UK Covid Inquiry: Terms of Reference & suggested areas of focus

The UK government has ordered a public Inquiry into the Covid-19 pandemic, examining the UK's pandemic response and with a view to learning lessons for the future. The Inquiry is set to begin its investigations once the terms of reference are finalised, with a view to public hearings commencing in 2023; the draft terms of reference have been published for consultation.

Health is a devolved issue in the UK and in December 2021 the Scottish government published terms of reference for their own public inquiry to examine the handling of the Covid-19 pandemic specifically in Scotland. As anticipated, the UK Inquiry has very similar terms of reference to the Scottish Inquiry. Both will be wide ranging, with the areas of interest most relevant to health and social care being:

1. the provision of healthcare services, including the management and support of staff;
2. the delivery of end of life care and the use of DNACPR (do not attempt cardiopulmonary resuscitation decisions);
3. the supply, distribution and use of Personal Protective Equipment; and
4. for care and nursing homes: the transfer of residents to or from homes, treatment and care of residents, restrictions on visiting, infection prevention and control, and inspections.

The UK Inquiry will also look at central, devolved and local public health decision-making and its consequences. Suggested areas of focus cover how decisions were made, communicated and implemented for example over shielding. It will also look at the use of lockdowns and other ‘non-pharmaceutical’ interventions such as social distancing and the use of face coverings. The decisions to close and reopen the hospitality sector will be under review including what support was given to businesses and jobs. It is proposed that the impact on broader sectors of society will be included in the Inquiry including impacts on homelessness, in prisons and the justice system and immigration and asylum. Finally, with recent concerns about fraud, the terms of reference include the safeguarding of public funds and management of financial risk.

There will now be a further public consultation to consider any changes to the terms before they are finalised. The consultation will run until 7 April.

In preparation for the Inquiry, health and social care providers, including NHS trusts, will need to be aware of the importance of document preservation. Once the terms of reference for the Inquiry have been confirmed, participants and evidence providers may be required to disclose documents that fall within the terms as set out by the Inquiry. A ‘document’ is anything that records information. This includes records of decisions, the process by which decisions were reached, and the evidence and data used to support them. It does not matter whether the ‘document’ is hard copy or electronic or where and how it is stored and relevant devices will include mobile phones. It is therefore important that relevant documents are preserved. Providers should not delete or destroy any documents which are potentially relevant to the Inquiry and should suspend any routine document destruction policies. We would advise erring on the side of caution in preserving documentation to ensure transparency and enable participants and evidence providers to describe how they responded to the pandemic, whilst endeavouring to deliver normal activities and why key decisions were taken. Retention and access to relevant documents will be essential to enable those who are required to give evidence to describe what happened during a period when many decisions were being made at a time of significant organisational pressure.

The final terms of reference will be published once Baroness Hallett has consulted with the public, including with bereaved families and other affected groups. For advice and guidance for both core participants and others providing evidence please contact Joanna Lloyd or Carlton Sadler.