- RCN infection prevention and control expert is the first nurse to give evidence in UK Covid-19 Inquiry
- The government was planning for the wrong pandemic, with plans disproportionately focused on influenza ('flu'), despite expert warnings and experience about other airborne threats
- Plans for a respiratory disease pandemic such as Covid-19 were inadequate
- Years of underfunding and health service restructures led to the UK and the NHS not being prepared
- Lessons were not learnt from previous incidents about equipment needed to protect healthcare workers and the training needed for it to be effective
- Despite representing the largest group within the healthcare workforce, the RCN was not part of the government’s pandemic planning
The government was not prepared for Covid-19 because it was planning for the wrong pandemic, according to the first nurse to give evidence in the Covid-19 Inquiry.
The Royal College of Nursing (RCN)’s Rose Gallagher MBE, a nurse, expert and professional lead in infection prevention and control, today gave evidence to the first module of the inquiry examining resilience and preparedness.
She told the inquiry that years of underfunding, health service restructures and a lack of engagement with key professions led to the UK and the NHS not being prepared for the Covid-19 pandemic.
In her written evidence, she also described how the focus on Brexit preparation meant government resources and priorities were diverted away from pandemic planning.
Mrs Gallagher is the first nurse to contribute to the inquiry, which expects to hear from around 1,000 people by the time it concludes in 2026.
The inquiry heard how the nursing workforce crisis was already well entrenched before Covid-19 struck due to a long-term lack of investment and planning. Chronic nursing shortages, especially in emergency and critical care, significantly undermined the UK’s ability to deal with a pandemic on this scale, as well as ongoing demands. Nursing vacancies alone topped 50,000 as the pandemic hit.
Nursing staff, who worked on the frontline of health services before and during the pandemic, experienced the impact of the UK government’s failure to prepare first-hand. They were at considerable personal risk as they worked under extreme pressure, regularly facing deeply harrowing situations.
Contributing on behalf of the RCN both verbally and in writing, Mrs Gallagher described how:
- The UK’s pandemic preparedness was inadequate and focused only on influenza – as previous witnesses have explained, including former Prime Minister David Cameron. This was despite strong evidence and expert advice that other potential infections should not be ignored
- NHS and Department of Health restructures and reorganisations from 2012 onwards – as austerity measures took hold - undermined the resilience of the health system, and the quality and coherence of pandemic and emergency planning
- The NHS workforce was already in crisis due to a long-term failure to invest and plan adequately for a sustainable nursing workforce within the wider health and care system
- Learnings from previous major incidents weren’t reflected in the UK’s pandemic preparedness plans. They had highlighted the need for better training and supply of personal protective equipment (PPE), to include the nursing voice and expertise in shaping government decisions, and how psychological support for staff is vital. But in Covid-19, these weren’t addressed
- Emergency planning and preparedness for an infectious disease was not high enough on the Government’s agenda and took a back seat to Brexit preparations. In the run-up to Covid-19, resource and manpower was diverted to plan for the UK’s exit from the EU and pandemic preparedness meetings were regularly cancelled
Rose Gallagher, Professional Lead for Infection Prevention and Control at the RCN said:
“The UK and the NHS was not prepared for the Covid-19 pandemic because the government focused on the most predictable risk – influenza, or flu – despite warnings from experts including the RCN who raised concerns about other organisms with pandemic potential.
“We went into the pandemic about 50,000 nurses short. That immediately put us at risk when we needed to increase capacity to support patients who were infected, either at home or in hospitals. and significantly undermined the UK’s resilience to deal with a pandemic on this scale.
“The government were planning for the wrong pandemic and focused too much on NHS hospitals, rather than including primary care and other care settings. They failed to act on lessons learnt and warnings. If you are planning for a pandemic, you must consider all eventualities, including the need to use respiratory protective equipment (RPE) to protect staff for prolonged periods of time. Inadequate consideration was given to the extended use of RPE, in addition to the variety of staff who may require it if the infection becomes widespread.
“Endless restructures and reorganisations within the NHS and the Department of Health from 2012 onwards, together with a reconfiguration of public health did not help planning. By 2018/19, the NHS and UK government had lost much of its memory from previous incidents. Non-hospital settings such as care homes were not adequately prepared or supported.
“Despite learnings from previous incidents, those representing the nursing profession were not consulted or engaged in developing clinical guidance for Covid-19. Despite being the largest group within the healthcare workforce, they were effectively shut out from key decision-making in Covid-19, and their voice and expertise were ignored.
“In short, nurses were put at risk before and during Covid-19. And we remain unprepared for any future emergence of Covid-19, or any other health emergency. The Covid-19 inquiry and its findings will be crucial to shape the country's future plans for pandemic preparedness.”
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