Reports & recommendations

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 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 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).