The UK Covid-19 Inquiry is an independent public inquiry set up to examine the UK’s response to and impact of the Covid-19 pandemic, and to learn lessons for the future. The Inquiry’s investigations are divided into modules which examine different aspects of the pandemic in turn.

In addition, the BMA and BMA Scotland are contributing to the Scottish Covid-19 Inquiry which is separate to the UK Covid-19 Inquiry. The Scottish Covid-19 Inquiry is investigating aspects of Scotland’s strategic response to the pandemic, including its impact on the provision of health and social care. Hearings began in October 2023. Read more on our engagement with the Scottish Covid-19 Inquiry.

Latest UK Covid-19 Inquiry activity

Module 3: Impact of the pandemic on healthcare

The third module of the UK Covid-19 Inquiry examines the impact of the pandemic on healthcare delivery, healthcare staff and patients.

The BMA is a core participant for Module 3. Evidence hearings will run from 9 September 2024 to 28 November 2024.

The BMA believes that:

• Adequate protections were not put in place to protect staff from harm. This includes PPE shortages, inadequacy of the recommended PPE, insufficient risk assessments, an initial lack of regular testing for staff and patients, and buildings that were unsuitable for full infection prevention and control measures. Infection Prevention and Control (IPC) guidance failed, and continues to fail, to properly recognise that Covid-19 spreads via the air, and instead leaves staff exposed and unprotected.
• Healthcare staff worked tirelessly to safeguard the nation’s health and care for those in need, often at great personal cost to their physical and mental health. The impact on staff continues to this day, with ongoing experiences of Long Covid, burnout, trauma, stress, and poor psychological safety.
• Impacts were not felt equally, for staff or for patients. The pandemic had a large disproportionate impact on certain groups, including ethnic minorities and those with disabilities or long-term health conditions.
• The overall state of health and care systems across the UK in the years leading up to the pandemic played a major role in the inability of these systems to cope when Covid-19 arrived. It exacerbated the severe disruption to healthcare delivery, with major consequences for staff and patients, and continues to impact health services today.
• These pre-pandemic failures resulted in unprecedented measures to bring in staff, including calls for retired staff to return to service, medical students joining the workforce early and the use of volunteers. Staff had to be redeployed, often starting new roles without training or adequate supervision.

It is essential for the Inquiry to make recommendations that will reduce the impact of a future pandemic on healthcare staff, including ensuring that staff are protected against risks and that unequal impacts are prevented and mitigated.

The severe consequences of entering the pandemic with under-resourced and understaffed healthcare systems mean it is also vital for the Inquiry to make recommendations that will lead to a better resourced NHS with sufficient capacity for both ‘normal’ times and emergencies, and which supports staff physical and mental health.

Opening statement of the BMA to Module 3 of the UK Covid-19 Inquiry

On 10 September 2024, the BMA delivered its opening oral statement for Module 3 of the UK Covid inquiry. The BMA highlighted the severe impact of the pandemic on healthcare workers and patients, emphasising how under-resourced systems worsened the crisis. It called attention to failures in staff protection, particularly within relation to inadequate PPE, and the unequal impact on certain minority groups, including along lines of disability, ethnicity and gender. The BMA urged the Inquiry to make recommendations for better–resourced healthcare systems, improved staff protections, and actions to address poor population health and health inequalities for future emergencies. Emergencies. Read the opening oral statement.

Other modules

Module 1: Resilience and preparedness

The first module focused on pre-pandemic resilience and preparedness from 2009 to 2020. The evidence hearings for this module have concluded, and the Chair's report and recommendations were published on 18th July 2024. The BMA actively participated in Module 1, including by providing oral and written evidence, making opening and closing statements and asking questions of witnesses.

The BMA believes the UK entered the pandemic significantly underprepared and lacking resilience, largely due to:

• A lack of preparation for a range of pandemic threats beyond influenza
• The failure to implement the recommendations from pandemic planning exercises
• A decade of underfunding for public health systems which meant they lacked vital capacity and were not able to scale up activity
• Chronic underinvestment in healthcare systems, with reduced bed stock, acute staffing shortages and already high waiting lists
• Poor population health and widening health inequalities

Key findings from the Chair’s report:

• The UK was ill-prepared to handle a catastrophic emergency, leading to preventable loss of lives.
• The report acknowledges that the impact of the pandemic on the NHS has been immense.
• The likelihood of pandemics is increasing, and improvements are required immediately.
• The UK entered the pandemic with poor population health and significant health disparities, which affected the UK’s resilience. Future pandemic preparedness efforts need to better address and mitigate health inequalities.
• There was an absence of the infrastructure needed for a pandemic, including in relation to health and social care and a large-scale testing, tracing, and isolating system.
• The pandemic preparedness exercises were found to be significantly inadequate, highlighting the urgent need for better planning and preparedness.
• Pandemic preparedness relies on expert advice and during Covid-19 this advice was overly focused on biomedical science.
• Updates to pandemic plans made by the UK Government since the acute Covid-19 pandemic have been inadequate, and more effective measures are needed.

Module 2: Core UK decision-making and political governance

The second module examines core administrative and political decision making of the UK Government during the pandemic. There are also sub-modules 2a, 2b, and 2c examining the same issues in relation to the Devolved Administrations in Scotland, Wales and Northern Ireland

The BMA is a core participant for Module 2 and provided oral and written evidence. The evidence hearings for this module have now finished, with the Chair’s report expected to be published in 2024.

The BMA believes that:

• The UK Government’s response to the pandemic was categorised by a failure to take a sufficiently precautionary approach, despite repeated warnings from the BMA and others, and missed opportunities to learn lessons as the pandemic progressed.
• Government actions – and inaction – very likely led to greater transmission of the virus, increased risk of harm for those who caught Covid including due to long Covid, and adversely impacted patients who required non-Covid care and treatment.
• Doctors and healthcare workers were not sufficiently considered in UK Government decisions. These decisions had huge impacts for healthcare workers by putting extra pressure on already stretched and stressed healthcare and public health systems, increasing workload, and causing moral distress and injury for doctors and healthcare workers who felt unable to provide the right level of care for all who needed it, including for non-Covid patients.

Module 4: Vaccines and therapeutics

The fourth module examines the development of Covid-19 vaccines and the implementation of the vaccination rollout programme.

The BMA is a core participant for Module 4. Evidence hearings will take place from 14 - 30 January 2025.

Module 5: Procurement

The fifth module examines procurement processes, the adequacy of items obtained (including specifications, quality, and quantity) and the distribution to the end-user of PPE, ventilators, oxygen, lateral flow tests and PCR tests across the UK.

The BMA is a core participant for Module 5. Evidence hearings will take place from 3rd March – 3rd April 2025.