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 7: Test, Trace and Isolate
The seventh module of the inquiry is examining the Test, Trace and Isolate systems which were set up across the UK. The Inquiry will delve into these systems which were critical to the government’s public health strategy, aiming to identify and contain the spread of the virus through mass testing, contact tracing, and isolation measures. The Inquiry is hearing evidence about how effectively these mechanisms functioned, their coordination across devolved nations and the extent to which they contributed to or hindered the control of COVID-19. It is also examining the decision-making processes, the use of data and technology and the consequences for individuals and communities.
The BMA’s views on the content of Module 7 are as follows:
- The BMA believes the UK's pandemic response was significantly hampered by the lack of an effective test, trace, and isolate system and the failure to scale it up rapidly.
- The UK's contact tracing and testing systems were unprepared for a pandemic due to years of budget reductions and funding cuts in Public Health, inadequate staffing, and the impact of the 2012 Health and Social Care Act.
- There was a failure to utilise existing Public Health resources and expertise in relation to testing and contact tracing. The BMA advocates for England's contact tracing systems to be run at the local authority level, believing they were better equipped.
- Key priorities were ensuring timely testing for healthcare staff, patients, and the public, and a well-resourced contact tracing system to reduce transmission.
- The BMA expresses concerns about the Government’s overreliance on a private sector lacking relevant expertise for the establishment of test centres and laboratories, and the failure to utilise pre-existing NHS, Public Health and university laboratories.
- Delays in accessing tests and receiving results for healthcare workers led to severe staff shortages due to unnecessary self-isolation.
- The end of free testing, contact tracing, and self-isolation payments weakened the ability to safeguard the most clinically vulnerable.
- Overall confidence by doctors in the ability of TTI systems to contain the spread of Covid was low, something the BMA voiced regularly
- Testing capacity was slow to increase and lagged behind other countries in the initial stages of the outbreak.
- The outsourced model of contact tracing in England was considered a critical and costly failure The BMA believes publicly run models were potentially more effective and cheaper.
- The BMA worked closely with the Government and NHS England on the design of the NHS Covid-19 app, raising concerns about privacy implications and advocating for a decentralised model for data storage.
- There was an initial lack of testing capacity in the community and in health and social care settings, leading to issues such as patients being discharged from hospital into community care settings without being tested for Covid-19.
- The BMA highlights the lack of culturally competent communications on the need to self-isolate and how to access support.
- The government failed to consider clinically vulnerable people when it ended free testing and other public health protections.
While the BMA is not a core participant for Module 7, we are following closely and will keep our community updated via social media and our newsletter. The hearings will run from the 12 May – 30 May.
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.
- BMA written witness statement 24/04/23
- BMA opening oral statement 13/06/23 - readout
- BMA opening oral statement 13/06/23 - video
- Press release 20/06/23
- BMA oral evidence 17/07/23
- Press release 17/07/23
- BMA closing oral statement 19/07/23 - video
- BMA closing oral statement 19/07/23 - readout
- BMA closing written statement 07/08/23
- Inquiry's Module 1 report
- Inquiry's Module 1 report ‘In Brief’ summary
- Press release 18/07/24
- The Doctor Magazine article 18/07/24
- UK Government response to the Inquiry's Module 1 recommendations 16/01/25
- BMA blog on UK Government's response 29/01/25
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 2025.
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.
- BMA written witness statement 21/07/23
- BMA opening oral statement 04/10/23 - readout
- BMA opening oral statement 04/10/23 - video
- BMA oral evidence 05/10/23
- Press release 05/10/23
- Press release 31/10/23
- BMA questions to Dr Yvonne Doyle 02/11/23
- BMA questions to Kemi Badenoch 23/11/23
- BMA questions to Professor Dame Jenny Harries 29/11/23
- BMA questions to Matt Hancock 01/12/23
- BMA questions to Boris Johnson 07/12/23
- Press release 07/12/23
- BMA closing oral statement 13/12/23 - readout
- BMA closing oral statement 13/12/23 - video
- BMA closing written statement 30/01/24
Module 3: Impact of the pandemic on healthcare
The third module of the UK Covid-19 Inquiry examined the impact of the pandemic on healthcare delivery, healthcare staff and patients.
The BMA is a core participant for Module 3 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 2026.
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.
- BMA oral statement (preliminary hearing) 28/02/23
- BMA oral statement (preliminary hearing) 27/09/23
- BMA oral statement (preliminary hearing) 10/04/24
- BMA written witness statement 03/05/24
- BMA opening written statement 22/08/24
- BMA opening oral statement 10/09/24 - video
- BMA opening oral statement 10/09/24 - readout
- BMA questions to the Health and Safety Executive 12/09/24
- BMA questions to Professor Sir Chris Whitty 26/09/24
- Oral evidence of Dr Tilna Tilakkumar (General Practitioner – Impact Evidence, BMA)
- The Doctor Magazine article 15/10/24
- BMA Oral Evidence 28/10/24
- BMA questions to Professors Brightling and Evans (Long Covid experts) 29/10/24
- BMA question to Professor Dame Jenny Harries 06/11/2024
- BMA question to Professor Sir Stephen Powis 11/11/2024
- BMA question to Amanda Pritchard 11/11/2024
- BMA question to Sir Christopher Wormald 12/11/2024
- Press release 21/11/2024
- BMA question to Matt Hancock 22/11/2024
- BMA closing oral statement 27/11/2024 - video
- BMA closing oral statement 27/11/2024 - readout
- BMA closing written statement - 20/12/2024
Module 4: Vaccines and therapeutics
The fourth module of the UK Covid-19 Inquiry examined a range of issues relating to the development of Covid-19 vaccines and the implementation of the vaccine rollout programme in England, Wales, Scotland and Northern Ireland.
