as a matter of standard practice, to nominate relevant ministers and officials to attend COBR meetings in the event of relevant whole-system civil emergencies that have the potential to have UK-wide effects.
In its March 2026 response, the UK Government accepted the recommendation, agreeing that devolved government representatives should be invited to COBR and associated taskforce meetings where relevant, while stating that attendance decisions remain on a case-by-case basis for the meeting chair under the Amber Book (Cabinet Office response, Mar 2026). The record holds no update since the Cabinet Office's response of March 2026 (Cabinet Office response, Mar 2026).
Four Nations Pandemic Structure
While intergovernmental relations should be facilitated through COBR in the initial months of any future pandemic, the UK government and devolved administrations should ensure that a specific four-nations structure, concerning pandemic response, is stood up at the same time as the transition away from COBR to nation-specific decision-making structures. This should meet regularly during a pandemic and be attended by all heads of government.
Arrangements for these four-nations meetings should be incorporated into future pandemic preparedness strategies (see the Inquiry’s Module 1 Report, Recommendation 4).
The Inquiry recommended creating a specific four-nations pandemic structure when transitioning from emergency response. In June 2026, Dan Jarvis, Minister for Security, stated that resilience plans had been updated to strengthen relationships with devolved administrations through the four nations ministerial group (Dan Jarvis, Jun 2026). In March 2026, the Cabinet Office agreed a four-nations structure is needed when moving away from Cabinet Office Briefing Rooms (COBR), noting discussions would finalise arrangements and ministerial representation (Cabinet Office response, Mar 2026). That month, the Welsh Government, Scottish Government, and Northern Ireland Executive each agreed to develop joint arrangements, with the Welsh Government stating agreement was achievable within 12 months (Welsh Government response, Mar 2026; Scottish Government response, Mar 2026; Northern Ireland Executive response, Mar 2026).
IPC Structures and Transmission Risk
The UK government must ensure that there is a body (equivalent to the UK Infection Prevention and Control Cell) in place ready to be convened at the outset of any future pandemic, to consider and draft infection prevention and control guidance for healthcare settings. This body must: have clear lines of responsibility and a clear, pre-defined role and remit during a pandemic; have multidisciplinary membership, including experts in the science of viral transmission as well as those with clinical expertise; ensure that its guidance accounts for the risk of all plausible routes of transmission until sufficient evidence emerges to rule out specific routes; and ensure that guidance clearly explains the underlying rationale for the precautions recommended. Separately, the Department of Health and Social Care, NHS National Services Scotland, Public Health Wales and the Public Health Agency (Northern Ireland) should review the national infection prevention and control manuals and any future guidance to ensure that the approach to identifying risk of transmission is not confined solely to specific procedures. Emphasis should be placed on a combination of risk factors, such as rates of transmissibility, environment, setting and procedure.
The UK government (Department of Health and Social Care) accepted the recommendation in September 2026, agreeing that clear, accountable structures must support infection prevention and control decision-making during a pandemic (Department of Health and Social Care and Cabinet Office response, Sep 2026). In the same month, the Scottish Government stated that although the recommendation was not directed at it, joint work was underway on pandemic preparedness proposals and updated guidance had been published (Scottish Government response, Sep 2026). The Welsh Government confirmed in September 2026 that it is participating in a UK-wide review of advisory arrangements and will require health boards to appoint infection prevention and control directors by summer 2027 (Welsh Government response, Sep 2026). The record holds no update since the department's response of September 2026 (Department of Health and Social Care and Cabinet Office response, Sep 2026).
Visiting Restrictions Guidance
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should publish guidance for the implementation of visiting restrictions in hospitals in the event of a future pandemic. The guidance should identify the circumstances in which visiting restrictions should be introduced, escalated, decreased and removed alongside the measures and exemptions at each level. The guidance should be led by the following core principles: 1. Measures applied should be the least restrictive possible, both in terms of severity and the length of time for which they apply. 2. Restrictions should be decided upon and applied at the most local level possible. 3. Unless restrictions are applied at a specified level, trusts and health boards should take decisions on the severity of restrictions based on local risk assessments. 4. Communications with the public must clearly explain the measures in place and the reasons why restrictions apply. The guidance should be reviewed every three years in line with the Inquiry's Module 1 Report (Recommendation 4).
