Asked by: Baroness Wolf of Dulwich (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 15 December 2023 (HL453), why they have decided to abolish the COVID Strategic Intensive Care Unit Reserve in March 2024 when they have not yet completed their preparation for a range of pandemic and emerging infectious disease scenarios.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The COVID Strategic Intensive Care Unit (ICU) Reserve was set up in April 2020, in response to shortages in key respiratory equipment and in anticipation of increased demand during the pandemic. Over the last two years, the National Health Service has not needed to access the reserve to manage increases in the numbers of respiratory patients. With lack of demand from the NHS, and increasing costs associated with storing and maintaining ageing equipment, the decision was taken to close the reserve by March 2024. Until then, the reserve will continue provide a reserve capable of supporting 1,000 ICU beds.
Asked by: Baroness Wolf of Dulwich (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 15 December 2023 (HL453), whether their planning scenarios specifically include (1) a respiratory pandemic that creates greater demand for critical care than the COVID-19 pandemic, and (2) a respiratory pandemic that affects a different demographic, in particular one that disproportionately affects children and babies.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We cannot perfectly predict the characteristics of a future pandemic or know precisely which groups will be most affected by it. We are therefore strengthening our pandemic preparedness by considering the flexible and scalable response capabilities that can be adapted to any threat that the health and social care system may need to respond to.
The National Risk Register 2023 outlines the most serious threats facing the United Kingdom with an updated assessment of likelihood and potential impact. Risk 54 describes the risk from a pandemic and provides a reasonable worst-case scenario (RWCS) for an unmitigated respiratory pandemic, as well variations based on different pathogens with different routes of transmission. A copy of the register is attached.
The RWCS assumes that 50% of the UK’s population fall ill during the whole course of the pandemic, with approximately 1.34 million people estimated to require hospital treatment, possibly resulting in up to 840,000 deaths.
We continue to review our pandemic planning in response to information and lessons learned from COVID-19 and other disease outbreaks.
Asked by: Baroness Wolf of Dulwich (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 16 October (HL10485), over what period they plan to maintain the strategic reserve of intensive care unit equipment originally established in response to the COVID-19 pandemic; and whether, in considering the future of that strategic reserve, their planning scenarios include (1) a respiratory pandemic that creates greater demand for critical care than the COVID-19 pandemic, and (2) a respiratory pandemic that affects a different demographic, specifically one that disproportionately affects children and babies.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The COVID Strategic Intensive Care Unit Reserve will hold equipment on hand for emergency use in the National Health Service until March 2024. The Government continues to prepare for a range of pandemic and emerging infectious disease scenarios, in line with our revised assessment of the pandemic risk. This includes preparing for all five routes of disease transmission.
Asked by: Baroness Wolf of Dulwich (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 16 October (HL10484), what was the basis for setting the number of intensive care bays catered for in their current strategic reserve of intensive care unit equipment at 1,000; and how that figure relates to (1) the current number of 383 adult critical care beds across NHS England trusts and (2) the peak of 4,500 COVID-19 patients receiving critical care.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
During winter 2022/23, the COVID Strategic Intensive Care Unit Reserve had a core holding equivalent to supporting 3,000 intensive care bays for up to six weeks, a level consistent with the demand peak of January 2021. Between October 2022 and March 2023, the number of COVID-19 patients requiring mechanical ventilation peaked at 232 and the National Health Service did not require additional equipment from the reserve to meet this demand. The current holding of 1,000 bays is sufficient to meet the demand seen across the last two winters and enables excess holdings to be disposed of ahead of the closure of the reserve in March 2024.
Asked by: Baroness Wolf of Dulwich (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether intensive care unit capacity is secure in the event of a future respiratory pandemic, given current UK manufacturing capacity.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department continues to plan and prepare for a range of pandemic and emerging infectious disease scenarios, including those caused by respiratory (influenza and non-influenza), contact and vector-borne pathogens. The Department’s plans build on lessons learned from exercises and incidents, including the COVID-19 pandemic.
The Department currently holds a strategic reserve of intensive care unit equipment, originally established in response to the COVID-19 pandemic. The strategic reserve holds both invasive and non-invasive ventilators, with supporting equipment which can be accessed by National Health Service trusts across the United Kingdom and provides capacity to provide support for up to 1,000 intensive care unit bays. During the COVID-19 pandemic, the Department additionally procured a range of medicines to support intensive care, based on critical need and supply resilience. This included, but was not limited to, analgesia, sedation, and antibiotics. Options to maintain access to these products, including stockpiling for a future pandemic and potential volumes required, are currently being considered.
NHS England has published Adult Critical Care surge planning guidance, which sets out escalation thresholds and the actions required by trusts, systems, regional and national teams to support a response to any sudden increase in demand on services. A copy of this guidance is attached.
Asked by: Baroness Wolf of Dulwich (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what intensive care unit stockpiles are in existence which are available and suitable for use for a future respiratory pandemic; and what plans they have to maintain these stockpiles and at what levels.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The United Kingdom currently stockpiles medicines, vaccines, respiratory equipment including ventilators, and clinical consumables for a future pandemic.
The Department holds a strategic reserve of Intensive Care Unit equipment, originally set up in response to the COVID-19 pandemic. It is currently scaled to provide support for up to 1,000 intensive care unit bays and holds both invasive and non-invasive ventilators which can be accessed by National Health Service trusts across the UK.
During the COVID-19 pandemic, the Department additionally procured a range of medicines to support intensive care, based on critical need and supply resilience. This included, but was not limited to, analgesia, sedation, and antibiotics. Options to maintain access to these products, including stockpiling for a future pandemic and potential volumes required, are currently being considered.