Delivering core NHS and care services during the pandemic and beyond Contents


1.The coronavirus pandemic posed an unprecedented dual challenge to the NHS and social care system. The first part of this was to ensure swift and effective medical treatment to those who had contracted the virus under a potentially disastrous yet very real threat of the NHS becoming overwhelmed, as was seen for example in parts of Italy. The second element was to ensure that in dealing with the pandemic, the NHS and care services did not neglect the ongoing and critical health and care needs of the population not affected by COVID-19.

2.Our work in the weeks and months following the arrival of COVID-19 in the UK has considered the response to both challenges. In evidence sessions on Management of the Coronavirus Outbreak,1 we have heard from the Chief Medical Officer and his deputies, the Government Chief Scientific Adviser, the Secretary of State, the Head of NHS Test and Trace and international scientific experts on the pandemic response, as well as from staff and care users involved at the front line of the response to the pandemic. Meanwhile, in a separate series of evidence sessions held under the title Delivering core services during the pandemic and beyond,2 we have heard from a wide variety of stakeholders including Royal Colleges, NHS Providers, the NHS Confederation, patients and patient groups, health think tanks, and the Chief Executive of the NHS and other senior NHS England and Improvement leaders.

3.During this inquiry, we received over 350 items of written evidence which can be found on our website. We are grateful to all those who have taken the time to contribute to our work since the coronavirus pandemic hit the UK, and particularly to NHS patients Rob Martinez and Daloni Carlisle and third sector organisations Versus Arthritis, MacMillan Cancer and National Voices for championing the patient voice throughout our inquiry. The work we have done has played a key role not only in scrutinising and publicly holding to account those who have been advising and making decisions in Government and the NHS in recent months, but also in giving a public voice to staff, patients and care users on the front line of the pandemic response.

4.We also thank the Government, NHSE/I and Public Health England, who have, despite inevitable controversy, endeavoured to put patients first and ensure clinical care continues in the best way possible. The construction of Nightingale Hospitals in record time alongside rapid securing of capacity from the independent sector through landmark deals meant ultimately that not a single coronavirus patient was denied a hospital bed (IU or otherwise) or a ventilator—a significant achievement that did not happen in a number of other countries and is a tribute to all those who made it possible.

5.This report draws together some key conclusions and recommendations from our work on Delivering core services during the pandemic and beyond.3 It also follows a letter which we sent to the Secretary of State and the Chief Executive of NHS England and Improvement in July 2020,4 which highlighted three key areas which required urgent attention: communication with patients; waiting times and managing the backlog of appointments caused by the pandemic; and the value of routine testing of all NHS staff for COVID-19. We have received replies to that letter,5 for which we are grateful to both the Secretary of State and the Chief Executive of NHSE/I. Those replies partially address our concerns but we still believe further work needs to be done in order to prepare the NHS for a possible winter spike in the virus, provide much-needed reassurance to NHS and care workers, and ensure that patients receive the care they need in a safe environment.

6.The purpose of this report is to address the key points which have arisen from the substantial amount of written and oral evidence we have taken during this inquiry. We begin with patients: first of all drawing out communication issues which may not necessarily be the top priority in the context of a pandemic, but which our inquiry shows to be deserving of much greater and more focused attention; and then addressing the question of the response of the NHS to managing the backlog of appointments which has built up as services were scaled back to deal with COVID-19. We then turn to issues facing the NHS and care staff, particularly those who have been part of the front-line response to the pandemic: access to personal protective equipment (PPE); regular testing of all staff; and workforce fatigue and burnout, and race and discrimination in the NHS. Finally, we consider some important lessons which can be learnt from the pandemic response for the future of NHS services.

7.Delivering core NHS and care services during the pandemic has been a huge challenge; the task of continuing to deliver them beyond the pandemic—and potentially through a second wave—will be just as arduous. The recommendations of this report are designed to focus the attention of the Government and the management of the NHS on key points which we believe will equip the NHS and care services better to deal with the challenges in the next phase of the pandemic, to the benefit of patients, NHS and care staff, and future reform of the system alike.

Published: 1 October 2020