In September 2026, the UK government (Department of Health and Social Care) accepted the recommendation, agreeing to publish additional guidance on visiting restrictions to support decision-making in the event of a future pandemic (Department of Health and Social Care and Cabinet Office response, Sep 2026). The Scottish Government also accepted the recommendation in September 2026, committing to review and strengthen its guidance, while the Welsh Government noted it and committed to developing a clearer national approach (Scottish Government response, Sep 2026; Welsh Government response, Sep 2026). The record holds no update since the department's response of September 2026 (Department of Health and Social Care and Cabinet Office response, Sep 2026).
Fit-Testing Preparedness
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should work with employers, including health boards and trusts, to review the availability of qualified fit testers and take steps to increase the number of fit testers accordingly. Availability should be reviewed every three years in line with the Inquiry's Module 1 Report (Recommendation 4). The Health and Safety Executive and the Health and Safety Executive for Northern Ireland should update their guidance to employers to emphasise the need to ensure that sufficient fit-testing capacity is available.
In September 2026, the Department of Health and Social Care accepted the recommendation, stating that the Health and Safety Executive intends to update its pandemic preparedness guidance for employers by the end of 2026 (Department of Health and Social Care and Cabinet Office response, Sep 2026). In September 2026, the Scottish Government accepted reviewing qualified fit-tester availability while accepting in principle proposals to increase tester numbers, and the Welsh Government noted the recommendation while assessing capabilities across health and social care (Scottish Government response, Sep 2026; Welsh Government response, Sep 2026). The record holds no update since the department's response of September 2026 (Department of Health and Social Care and Cabinet Office response, Sep 2026).
Data Systems for High-Risk Individuals
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive must ensure that health data and digital systems have the capability to identify individuals at high risk of morbidity or mortality from a pandemic disease quickly and accurately in a future pandemic. This should include action to improve health data systems and patient record-keeping by: improving patient data by enabling more granular diagnostic coding; ensuring that care records are compatible across primary and secondary care; and enabling secure data-sharing and linkage across multiple health datasets and systems for identifying individuals at high risk.
In September 2026, the Department of Health and Social Care accepted the recommendation, stating that its 10 Year Health Plan and existing data policy work provide a strong foundation to achieve the required improvements to data systems (Department of Health and Social Care and Cabinet Office response, Sep 2026). The Scottish Government also accepted the recommendation in September 2026, noting that adopting ICD 11 standards will be examined next financial year, while the Welsh Government noted it and committed to provide a more detailed update in May 2027 (Scottish Government response, Sep 2026; Welsh Government response, Sep 2026). The record holds no update since the department's response of September 2026 (Department of Health and Social Care and Cabinet Office response, Sep 2026).
Scale Up Urgent and Emergency Care
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive, in conjunction with organisations responsible for delivering services, should plan for surge capacity in urgent and emergency care during a pandemic. Plans must ensure that there is sufficient workforce capacity and the ability to surge, including the number and type of staff required, recruitment and training provision. This should be completed as part of the whole-system civil emergency strategy recommended in the Inquiry's Module 1 Report (Recommendation 4). Plans should be published and subject to review every three years.
The UK government (Department of Health and Social Care) accepted the recommendation in principle in September 2026, stating that it agrees it is important to continue preparing to scale up urgent and emergency care capacity (Department of Health and Social Care and Cabinet Office response, Sep 2026). In the same month, the Scottish Government also accepted it in principle, commissioning NHS boards to review capacity and surge plans, while the Welsh Government noted the recommendation alongside its winter and year-round emergency planning (Scottish Government response, Sep 2026; Welsh Government response, Sep 2026). The record holds no update since the department's response of September 2026 (Department of Health and Social Care and Cabinet Office response, Sep 2026).
Scale Up Hospital Capacity
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should work with trusts and health boards to ensure that pandemic plans include practical steps to rapidly scale up hospital capacity to treat acutely unwell patients. This should include critical care services that can deliver multiple levels and types of organ support. It should also cover necessary equipment, supplies, space and staff, including redeployment and training. All trusts and health boards must keep an easily accessible, up-to-date record of the information needed to implement these plans in the hospital sites they operate. This should include technical aspects of critical care expansion such as power, ventilation, oxygen and waste management systems. Plans for expanding capacity should be published, subject to review every three years and tested as part of the pandemic response exercises recommended in the Inquiry's Module 1 Report (Recommendation 6).
