Nurses still facing pressures from government’s Covid pandemic ‘failures’

The former government’s response to the Covid-19 pandemic ‘repeatedly amounted to a case of “too little, too late”’, a national inquiry has found.

The latest report from the UK Covid-19 Inquiry concluded that the response to the outbreak was too delayed and that early inaction meant mandatory national lockdowns were ‘the only viable option’.

Royal College of Nursing (RCN) general secretary and chief executive Professor Nicola Ranger said nurses would ‘never forget how they and their patients were failed’ by those in government and warned that a failure to respond to the pandemic with urgency added ‘unprecedented pressures’ on the health service that were still being felt more than five years later.

Published on Thursday, the second report from Baroness Heather Hallett, chair of the inquiry, focused on ‘core decision-making and political governance’ and drew on oral evidence from more than 160 witnesses across nine weeks of hearings in late 2023 and early 2024.

Although politicians faced ‘unenviable choices’, the Baroness Hallett concluded that the response of the four UK governments was repeatedly ‘too little, too late’.

‘When they did realise the scale of the threat, politicians and administrators in the UK government and the devolved administrations were presented with unenviable choices as to how to respond,’ she said in a speech to media yesterday.

‘Whatever decision they took there was often no right answer or good outcome. They also had to make decisions in conditions of extreme pressure. Nonetheless, I can summarise my findings of the response as ‘too little, too late’.

The report also said the Department of Health and Social Care (DHSC) gave ‘misleading assurances’ about the UK’s preparedness for a future pandemic.

Earlier, stronger measures ‘could have avoided lockdown’

The report states that stronger restrictions introduced earlier could have prevented the need for full national lockdowns.

‘Had more stringent restrictions, short of a stay-at-home lockdown, been introduced earlier than 16 March, when the number of Covid-19 cases was lower, the mandatory lockdown that was imposed might have been shorter or conceivably might not have been necessary at all’, it says.

It also found the UK Government, Welsh Government and Northern Ireland Executive introduced restrictions too late during rising infection rates in autumn 2020. These restrictions were ‘not in place for long enough or were too weak’ to control spread.

According to the report, a ‘circuit breaker’ lockdown in late September or early October 2020 could have shortened or even avoided England’s second national lockdown on 5 November.

The report cites modelling which says if a lockdown had first been introduced on or immediately after 16 March 2020, then it would have reduced the death toll in the first wave – up to the start of July – by 23,000 in England.

‘No choice’ but to mandate lockdown

Baroness Hallett said: ‘The governments of the UK, in taking the ultimate step to impose a mandatory lockdown, acted in the genuine and reasonable belief that it was required. They had no choice.’

She continued: ‘While the lockdowns of 2020 and 2021 undoubtedly saved lives, they also left lasting scars on society, the UK economy, they brought ordinary childhood to a halt, delayed the diagnosis and treatment of non-Covid health conditions, exacerbated societal inequalities and had a severe impact on people’s mental health.

‘These are all issues being explored in other modules in greater detail.’

The inquiry’s next report, focusing on the Impact of Covid-19 pandemic on healthcare systems in the four nations of the UK, will be published next year.

Another six reports will follow this, with the final report scheduled to be published no later than summer 2027.

Nurses ‘paid the ultimate price’

Responding to the findings the RCN general secretary and chief executive, Professor Nicola Ranger, said: ‘Nursing staff will never forget how they and their patients were failed by those at the highest levels of government.

‘While those on the frontline of the battle against the virus were sounding the alarm, warnings were left unheeded.’

Professor Ranger described how nurses’ voices ‘went unheard’ and said many ‘paid the ultimate price’ to protect their patients.

‘The failure to respond with any sense of urgency at the start of the pandemic not only cost lives it added unprecedented pressures on the NHS, which are still being felt to this day.

‘This report must mark a turning point in how health emergencies are responded to and how the voice of nursing must never be ignored again.

‘The nursing profession made a profound sacrifice, and this is a debt that is still to be repaid.’

In March this year, Professor Ranger said nursing was at risk of being seen as ‘expensive and dispensable’ after the pandemic, despite the extraordinary efforts of the workforce during this time.

Care homes: older and disabled people ‘especially hard-hit’

The report highlighted the disproportionate impact of Covid-19, and of the restrictions used to control it, on older and disabled people. It stressed the need for future pandemic plans that protect those most vulnerable to both infection and social isolation.

It references former health secretary Matt Hancock’s evidence that the decision to discharge untested patients into care homes had been ‘the least worst of all the options’.

Related Article: QICN to close long Covid nursing network

Meanwhile, Age UK’s charity director Caroline Abrahams had told the inquiry: ‘Older people in residential care described losing the will to carry on; people living with dementia lost their remaining memories and recognition of people in their lives; and thousands of people would go on to die without ever seeing their loved ones again.’

On 17 March 2020, the then Prime Minister Boris Johnson told Cabinet that patients occupying hospital beds who would otherwise be in social care should be discharged to free capacity.

That same day Sir Simon Stevens, then chief executive of NHS England (NHSE), instructed trusts to ‘urgently discharge all hospital inpatients who are medically fit to leave’ to free more than 30,000 beds, and advised postponing all non-urgent elective operations from 15 April for at least three months.

In July, a former social care nurse told the Covid-19 Inquiry that she wrote her final wishes on a card in case she died at work and was forced to freeze face masks to reuse in the future because of a scarcity of personal protective equipment (PPE).

‘Important lessons to be learnt’

Responding to the Covid inquiry report Unison general secretary Christina McAnea said: ‘Ministers failed to keep thousands of vulnerable people and workers safe.

‘There are important lessons to be learned. Among them, fixing social care must be a top government priority.

‘A nationally integrated, fully funded system could have saved lives. And the UK might have avoided one of the worst death rates in Europe.’

According to World Health Organization (WHO) data, between 5 January 2020 and 22 April 2022, when the EU declared the emergency phase of the pandemic over, Britain recorded 2,905.6 deaths per million people.

This was higher than the EU average of around 2,401.4 per million.

In October, the chief executive of the Institute of Health Visiting (iHV) Alison Morton told the latest phase of the UK Covid-19 Inquiry that the concerns of health visitors about families and children were not ‘taken seriously enough’ and that the significance of their role was not appreciated by healthcare leadership.

Last September, former chief nursing officers (CNOs) from the UK’s four nations shared their experiences of the Covid-19 pandemic.

Dame Ruth May, the former CNO for England, said the removal of the bursary for student nurses was a ‘catastrophic decision’ which undermined pre-pandemic preparations and had a lasting impact on the nursing workforce.

Last November, nurses who contracted long Covid during the pandemic told the inquiry they were made to feel ‘disposable’ by NHS management and that a more ‘robust system’ is needed to support nurses at home when they develop the condition.

A Cabinet Office spokesperson said: ‘The government thanks Baroness Hallett and her team for their thorough work on these serious issues.

‘We will consider its findings and recommendations in detail and respond in due course. The government remains committed to learning the lessons needed from the Covid Inquiry to protect and prepare us for the future.’

The Conservative Party has been contacted for comment.