Key lessons for future emergencies

In Chapter 15, in Volume II, the Inquiry presents the key lessons that should inform the response in a future pandemic. Ten lessons have been identified across five themes and these should be considered in the development of future pandemic preparedness strategies (see the Inquiry’s Module 1 Report, Recommendation 4).

Multiple scenario planning

Firstly, planning both before and during an emergency must anticipate multiple scenarios and consider the short term and long term in parallel. While no plan will ever be 100% comprehensive, the more potential scenarios that are considered in advance, the better placed decision-makers will be to react quickly and decisively.

Better strategy

Secondly, there must be an unambiguous strategy with clear objectives and a framework to guide how decisions are considered and support faster decision-making. The potential impact of those decisions should be understood in advance of them being implemented.

Acting quickly and decisively

Thirdly, when faced with a virus with the potential for exponential growth, interventions must be imposed earlier and ‘harder’ than might be considered ideal. Even where the available evidence is sub-optimal, decisions still need to be made – putting off decisions until later is in itself a decision not to intervene.

Constructive working

Fourthly, leaders must work constructively within their own governments and across the four nations. Political differences should not be a consideration at a time of national emergency. Leaders should accept responsibility for their decisions and explain clearly to the public if and when they change their mind.

The importance of data

Finally, as part of pandemic preparedness, governments must understand what data they are likely to need during a pandemic and identify how these will be collected. The limitations of data should be understood and clearly explained to decision-makers, and consideration should be given to how front-line experiences can sit alongside quantitative data.

Specific recommendations

Across this Report, the Inquiry also makes a series of recommendations aimed at improving the end-to-end decision-making process during emergencies across the four nations of the UK. Although each recommendation is important in its own right, all the recommendations must be implemented in concert – both with each other and with the recommendations from the Inquiry’s Module 1 Report – to produce the changes that the Inquiry judges to be necessary. In summary, the Inquiry recommends:

• Broadening participation in SAGE: Open recruitment of potential experts and representation of the devolved administrations would ensure that advice to decision-makers draws on a wide range of expertise. The Inquiry also recommends extending the principles of transparency of scientific advice to other forms of technical advice provided to governments, so that the public can understand the range of factors beyond scientific advice that influence decision-making during an emergency.
• Improving the routine consideration of the impact that decisions might have on those most at risk in an emergency: This includes extending to England and Northern Ireland the implementation of the socio-economic duty within the Equality Act 2010 and the use of child rights impact assessments. These changes should aim to identify, during the planning phase, any risks to which vulnerable groups are likely to be exposed during a future pandemic and to ensure that those assumptions are revisited at the outset of an emergency, that the assumptions remain valid and that adequate mitigations are in place.
• Reforming and clarifying the structures for decision-making during emergencies within each nation: Clear arrangements for synthesising advice from across governments and presenting it to decision-makers should be in place from the outset of any future pandemic. Specific recommendations are made in relation to the arrangements in Northern Ireland to avoid a potential vacuum of decision-making powers, should an emergency occur during a period where power-sharing arrangements are suspended.
• Ensuring that decisions and their implications are clearly communicated to the public: The laws and guidance in place should be easily understood, including by having clear plans for making key messages available in accessible formats such as British Sign Language.
• Enabling greater parliamentary scrutiny of the use of emergency powers through safeguards such as ‘sunset clauses’ and regular reporting on the use of powers: The role of the Civil Contingencies Act 2004 should also be re-examined to identify if, when and how it could be used in future emergencies – particularly during the initial phase. Communication of the regulations to the public should also be improved through the creation of a central repository of regulations and guidance.
• Establishing structures to improve the communication between the four nations during an emergency: These structures should aim to minimise the risk of confusion caused by similar, but different, rules being implemented in each nation, seeking alignment of approaches where desirable and providing a clear rationale for differences in approach where they are necessary.

A full list of the Inquiry’s recommendations for Modules 2, 2A, 2B and 2C is included in Appendix 3, in Volume II, to this Report.