In September 2026, the Department of Health and Social Care accepted the recommendation in principle, agreeing that it is important to continue preparing to scale up hospital capacity and regularly test this ability during a pandemic (Department of Health and Social Care and Cabinet Office response, Sep 2026). That same month, the Scottish Government also accepted the recommendation in principle, commissioning health boards to review their surge arrangements, while the Welsh Government noted it and stated that its next phase of work will develop plans to increase general hospital capacity (Scottish Government response, Sep 2026; Welsh Government response, Sep 2026). The record holds no update since the department's response of September 2026 (Department of Health and Social Care and Cabinet Office response, Sep 2026).
ICU Resource Allocation Framework
The UK government and devolved administrations should publish a UK-wide framework setting out ethical and operational principles to guide the allocation of adult intensive care resources in the extreme event that they are saturated during a pandemic. That framework must: be informed by comprehensive engagement with the public and developed in conjunction with professionals across healthcare, law and ethics, as well as with regulators of healthcare professionals; set out clearly established triggers for its use, based at least in part on a UK-wide system that measures critical care capacity strain and facilitates mutual aid (such as the CRITCON tool used in England); establish clinicians' legal and professional duties in applying the framework, which should be clearly explained to clinicians through guidance; and be regularly reviewed with reference to contemporary patient data during a pandemic, and any future use of it must be evaluated and reported on publicly. A plan and timeline for completing this work should be published within six months of this Report. Application of the framework should be tested as part of the pandemic response exercises recommended in the Inquiry's Module 1 Report (Recommendation 6).
The Department of Health and Social Care stated in September 2026 that it will explore developing principles to guide adult intensive care allocation during pandemic saturation, but noted that formulating a plan and timeline will take longer than six months (Department of Health and Social Care and Cabinet Office response, Sep 2026). That month, the Scottish Government accepted the recommendation in principle and confirmed work with the other nations, while health advisers and ministers in Wales likewise committed to developing a UK-wide framework (Scottish Government response, Sep 2026; Welsh Government response, Sep 2026). The department stated it will provide an update in May 2027 through the inquiry implementation dashboard, and the record holds no update since the Welsh Government's response of September 2026 (Department of Health and Social Care and Cabinet Office response, Sep 2026; Welsh Government response, Sep 2026).
Recording Healthcare Worker Deaths
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should work with their respective public health agencies and healthcare employers to develop nation-specific mechanisms to collect, analyse and publish data systematically on the deaths of healthcare workers in the event of a pandemic outbreak. The UK Statistics Authority should work with data providers to ensure that the data are comparable across the four nations of the UK.
In September 2026, the Department of Health and Social Care accepted the recommendation, stating that it will take a "proportionate, staged approach" to implementation (Department of Health and Social Care and Cabinet Office response, Sep 2026). The Scottish Government accepted the recommendation in principle in September 2026, proposing a phased approach to test data linkage while noting that differing data sources may prevent complete comparability across the UK (Scottish Government response, Sep 2026). The Welsh Government also agreed in September 2026 to adopt a staged approach, stating that practical, legal, and information governance issues must still be resolved before establishing a reporting mechanism (Welsh Government response, Sep 2026). The record holds no update since the department's response of September 2026 (Department of Health and Social Care and Cabinet Office response, Sep 2026).
Standardised Advance Care Planning
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive, working with trusts and health boards, should establish and promote one standardised process across the UK (such as ReSPECT, the Recommended Summary Plan for Emergency Care and Treatment) for clinicians to ascertain and record their patients' wishes and preferences for future care and treatment in order to inform individualised decision-making, including Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) notices.
In September 2026, the UK government (Department of Health and Social Care) stated that it does not specifically intend to introduce a standard process across the UK and the devolved governments at this time (Department of Health and Social Care and Cabinet Office response, Sep 2026). In September 2026, the Scottish Government accepted the recommendation in principle, stating that while it does not support a mandatory UK-wide process, work is underway to develop a business case for a standardised digital future care plan in Scotland (Scottish Government response, Sep 2026). The Welsh Government also stated in September 2026 that it does not support a single UK-wide process, confirming that it will instead review and strengthen its existing Advance and Future Care Planning Framework (Welsh Government response, Sep 2026).
