‘Coped, but only just’: Covid Inquiry healthcare report prompts calls for urgent reform to protect patients and families

John’s Campaign, Care Rights UK and the Patients Association were Core Participants in Baroness Hallett’s Inquiry as she investigated the impact of the pandemic on healthcare systems across the UK. 

The organisations have welcomed some of the Inquiry’s findings, which recognise the immense strain placed on healthcare systems and the devastating human impact on patients and families. However, they say there is a clear disconnect between those findings and the report’s headline recommendations, which they believe fall short of delivering the meaningful, person-centred change required, particularly in relation to visiting, end-of-life care, communication, and patients’ rights.

The report concludes that the UK entered the pandemic ill-prepared, with overstretched healthcare systems already in a precarious state. It found that services “coped, but only just”, teetering on the brink of collapse under “intolerable” pressure as wave after wave of infection hit. This came at a cost to patients, families and healthcare workers, with many patients not receiving the level of care they would ordinarily have expected.

It highlights the devastating consequences for non-Covid patients, including missed or late diagnoses, delays to treatment, deterioration of conditions and, in some cases, loss of life.  

A central theme of the report is the severe impact of visiting restrictions. The Inquiry recognises that “terrible trade-offs” were made, including decisions to restrict or refuse visits at the end of life, resulting in some patients dying alone and families being denied the opportunity to say goodbye. It records the profound and lasting distress this caused, as well as the wider emotional toll on healthcare staff.

The report also highlights that visiting restrictions left many vulnerable patients - such as those with dementia, learning disabilities or communication needs - without essential support when attending appointments or receiving care. It acknowledges that carers and loved ones often play a vital role not only in supporting patients’ mental health and wellbeing, but also in communication and care delivery, sometimes more effectively than unfamiliar clinical staff.

Evidence cited by the Inquiry, including from Julia Jones of John’s Campaign, underscores the importance of clearer and more consistent guidance on visiting. While the Inquiry accepts that complete consistency may not be possible, it finds that greater clarity - particularly in distinguishing between general visitors and essential “partners in care” - would have reduced unfairness and improved patient care.

The report further recognises that essential support from carers and loved ones, especially for those with cognitive impairments or communication difficulties, should be maintained wherever possible in future pandemics. It also highlights the need for better communication with patients and families, noting that poor communication contributed to confusion, anger and lasting mistrust.

Despite these findings, the organisations note that the report’s recommendations do not go far enough in embedding these principles. In particular, while the Inquiry acknowledges the importance of facilitating visits, including at the end of life, this is not reflected in clear recommendations to that effect.

While noting the introduction of Regulation 9A in England following the pandemic, which aims to support visiting and accompaniment, the organisations stress that this does not go far enough to guarantee patients’ rights. They highlight concerns that it is not framed as an enforceable right for individuals, may be overridden in crisis situations, and relies on regulatory oversight rather than direct access to justice.  

The report also emphasises the importance of better planning for end-of-life care, including earlier and more personalised discussions around advance care planning and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions. It recognises the need to preserve dignity in death and to support bereaved families with compassion and sensitivity.

More broadly, the report identifies systemic failures in preparedness, including flawed early assumptions about transmission, shortages of PPE and critical supplies, workforce pressures, and inadequate data systems. It also documents the toll on healthcare workers, who worked under sustained and extreme pressure for prolonged periods.

The Inquiry makes ten recommendations aimed at improving future pandemic preparedness, including strengthening infection prevention and control guidance (with greater clarity and least possible restriction around visiting), increasing healthcare capacity, improving data collection, and introducing a more standardised approach to advance care planning. However, the organisations say these recommendations do not sufficiently reflect the report’s own findings or provide concrete enough action points about the need to prioritise people, relationships and human rights within healthcare.

The Core Participant group are represented by Emma Jones, Carolin Ott and Tessa Gregory, human rights solicitors at law firm Leigh Day.

Carolin Ott said:

"Our clients welcome some of the Chair’s findings and particularly the clear acknowledgement of the substantial failings that meant that UK healthcare systems were "only just" coping during the pandemic. However, they emphasise that ‘just coping’ is not enough and that this should have been far more clearly reflected in concrete recommendations that put those the healthcare system is intended to serve first.

"Healthcare should have patients and their dignity in life and death at its very core. Questions should have been asked much sooner and far more consistently about ‘how’ not just ‘if’ both patients and those caring for them are coping. Our clients consider that in order to avoid repeating mistakes made that had such devastating consequences, patients and their carers must be listened to and heard when they provide feedback on the impacts of policy decisions and guidance on the ground and in planning for a future pandemic."

Julia Jones from John’s Campaign said:

"Many people across all four nations, particularly the bereaved and separated, will have been looking eagerly forward to this report. They will have expected it to explore and acknowledge the shortcomings of the past and make recommendations which begin to heal deep wounds and thus build hope and trust for the future. The impact of the Covid-19 pandemic was an impact on healthcare systems, but it was more crucially an impact on the people for whom these systems exist.

"Although there are many interesting findings, perceptive and important comments in the text of this 387-page report, its ten headline recommendations will generally disappoint those who were hoping for remedial, human-scale actions. Above all, those who were separated from people they love, both physically and by poor communication, even at the moment of death will look to these recommendations and find little comfort. There are systemic issues involved here but the personal issues matter the most."

Rachel Power from the Patients Association said:

"This report lays bare what patients told us - the NHS became the National Covid Service. It starkly tells the stories of those patients who were waiting for treatments or couldn’t access the care they needed. These failures had a devastating impact on so many lives. Poor communication and engagement with patients are a major theme throughout the report which acknowledges the impact that this had on patients. Many patients felt lost, confused and isolated.

"The report also highlights a critical failure to communicate clearly and engage meaningfully with patients, and the impact this had on public information development and how patients accessed their NHS. People were left feeling confused, isolated, and unsure where to turn. While it is right that this is recognised, it is disappointing that the recommendations do not go further in setting out how this must change."

Helen Wildbore, CEO of Care Rights UK said: 

"Throughout the pandemic our advice line heard of the devastating impact as the health of older people in care deteriorated. The lack of access to healthcare, inadequate support at end-of-life and isolation from loved ones caused untold suffering and hastened deaths.

"People’s fundamental rights to life, dignity and wellbeing were breached as laws designed to protect us were sidelined and ignored. The focus must be on ensuring decisions in times of crisis uphold people's human rights, protect equality, and support person-centred care so that this unnecessary suffering never happens again."