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.
- DHSC published a Pandemic Preparedness Strategy on 25 March 2026, which includes commitments on vulnerability frameworks.
- Cabinet Office published updated guidance on identifying vulnerable people in emergencies in April 2025 (Identifying and supporting persons who are vulnerable in an emergency, Cabinet Office, April 2025).
- The UK Government Resilience Action Plan was published in July 2025.
- The National Situation Centre has created a Risk Vulnerability Tool to estimate vulnerable populations.
- NHS England's Core20PLUS5 framework is in use to address healthcare inequalities.
- DHSC has committed to reviewing existing guidance to identify gaps, but this review is still underway.
How was this evidence gathered?
Response
Accepted
Response
AcceptedThe government agrees with the Inquiry that it is important to consider those most at risk in an emergency and to take specific steps to mitigate these risks as part of any future pandemic response.
The government has a number of guidance documents for identifying and supporting vulnerable people during a civil emergency. DHSC will undertake a review of the guidance to identify any gaps and establish a programme of work to better embed and consolidate the use of existing frameworks into decision-making.
Communicable disease outbreaks, including pandemics and emergencies, can amplify health, social, and economic inequities through disproportionate infection and illness rates and unequal impacts of response measures. This can result in income loss, job insecurity, education gaps and social isolation. Inequities can affect groups that have been identified as vulnerable or at risk before a pandemic, as well as groups that are more likely to be negatively impacted by decisions taken as part of a pandemic response (including health and care staff). This can also be particularly acute for children. It is also important to consider that different groups will be impacted variably in different emergencies, for example, Covid-19 and elderly people or HIV and gay, bisexual and other men who have sex with men (GBMSM) and people who inject drugs (PWID).
Since the Covid-19 pandemic, the government has significantly strengthened preparedness and planning for pandemic and emergency response and the protection of vulnerable groups. For example:
- The Department of Health and Social Care has published a Pandemic Preparedness Strategy on 25 March 2026.
- Cabinet Office published updated guidance in April 2025, Identifying and supporting persons who are vulnerable in an emergency: Supporting guidance for Local Resilience Forums in England.
- Cabinet Office and the GO Science circulated internal guidance to departments in November 2025, which sets out principles to help identify potentially vulnerable people during an emergency.
- Cabinet Office published the UK government Resilience Action Plan in July 2025.
- NHS England has adopted Core20PLUS5 which seeks to reduce healthcare inequalities at both national and local system level.
- The National Situation Centre has created a Risk Vulnerability Tool (RVT) to estimate the number of people who are vulnerable to the negative impacts of NSRA risks.
- The NSRA update in 2025 for R78 for a pandemic has a more extensive assumption than before to be used for vulnerable groups for pandemic planning.
DHSC's review of the existing relevant guidance documents will identify any gaps and establish a programme of work to better embed and consolidate use of existing documents into decision-making, including the needs of vulnerable children.
Outcome 5 of the Strategy commits to publishing health evidence reviews on the effectiveness of community protection measures including specific consideration of health inequalities.
DHSC will also review how data, evidence, and analysis, including vulnerability assessments, inform decision-making and can evaluate the impacts of measures (Outcome 12).
Health is a devolved matter in the UK and the government recognises that there are different approaches to identify and protect vulnerable groups across the four nations.
No formal response published by this government.
No formal response published by this government.
No formal response published by this government.
The government agrees with the Inquiry that it is important to consider those most at risk in an emergency and to take specific steps to mitigate these risks as part of any future pandemic response.
The government has a number of guidance documents for identifying and supporting vulnerable people during a civil emergency. DHSC will undertake a review of the guidance to identify any gaps and establish a programme of work to better embed and consolidate the use of existing frameworks into decision-making.
Communicable disease outbreaks, including pandemics and emergencies, can amplify health, social, and economic inequities through disproportionate infection and illness rates and unequal impacts of response measures. This can result in income loss, job insecurity, education gaps and social isolation. Inequities can affect groups that have been identified as vulnerable or at risk before a pandemic, as well as groups that are more likely to be negatively impacted by decisions taken as part of a pandemic response (including health and care staff). This can also be particularly acute for children. It is also important to consider that different groups will be impacted variably in different emergencies, for example, Covid-19 and elderly people or HIV and gay, bisexual and other men who have sex with men (GBMSM) and people who inject drugs (PWID).
Since the Covid-19 pandemic, the government has significantly strengthened preparedness and planning for pandemic and emergency response and the protection of vulnerable groups. For example:
- The Department of Health and Social Care has published a Pandemic Preparedness Strategy on 25 March 2026.
- Cabinet Office published updated guidance in April 2025, Identifying and supporting persons who are vulnerable in an emergency: Supporting guidance for Local Resilience Forums in England.
- Cabinet Office and the GO Science circulated internal guidance to departments in November 2025, which sets out principles to help identify potentially vulnerable people during an emergency.
- Cabinet Office published the UK government Resilience Action Plan in July 2025.
- NHS England has adopted Core20PLUS5 which seeks to reduce healthcare inequalities at both national and local system level.
- The National Situation Centre has created a Risk Vulnerability Tool (RVT) to estimate the number of people who are vulnerable to the negative impacts of NSRA risks.
- The NSRA update in 2025 for R78 for a pandemic has a more extensive assumption than before to be used for vulnerable groups for pandemic planning.
DHSC's review of the existing relevant guidance documents will identify any gaps and establish a programme of work to better embed and consolidate use of existing documents into decision-making, including the needs of vulnerable children.
Outcome 5 of the Strategy commits to publishing health evidence reviews on the effectiveness of community protection measures including specific consideration of health inequalities.
DHSC will also review how data, evidence, and analysis, including vulnerability assessments, inform decision-making and can evaluate the impacts of measures (Outcome 12).
Health is a devolved matter in the UK and the government recognises that there are different approaches to identify and protect vulnerable groups across the four nations.
Progress Timeline
Status: Pending. No government response yet received. Module 2 report published 20 November 2025.