Healthcare Worker Support
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive, working with healthcare employers and professional bodies, should put in place plans to deliver effective support for healthcare workers at scale from the outset of a pandemic. Plans should cover the nature and level of support that will be provided during and after a pandemic. All four governments should develop a programme of peer support visits that can, from the outset of a pandemic, be targeted towards areas of acute hospitals under considerable strain. The purpose of the visits should be to support front-line staff, collect insights on the pressures that healthcare workers are facing and understand what further support they might need.
In September 2026, the UK government (Department of Health and Social Care) partially accepted the recommendation, stating that it will partner with healthcare employers and professional bodies to establish a scalable psychological support programme with clear triggers and a defined minimum offer (Department of Health and Social Care and Cabinet Office response, Sep 2026). In September 2026, the Scottish Government accepted the recommendation in principle, proposing to develop lists of trained peer supporters, while the Welsh Government noted the recommendation and highlighted its existing workforce wellbeing guidance (Scottish Government response, Sep 2026; Welsh Government response, Sep 2026). The record holds no update since the Scottish and Welsh Governments' responses of September 2026 (Scottish Government response, Sep 2026; Welsh Government response, Sep 2026).
Establish Pharmaceutical Expert Advisory Panel
The UK government should establish a standing pharmaceutical expert advisory panel, in consultation with the Department of Health and Social Care and the Department for Science, Innovation and Technology. The panel should include ministers, civil servants and representatives from industry and academia, and be led by an independent Chair with experience of working in a relevant industry. The panel's role should be to: oversee the UK's preparedness to develop, procure and manufacture pharmaceuticals (vaccines and therapeutics) in the event of a pandemic or health emergency, assisting with cross-government strategy development; ensure that the UK government and devolved administrations, their agencies, industry and academia are aligned around shared goals in developing vaccines and therapeutics for pandemic diseases; oversee strong links between government and the pharmaceutical industry; advise the UK government on how to incentivise pharmaceutical companies to invest in manufacturing facilities and research in the UK; and advise the UK government on its research investments, with a view to ensuring a diverse portfolio of pharmaceutical research in the UK. During a pandemic, the panel should form the basis of specialist taskforces, which would be responsible for securing and developing medical interventions and leading on their procurement on behalf of the four nations of the UK. They should have sufficient autonomy, delegation and direct access to senior ministers, similar to that which worked well in the Covid-19 pandemic.
Formalise Community Vaccine Equity Networks
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should maintain networks with local communities to produce targeted vaccination strategies and communications. To achieve this: The Scottish Government, Welsh Government and Northern Ireland Executive should establish local community networks, mirroring the approach being taken by the UK Health Security Agency. All four governments should work with their network to identify specific and measurable actions to improve vaccine uptake and reduce inequalities and consult with these networks on communications campaigns and delivery approaches. All four governments should publish a report annually on progress against these actions.
The record holds no published response from the UK Health Security Agency, and the Scottish Government had published no formal response to the Module 4 report when checked in September 2026 (Scottish Government response, Sep 2026). The Welsh Government had likewise not published a response when its inquiry module responses were checked in September 2026 (Welsh Government response, Sep 2026). The Northern Ireland Executive had also not published a response when its publications list was checked in September 2026 (Northern Ireland Executive response, Sep 2026).
Improve Vaccine Uptake Monitoring and Evaluation
Each of the four UK public health or health security agencies should work together to: maintain accurate, UK-wide insight into the state of vaccine uptake and hesitancy; and understand the measures proven to be effective in increasing uptake across the four nations of the UK. There should be collaboration and some standardisation in the agreed approach across the four nations for monitoring and publishing routine vaccine uptake and vaccine confidence levels in order to better understand regional variations and patterns. Each nation should set and regularly review its minimum acceptable standards of vaccine uptake, which would trigger targeted uptake campaigns if not reached. The effectiveness of vaccine uptake campaigns should be evaluated against clear, standardised measures. This includes retrospective analysis of the Covid-19 uptake campaigns, as well as evaluation of routine vaccination uptake campaigns.
