The third investigation in the COVID-19 Inquiry opened today with Baroness Hallett, Chair of the Inquiry saying:

“The pandemic had an unprecedented impact on health systems across the UK. The Inquiry will investigate and analyse the healthcare decisions made during the pandemic, the reasons for them and their impact, so that lessons can be learned and recommendations made for the future. 

“During the consultation on our Terms of Reference, bereaved families and healthcare workers told me candidly about the devastating and prolonged impact of the pandemic on healthcare. Those most affected by the pandemic deserve answers on what happened and why. I am determined to get those answers.”

Module 3 will examine the consequences for healthcare of the response to the pandemic, looking at how healthcare systems responded, the impact on systems and services, including on patients, doctors, nurses and other healthcare staff. It will consider the primary, secondary and tertiary healthcare sectors and services and people’s experience of healthcare during the pandemic, including through illustrative accounts. It will also examine healthcare-related inequalities (such as in relation to death rates, PPE and oximeters), with further detailed consideration in a separate designated module.

The Inquiry has set out 12 key areas for investigation in its scope which can be found in the Module 3 provisional scope document. These are:

1. The impact of COVID-19 on people’s experience of healthcare.
2. Core decision-making and leadership within healthcare systems during the pandemic.
3. Staffing levels and critical care capacity, the establishment and use of Nightingale hospitals and the use of private hospitals.
4. 111, 999 and ambulance services, GP surgeries and hospitals and cross-sectional co-operation between services.
5. Healthcare provision and treatment for patients with COVID-19, healthcare systems’ response to clinical trials and research during the pandemic. The allocation of staff and resources. The impact on those requiring care for reasons other than COVID-19. Quality of treatment for COVID-19 and non-COVID-19 patients, delays in treatment, waiting lists and people not seeking or receiving treatment. Palliative care. The discharge of patients from hospital.
6. Decision-making about the nature of healthcare to be provided for patients with COVID-19, its escalation and the provision of cardiopulmonary resuscitation, including the use of do not attempt cardiopulmonary resuscitation instructions (DNACPRs).
7. The impact of the pandemic on doctors, nurses and other healthcare staff, including on those in training and specific groups of healthcare workers (for example by reference to ethnic background). Availability of healthcare staff. The NHS surcharge for non-UK healthcare staff and the decision to remove the surcharge.
8. Preventing the spread of COVID-19 within healthcare settings, including infection control, the adequacy of PPE and rules about visiting those in hospital.
9. Communication with patients with COVID-19 and their loved ones about patients’ condition and treatment, including discussions about DNACPRs.
10. Deaths caused by the COVID-19 pandemic, in terms of the numbers, classification and recording of deaths, including the impact on specific groups of healthcare workers, for example by reference to ethnic background and geographical location.
11. Shielding and the impact on the clinically vulnerable (including those referred to as “clinically extremely vulnerable”).
12. Characterisation and identification of Post-Covid Condition (including the condition referred to as long Covid) and its diagnosis and treatment.

The application process to become a Core Participant for Module 3 opens today, 8 November, and will close on 5 December at 5pm, with detail set out in the Core Participant application protocol.

In determining any applications the Chair must, in particular, consider whether:

• the person [or organisation] played, or may have played, a direct and significant role in relation to the matters to which the inquiry relates;
• the person [or organisation] has a significant interest in an important aspect of the matters to which the inquiry relates; or
• the person [or organisation] may be subject to explicit or significant criticism during the inquiry proceedings or in the report, or in any interim report.

It will not be necessary for those who plan to share their experiences through the Inquiry’s listening exercise to be designated as Core Participants and the Chair particularly invites applications from groups of individuals and organisations with similar interests, rather than from individual persons and organisations.