From Inquiry Findings to Future Planning: ICS's Call for Action

The publication of the COVID Inquiry’s module 2 report last week is a truly sober and difficult moment. It forces us to confront not only the sheer scale of death and loss, but also the systemic failures it details. I am sure that my personal memories of overcrowding, claustrophobia and challenging decision-making reflect many members recollections in the community. The frustration many of us felt with delayed decision making affected not only our patients but our entire communities. It is with some relief that I read evidence of this being highlighted in this section of the Inquiry.  

These memories are heavy, but they are twinned with the immense pride I feel for the extraordinary rapid response put forward by critical care teams across the country.  Critical leadership across the UK were not only caring for the sickest people but were also communicating with the public proactively on management and prevention. My colleagues, Ganesh Suntharalingham and Hugh Montgomery co-chaired the National Emergency Critical Care Committee (NECCC) which achieved an extraordinary amount by defining, supporting and disseminating evidence-based good practice which kept our response nimbler and more proactive.  

Let us hold onto this dual memory: the pain of loss and the power of what we achieved. There are lessons that can be learnt from the pandemic. 

The Intensive Care Society remains committed to delivering a full, structured response to the inquiry in the weeks ahead, and we continue to engage with decision-makers across the country to make sure the intensive care community is part of future preparations.  

Recently, we have been engaging with policy and decision-makers across about the need for a clear, strategic plan for critical care provision to better respond to future pandemic(s).  

Baroness Finlay of Llandaff has recently raised a series of questions, drafted by ICS, on behalf of our membership to address our concerns.  

The Ministerial Answers to these PQs now provide key disclosures from His Majesty’s Government relating to the resilience of critical care in the event of future pandemic(s), a resilience that the Inquiry’s findings show is desperately needed.  

The Ministerial Answers to these PQs highlighted three strategic areas:  

• Central Stockpile Closure: The Government confirmed the closure of the Covid Strategic Intensive Care Unit Reserve, stating that all remaining holdings, including ventilators, have been disposed of. The strategy for future equipment needs involves an assessment of requirements and feasibility of stockpiling at the point of a pandemic or emergency. 

• Oxygen Supply Management: Supply resilience for medical oxygen is managed solely through contractual arrangements between individual NHS organisations and their commercial suppliers. The responsibility for ensuring adequate supply for clinical and operational needs, including emergency planning, rests with each individual organisation. 

• Clinical Planning Role: The involvement of critical care expertise (such as ICU Directors) in local disaster planning and in national exercises like Exercise Pegasus is determined by 'local arrangements and operational needs,' rather than a mandated central requirement. 

We recognise that these disclosures define the operating landscape for critical care units in the face of future surges. We will continue to support our members by advocating for the necessary strategic alignment to safeguard patient care and clinical safety across the UK.