The Inquiry asked the UK Health Security Agency to monitor and evaluate vaccine uptake. In September 2026, the Northern Ireland Executive had not published a response to the Module 4 report of April 2026 on its publications list (Northern Ireland Executive response, Sep 2026). In September 2026, the Scottish Government had not published a response to the report within its collection of Inquiry responses (Scottish Government response, Sep 2026). In September 2026, the Welsh Government had not published a response to the report on its module responses page (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Proportionate Access to Linked Healthcare Records
The UK government and devolved administrations should work together, with their respective health delivery services, to facilitate and coordinate regulatory bodies' access to healthcare records in order to make the post-authorisation safety monitoring of new vaccines and therapeutics more efficient. In particular, the Medicines and Healthcare products Regulatory Agency should be granted specific and proportionate access to comprehensive and comparable data from across the four nations of the UK, including linked primary and secondary healthcare data records. This should include data on vaccines and therapeutics administration. This improved linkage must be accompanied by strong safeguards for patient confidentiality, which the Information Commissioner's Office should work with the four governments to ensure.
The Medicines and Healthcare products Regulatory Agency has no published response on record, and the Scottish Government had not published a response to the April 2026 report when its collection of inquiry responses was checked in September 2026 (Scottish Government response, Sep 2026). The Welsh Government had likewise not published a formal response when its responses page was checked in September 2026 (Welsh Government response, Sep 2026). When its publications list was checked in September 2026, the Northern Ireland Executive had also published no response to the report (Northern Ireland Executive response, Sep 2026).
Reform Vaccine Damage Payment Scheme
The UK government must reform the Vaccine Damage Payment Scheme as soon as possible. The reform should include as a minimum: increasing the £120,000 payment, at least in line with inflation to date; subsequently applying annual increases in line with inflation; introducing multiple levels of payment, commensurate with the degree of injury suffered; and any transitional arrangements necessary to provide for fairness between applicants to the existing scheme and applicants to the revised scheme.
The Inquiry recommended that the UK government reform the Vaccine Damage Payment Scheme (VDPS). In a June 2026 written parliamentary answer, Sharon Hodgson MP, answering for the Department of Health and Social Care, stated that the Government was actively considering the recommendations of the inquiry on reform of the scheme (Sharon Hodgson response, Jun 2026; Sharon Hodgson, Jun 2026). Referring to a Written Ministerial Statement from April 2026, the Minister added that the Government was carefully considering the findings and would respond within six months of publication (Sharon Hodgson, Jun 2026). The record holds nothing dated later than the response of June 2026 (Sharon Hodgson response, Jun 2026).
Pandemic Stockpile Composition and Inspection
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 Inquiry asked ministers to reform pandemic stockpile composition and introduce annual inspections. The Northern Ireland Executive had not published a response to the July 2026 Module 5 report when the Executive Office publications list was checked in September 2026 (Northern Ireland Executive response, Sep 2026). The Scottish Government had also not published a response to the report when its inquiry publications were reviewed in the same month (Scottish Government response, Sep 2026). Similarly, the Welsh Government had not published a response to the module when its inquiry page was checked in September 2026 (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Pandemic Exercises to Include Emergency Procurement
The UK government and devolved administrations should evaluate the readiness of the structures, systems and processes for the emergency procurement and distribution of healthcare equipment as part of UK-wide pandemic response exercises.
The Inquiry asked governments to evaluate emergency healthcare procurement systems during pandemic exercises across the UK. In September 2026, the Northern Ireland Executive had not published a formal reply to the July 2026 procurement report on the Executive Office publications list (Northern Ireland Executive response, Sep 2026). The Scottish Government also had not published a document addressing the report in its online collection of inquiry responses when checked in September 2026 (Scottish Government response, Sep 2026). The Welsh Government had likewise not published a paper on its inquiry module reports page when reviewed in September 2026 (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Emergency Procurement and Distribution Systems
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 Inquiry recommended that UK administrations establish emergency healthcare equipment procurement and distribution systems. In September 2026, the Northern Ireland Executive had not published a response to the July 2026 report on its publications list (Northern Ireland Executive response, Sep 2026). The Scottish Government had likewise not published a response in its collection of inquiry responses as of September 2026 (Scottish Government response, Sep 2026). Publications on the Welsh Government website in September 2026 also showed that it had not published a response to the report (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Emergency Healthcare Equipment Regulations
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.
