Week three of the public hearings for Module 3 of the Covid-19 Inquiry
This is the third in a series of weekly updates from the public hearings for Module 3 of the UK Covid-19 Inquiry, in which the RCoA, FICM and Association of Anaesthetists are jointly a Core Participant. Our thanks to the Association of Anaesthetists for producing these updates to share with members.
Consultant Anaesthetist, Professor Kevin Fong, gave evidence in week 3 in his role as the former National Clinical Advisor in Emergency Preparednes Resilience and Response. He spoke powerfully and movingly about the pressures facing those working on ICUs and how the reality was different to what the data available was showing. He spoke about the peer support programme he set up and the importance of speaking to all members of the team about the impact of working in units that were – in some cases – working at nearly double normal capacity.
Professor Fong also spoke about how clinicians knew the difference between the care they should deliver and the care they could deliver and the impact this had on them. When asked about his recommendations for the Inquiry, he said that while we are good at managing the technical elements of the system, we need to be better at managing the human elements and making the wellbeing of the workforce a priority.
Professor Sir Chris Whitty, Chief Medical Officer for England, gave evidence after Professor Fong and we used our position as Core Participants to suggest questions to the Inquiry legal team around the process for developing guidance around ethical decision making. He felt that a proper discussion around the issues was needed as this was not something that could be produced under pressure.
Professor Whitty was questioned about problems around escalation of care for patients. He said the system was unable to escalate care in the way it normally would and that this wasn’t surprising given the nature of the pandemic. He said the UK has a low ICU capacity compared to other countries which leads to less reserve when major emergencies occur and that a lack of trained professionals was the major limit in scaling up the system.
He also said it was unclear where ultimate responsibility for PPE lay which lead to uncertainty and that any future pandemic would need proper stocks of all reasonable PPE. Professor Whitty also spoke about the confusion around what should be classed as an Aerosol Generating Procedure – an issue we highlighted in our Opening Statement – and stated there needs to be international agreement on this.
Professor Sir Gregor Smith, Chief Medical Officer for Scotland spoke the issues caused by Scotland not having a national NHS body – like NHS England – instead having 22 health boards and the issues this caused when developing a national approach to the pandemic.
Professor Sir Michael McBride, Chief Medical Officer for Health, Northern Ireland, used his evidence to speak about the psychological impact of the pandemic and the work he did around bereavement support.
Week three also heard evidence from the Royal College of GPs and the College of Paramedics.
Looking ahead at week 4
Intensive care will be the main focus in week four of the hearings and we’re pleased to announce that Dr Daniele Bryden will appearing at the Inquiry on Thursday 3 October to give oral evidence on behalf of the Association, RCoA and FICM. Dr Bryden will be building on the comments made in our Opening Statement, helping the Inquiry to understand the role played by anaesthetists and intensivists during the pandemic and what lessons could be learned from the experience.
You can watch Dr Bryden’s evidence live on the Inquiry’s YouTube channel.
In addition to Dr Bryden’s evidence, Dr Stuart Edwardson, Immediate Past Chair of the Association’s Trainee Committee will be giving evidence on Tuesday 1 October about his personal experience as a trainee during the pandemic and the impact it has on his training. Dr Edwardson’s evidence will also be available live on the official YouTube channel for the Inquiry.