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 4: Vaccines and therapeutics

The fourth module of the UK Covid-19 Inquiry examines 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 is a core participant for Module 4 and will provide oral and written evidence. The evidence hearings for this module  will run 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.    

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 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.

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 2025.

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.

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 3 - 27 March 2025.