Government messaging urging the public to “stay at home” during the Covid pandemic deterred people from accessing vital healthcare – even in the event of life-threatening emergencies such as heart attacks, an inquiry has concluded.
The “stay home, protect the NHS, save lives” message, which was created by Cabinet Office officials without input from health leaders and pushed relentlessly by ministers, “sent the message that healthcare was closed”, according to the UK Covid-19 Inquiry.
Some people steered clear of A&E, even for life-threatening emergencies, and they did not seek help for other medical conditions to avoid being a burden to the NHS, as well as not attending hospitals for fear of catching the virus, according to the latest inquiry report.
The report found that delays prompted by the outbreak of Covid in the UK in early 2020 rendered some patients’ health conditions “untreatable” and “cost lives”.
“It is clear that, during the pandemic, worsening delays in diagnosis and treatment led to increased ill-health and suffering and, in some cases, cost lives,” the report said. “Some patients waited so long that they were no longer suitable for surgery and have been left with permanent loss of mobility.”
The report also highlights how the need to protect the NHS from being overwhelmed became a key priority for politicians.
Ministers, including Matt Hancock, the health secretary at the time, insisted the health service was not overwhelmed, but inquiry chair Heather Hallett said this was “semantics”, adding: “There was clearly overwhelm. Politicians, including the secretary of state for health and social care... were reluctant to accept that healthcare systems were ‘overwhelmed’, as they chose this to mean total collapse. Ultimately, in my view, it is a question of semantics. Whatever word one chooses, healthcare systems were placed under intolerable strain.”
Other findings from the new Covid public inquiry report include:
- Thousands of patients died in hospitals alone and grieving families were deprived of the opportunity to say goodbye
- Many patients with Covid-19 “did not get the quality of treatment they needed”
- Initial guidance on preventing the infection from spreading was “flawed” because it “failed properly to consider the extent to which the virus was also spread by aerosol transmission”, initially focusing on spread through contact
- Visiting restrictions “may be unavoidable” in a pandemic, but should be “facilitated as far as possible”
- Communications with millions of people shielding during the crisis “were not always appropriately handled”, with some incorrectly told to shield while others were not given the instruction when they should have
- Lady Hallett said there also needed to be better planning for end-of-life care, highlighting reports of blanket “do not attempt cardiopulmonary resuscitation” (DNACPR)
- Pausing cancer screening in some nations – such as pausing the bowel cancer screening programme in Scotland, Wales and Northern Ireland – led to a “steep drop in diagnosis” in 2020.
The 387-page report says the UK entered the crisis “ill-prepared”, with the NHS in a “parlous state”, with severe workforce shortages, low hospital bed numbers and high bed occupancy rates.
“It is unsurprising, therefore, that the impact on the healthcare systems of the four nations was devastating,” she wrote.
In a statement, she added: “I can summarise that impact as: we coped, but only just. The healthcare systems came close to collapse. Healthcare workers carried the burden of caring for the sick in unprecedented numbers. It came at a huge cost to them, their families, their patients and the loved ones of patients. Collapse was only narrowly avoided thanks to the extraordinary efforts of all those working in healthcare across the UK.
“Despite those efforts, some patients did not get the level of care they would usually receive. The enormous strain placed upon the healthcare systems was unprecedented. Those working within it were obliged to work under intolerable pressure for months on end.”
The report makes 10 recommendations “to prevent healthcare systems being overwhelmed in the next pandemic”. These include increasing capacity in urgent and emergency care; strengthening the body responsible for infection prevention and control guidance and better advanced care planning. But Lady Hallett warned the government that it may not have a healthcare workforce “able or willing” to work through a future pandemic, stressing the severity of the effect of Covid on healthcare staff.
Stressing its impact on healthcare staff, some of whom now have PTSD, she said: “There are many lessons to be learned from the experiences of the UK’s healthcare systems during the Covid-19 pandemic and many areas for improvement.”
Lady Hallett added: “I urge the governments of the UK to implement my recommendations and to do so as a matter of urgency. When the next pandemic strikes, there may not be a workforce in the healthcare systems able or willing to work under the conditions that arose during the Covid-19 pandemic.”
The NHS waiting list in England hit a record high in September 2023, with 6.5 million patients waiting for 7.77 million treatments.
The latest data shows the waiting list has fallen for the third month in a row, with an estimated 7.25 million treatments waiting to be carried out at the end of January, relating to 6.13 million patients.
The inquiry was formally launched in July 2022, and a report published in November last year found that chaos at the heart of government and a failure to take Covid seriously cost 23,000 lives in the first wave of the pandemic.
By the end of last December, the inquiry had spent just under £204m, including on setup, chair’s expenses and lawyer costs, and holding public hearings in all four nations of the UK. The government said it had spent £111m in responding to the inquiry, covering legal advice and staffing costs.
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