Today (28 February 2023) is the first preliminary hearing in Module 3 (healthcare impact) of the Covid-19 Inquiry. We have learnt a lot about the plan for Module 3 from Counsel to the Inquiry’s opening remarks.
This is an important milestone for the healthcare sector and the Inquiry as a whole, and NHS entities can expect to see movement from the Inquiry team imminently. We do know, however, that the Inquiry is already delayed in its intended progress. There will be another preliminary hearing for Module 3 later in 2023 in London, but the substantive hearing will not be until 2024.
The Inquiry has acknowledged, as of course expected, that Module 3 (healthcare) is a key investigation in an inquiry looking into a pandemic. This is a potentially huge module, and some issues relating to healthcare will also be considered in future modules. Module 3 covers the period from 1 March 2020 - 28 June 2022.
The list of core participants in Module 3 has been announced and published (here).There are 36 core participants in Module 3, including:
- Representatives of bereaved families in all four nations of the UK,
- Central government,
- The devolved governments,
- NHS England,
- NHS National Services Scotland,
- The UK Health Security Agency,
- Public Health Scotland,
- The Public Health Agency for Northern Ireland,
- A group of Scottish NHS organisations represented by NHS Scotland Central Legal Office,
- A group of Welsh NHS bodies represented by NWSSP Legal and Risk Services,
- The Welsh Ambulance Services NHS Trust,
- The British Medical Association,
- The National Pharmacy Association,
- Several Royal Colleges,
- The TUC,
- A group of 13 pregnancy, parenting and baby charities and organisations,
- Mind, and
No individual NHS trusts in England have been granted core participant status. However, Counsel to the Inquiry explained that the views of individual NHS trusts had been canvassed in a voluntary questionnaire, which was sent to over 500 recipients, including over 200 non-NHS organisations and over 300 NHS organisations. To date 269 responses had been received to the questionnaire about key issues relevant to the scope of module 3.
Initial themes from the questionnaire, likely to form the themes and issues for future rule 9 requests for evidence to NHS and other organisations include (but are not limited to):
- The authority and capacity of healthcare leaders to make decisions and deal with crisis management,
- The consequences of cancelling or pausing routine or non-urgent care and procedures on groups of patients and any inequalities,
- Mutual cooperation between trusts and coordination across local organisations, including integrated care systems,
- Measures used to manage healthcare system capacity, including coordination with the private sector and staffing,
- Mental health and wellbeing of healthcare staff and patients
- New ways of working, including technological delivery and online working,
- Access to and the suitability of PPE (although procurement of PPE is covered in a future module) and infection and control measures put in place for patient and staff safety.
These were described as ‘just some of the issues likely to feature in module 3’ (in addition to the original scope).
Rule 9 requests have only just begun on module 3, and there are many yet to come, particularly those directed to non-central government organisations.
We know that Rule 9 requests to 13 ambulance trusts in the UK about 999 calls are imminent, covering funding, capacity, response time, patient prioritisation, and policies amongst other things. Likewise, Rule 9 requests are imminent for evidence in relation to palliative care and maternity services in the pandemic.
Counsel to the Inquiry advised that there will be Rule 9 requests to NHS bodies across the four nations, as well as other organisations, on the specific areas of interest.
There will be monthly updates provided to core participants in Module 3 by the Solicitor to the Inquiry. The Inquiry has confirmed that it will continue to use the e-disclosure management software Relativity for disclosure and document management.
Those healthcare entities which are likely to be involved in the Inquiry in any way will likely already have started their preparations. We would be happy to discuss any steps required at this stage to prepare engagement, particularly preparation for receipt of Rule 9 requests and for your e-disclosure exercise. We strongly recommend that with the kick off of this module, healthcare organisations likely to get drawn into the Inquiry’s existing and new areas of interest start their preparations now.