The British Government has set out its draft terms of reference for the forthcoming COVID-19 Inquiry, which will examine, consider and report on preparations and response to the pandemic in the UK. The Inquiry, it has now been confirmed, will assess the availability and use of data during the health crisis, as well as look at the effectiveness of the UK’s test and trace system.
Prime Minister Boris Johnson announced late last year that Baroness Heather Hallett will chair the public inquiry, which will include powers to compel the production of documents and to summon witnesses to give evidence on oath.
The government has said that the Inquiry will play a key role in examining the UK’s pandemic response and help to ensure that it learns the right lessons for the future. It is due to begin work in Spring 2022.
Now that the terms of reference have been published, it is likely that a process of public engagement and consultation will begin shortly.
Data use during the COVID-19 pandemic has played a crucial role in the government’s response - and understanding what has worked and what hasn’t will not only play a critical in understanding the lessons learned, but may well also pave the way for future mandates with regards to how public institutions use data to respond to citizens' needs.
For instance, late last year the National Director for Digital Transformation at NHS England (formerly CEO of NHSX), Matthew Gould, highlighted the critical role of data use during the pandemic, where he said:
At an individual patient level, we made it really much, much easier for patient data to safely move around between clinicians. As often happened during the pandemic, people were seeing patients they hadn't seen before, and could see the sort of key elements of their record, in a way which was really important for patient safety.
Data also flowed for research. So the fact that vaccines were developed at such an incredible pace, the fact that we were able to find out the efficacy of Dexamethasone, was down to the role that data played. The ability to access that data safely and appropriately, but access it to develop various therapies - data for research took a massive boost.
The way the crisis was managed relied on the aggregation of data across the system. One of the very first things my team did with our NHS England colleagues, was to set up the NHS Data Store, which meant that we could see very swiftly, where there were pressure points in the system, where there was a shortage of oxygen, or ventilator beds, and then the same basis was really important during the vaccine rollout.
The COVID-19 dashboards have also, of course, influenced government policy and legislation around when restrictions should be put into place (or lifted).
The Inquiry will likely look at how data was collected, whether it was properly utilised, and how it was shared to inform decision making.
Local authorities have also showcased excellent examples of how data use could guide the delivery of services during the pandemic - where it’s clear that when a mandate to use more data is given, these local organizations can respond quickly.
Some examples of this, include:
Hackney Council combining internal and external datasets for the first time to help them identify residents who are particularly vulnerable to COVID-19 as an illness
The use of a new ‘VIPER' tool by local authorities in Essex, which enabled emergency services to share data in real time during the pandemic
An agreement between London authorities to share data about children in receipt of free school meals, allowing them to better be supported while schools were closed
However, it obviously hasn’t all been positive news over the past couple of years. For example, during the first year of the pandemic, Andrew Morris, Director of Health Data Research UK, an organization that advised the government’s Scientific Advisory Group for Emergencies (SAGE), said that the lack of data and intelligence in social care had been a “catastrophe”.
The comments came after widespread criticism of the government's handling of the spread of COVID-19 within social care environments, with a significant proportion of deaths being attributed to those living in care homes. The ONS had said that approximately 27.3% of all care home deaths between 2nd March and 1 May 2020 involved COVID-19 (12,526).
At the time, Morris said:
It's been a catastrophe, the lack of information and intelligence and huge data deficit in social care, specifically in care homes. One has to be reminded that there are 400,000 people living in 10,000 care homes across the UK. It was almost a complete data black hole. We couldn't even define key variables such as the denominator.
Then you've got care at home. I think what COVID-19 has done is really shine a light on the need to have far better information and intelligence on this very significant community. At the moment we are still wrestling with major data deficits and unknowns. I think we need a concerted effort to address this gap.
Test and Trace
The draft terms of reference for the Inquiry also include examining the government’s Test and Trace system, which was set up in May 2020 as part of the Department of Health and Social Care’s response to help reduce the spread of COVID-19.
A report released late last year by MPs on the Public Accounts Committee will likely frame some of the Inquiry’s work, given that it found Test and Trace relied too much on highly paid consultancy, didn’t use data properly to monitor success, and to top it off was given a budget of £37 billion for two years.
The report concluded that Test and Trace ultimately never set out what it specifically needed to do in order to achieve its main objective of breaking chains of COVID-19 transmission and that gaps in data also meant Test and Trace was unable to demonstrate how effective it has been.
At the time, Dame Meg Hillier MP, Chair of the Public Accounts Committee, said:
The national Test & Trace programme was allocated eye watering sums of taxpayers' money in the midst of a global health and economic crisis. It set out bold ambitions but has failed to achieve them despite the vast sums thrown at it.
Only 14% of 691 million lateral flow tests sent out had results reported, and who knows how many took the necessary action based on the results they got, or how many were never used. The continued reliance on the over-priced consultants who ‘delivered' this state of affairs will by itself cost the taxpayer hundreds of millions of pounds.
For this huge amount of money we need to see a legacy system ready to deliver when needed but it's just not clear what there will be to show in the long term. This legacy has to be a focus for government if we are to see any value for the money spent.
This Inquiry will likely not only frame the UK’s response to future pandemics, but also shape learnings regarding the use of data and digital tools to provide public services in the future. Technology and policy leaders in government will be watching closely, seeking to understand what worked and what didn’t. And whilst the headlines will inevitably be seeking to place blame (rightly so, in some cases) there’s a broader opportunity here to understand the delivery of government services in the modern age.