The BMA was a core participant for Module 4 and provided written evidence. The evidence ran from 14 January – 31 January 2025.
The BMA believes that:
The Covid-19 vaccination program was a major success of the pandemic response, thanks to the efforts of doctors, particularly GPs, their teams, and volunteers. However, despite its success, the vaccination rollout was not without its challenges.
- The pre-pandemic understaffing of health services, as well as the pressures of the pandemic, and insufficient consideration given to workforce planning in connection with the vaccination programme, meant that GPs and their teams were required to work even longer hours, while already overstretched, to deliver the vaccination programme while also maintaining non-COVID and COVID care.
- Issues with the vaccine supply chain presented a challenge for vaccination delivery and created uncertainty amongst GPs and healthcare teams regarding what they could provide to their communities, and when.
- Policies put in place in England that made vaccination a condition of deployment among staff in older adult care homes and its proposed expansion of the mandate to the health and wider social care sector, led to the loss of significant numbers of care home sector staff, and exacerbated the existing workforce crisis.
- Vaccination should be voluntary based on the principle of informed consent, being respectful of individual rights and liberties and that any move away from the existing voluntary model would need to be properly justified and proportionate. The BMA’s priority was to support doctors and other healthcare workers getting vaccinated while listening to and addressing any concerns staff may have, emphasising that vaccinations are safe and effective in protecting against the disease.
- In the general population, while the overall uptake of the vaccine programme was high, progress was not equal across the UK, and that an overall high rate masked significant disparities in vaccine uptake, particularly along the lines of deprivation and ethnicity.
- More could have been done to identify the needs of vulnerable and minority groups ahead of the vaccine programme’s delivery, particularly in light of the well-known pre-existing health inequalities and knowledge that vaccine uptake was lower in marginalised and minority groups, not least because of a history of structural racism. This significant disparity in uptake cannot be ignored, and the barriers to vaccination must be addressed if the UK is to be prepared for any future pandemic.
It is essential that the Inquiry consider the inefficiencies within the supply and delivery of vaccines around the country; to reflect the strain that the vaccination programme placed on general practice and the healthcare workforce; to acknowledge the detrimental impact on the workforce of vaccination as a condition of deployment; and to make recommendations that address the disparities in vaccine uptake and access to healthcare more broadly, which the BMA says requires urgent improvement by governments across the UK.
- BMA oral statement (preliminary hearing) 22/05/2024
- BMA opening written statement 13/12/2024
- BMA opening oral statement 14/01/2025 - video
- BMA opening oral statement 14/01/2025 - readout
- BMA opening written statement 14/01/2025
- BMA closing oral statement 30/01/2025 - video
- BMA closing oral statement 30/01/2025 - readout
Module 5: Procurement and distribution
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. The evidence hearings for this module have now finished.
The BMA believes that:
- The quantity and quality of PPE supply was inadequate. PPE issues arose from the failures in pre-pandemic planning (including inadequate pandemic stockpiles, a reliance on 'Just in Time' contracts and a lack of domestic manufacturing), a flawed procurement process and a slow government response.
- Inappropriate PPE was procured as a result of flawed Infection Prevention and Control (IPC) guidance which did not prioritise safety or take a sufficiently precautionary approach and was itself influenced by shortages of Respiratory Protective Equipment (RPE).
- As a result of these failings, staff faced severe PPE shortages, received poor-quality PPE and were not adequately protected from infection. This had a disproportionate impact on certain groups including female staff, ethnic minority staff, those with a disability or long-term health condition and those who wore beards for religious or cultural reasons.
- The UK faced significant shortages of tests in the early stages of the pandemic because of the limited capacity to conduct testing at the scale needed. The UK Government made relatively little use of the pre-existing NHS laboratories, which created further challenges. Lack of access to testing may have meant that staff unwittingly transmitted Covid-19 to patients and colleagues, and it also impacted staff capacity due to illness and self-isolation.
- There was a critical failure to consider ventilator capacity in pre-pandemic planning. This led to localised ventilator shortages and meant that, at times, ICUs were forced to use anaesthetic machines instead. This impacted patient care and put additional pressure and uncertainty on staff during an already highly stressful period.
- Oxygen supplies could not cope with increased demand. This led to critical oxygen shortages which posed a threat to patient care, exacerbated the impacts of the pandemic on staff mental health and exposed the vulnerabilities in the UK's medical oxygen supplies. These shortages were primarily caused by inadequate hospital infrastructure, which urgently needs upgrading.
- Private outsourcing increased significantly during the pandemic, including in relation to England’s NHS Test and Trace and the use of Independent Sector Providers (ISPs) to bolster healthcare provision. These outsourced arrangements were characterised by a lack of transparency and poor value for money.
It is essential for the Inquiry to make recommendations that will improve protections for staff and patients, enhance patient care, reduce staff moral injury and ensure greater transparency and accountability in procurement processes.
- BMA witness statement - 31/01/2025
- BMA opening written statement - 14/02/2025
- BMA opening oral statement 03/03/2025 - video
- BMA opening oral statement 03/03/2025 - readout
- BMA question to Paul Webster - 11/03/2025
- BMA question to Helen Whately - 13/03/2025
- BMA question to Lord Deighton - 18/03/2025
- BMA question to Matt Hancock - 19/03/2025
- BMA questions to Major General Philip Prosser - 26/03/2025
- BMA closing oral statement 27/03/2025 - video
- BMA closing oral statement 27/03/2025 - readout
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