The Inquiry asked governments to publish simplified emergency healthcare equipment regulations covering pandemic risks. The Northern Ireland Executive had not published a response to the Module 5 report of 14 July 2026 when the Executive Office's publications list was checked in September 2026 (Northern Ireland Executive response, Sep 2026). The Scottish Government had also not published a response to the report when its online collection was checked in September 2026 (Scottish Government response, Sep 2026). In September 2026, the Welsh Government had likewise not published a response on its inquiry responses page (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Emergency Healthcare Equipment Plan
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 Inquiry asked UK regulators to create an emergency healthcare equipment plan for future pandemics. When the Executive Office's publications list was checked in September 2026, the Northern Ireland Executive had not published a response to the Module 5 report of 14 July 2026 (Northern Ireland Executive response, Sep 2026). The Scottish Government had also not published a response to the report when its collection of inquiry responses was checked in September 2026 (Scottish Government response, Sep 2026). Similarly, the Welsh Government had not published a response when its module reports page was checked in September 2026 (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Blueprints for Critical Care Medical Technology
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 Inquiry recommended commissioning expert blueprints for scalable intensive care medical technology. In September 2026, the Northern Ireland Executive had not published a response to the Module 5 report when the Executive Office's publications list was checked (Northern Ireland Executive response, Sep 2026). A check of gov.scot in September 2026 recorded that the Scottish Government had not published a response to the July 2026 report (Scottish Government response, Sep 2026). The Welsh Government also had not published a response when its collection of inquiry module responses on GOV.WALES was checked in September 2026 (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Trade and Industry in the Civil Emergency Strategy
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 Inquiry asked the Cabinet Office to incorporate trade and industry objectives into civil emergency planning. When the Executive Office's publications list was checked in September 2026, a response to the July 2026 Module 5 report from the Northern Ireland Executive remained unpublished (Northern Ireland Executive response, Sep 2026). When the Scottish Government's online collection of inquiry responses was checked in September 2026, its response to the report also remained unpublished (Scottish Government response, Sep 2026). When the Welsh Government's page of inquiry module responses was checked in September 2026, its response likewise remained unpublished (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Training in Emergency Procurement and Distribution
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 Inquiry recommended establishing trained pools of officials for emergency healthcare equipment procurement and distribution. In September 2026, the Northern Ireland Executive's publications list indicated that a formal response to the July 2026 Module 5 report remained unpublished (Northern Ireland Executive response, Sep 2026). The Scottish Government's published records of inquiry responses similarly indicated in September 2026 that its formal response had not been published (Scottish Government response, Sep 2026). The Welsh Government also had not published a formal response to the report on its website as of September 2026 (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Commercial Framework for Emergency Procurement
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 Inquiry recommended establishing a UK-wide commercial framework for emergency healthcare procurement specialists. The Northern Ireland Executive had not published a response to the Module 5 report of July 2026 when the Executive Office's publications list was checked in September 2026 (Northern Ireland Executive response, Sep 2026). The Scottish Government had not published a response to the report when its collection of inquiry responses was checked in September 2026 (Scottish Government response, Sep 2026). The Welsh Government had likewise not published a response to the report when its module responses page was checked in September 2026 (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Transparency, Governance and Accountability in Emergencies
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.
The Inquiry asked UK governments to improve emergency procurement transparency, governance, and accountability. In September 2026, the Northern Ireland Executive had yet to publish a reply to the July 2026 Module 5 report on the Executive Office publications list (Northern Ireland Executive response, Sep 2026). A check of the Scottish Government website in September 2026 similarly showed that it had not published a reply to the report (Scottish Government response, Sep 2026). The Welsh Government had likewise not published a reply when its website was reviewed in September 2026 (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).
Data and Technology in Emergency Procurement
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.
The Inquiry recommended digitalising healthcare equipment procurement systems across the United Kingdom (UK). In September 2026, the Northern Ireland Executive had not published a formal reply to the July 2026 report on its publications list (Northern Ireland Executive response, Sep 2026). The Scottish Government in September 2026 had likewise not published a formal reply within its online collection of inquiry responses (Scottish Government response, Sep 2026). The Welsh Government in September 2026 had also not published a formal reply on its inquiry module reports page (Welsh Government response, Sep 2026). The record holds nothing dated later than the response of September 2026 (Welsh Government response, Sep 2026).