Module 3, the third of the UK Covid-19 Inquiry's 10 investigations, examined the impact of Covid-19 on healthcare systems across the four nations. It investigated how governments and society responded to the pandemic, the capacity of healthcare systems to adapt and the impact on patients, their loved ones and healthcare workers.

‘The impact of the Covid-19 pandemic on healthcare systems of the United Kingdom' (Module 3) report finds that the UK entered the pandemic ill-prepared. Healthcare systems were already overstretched and in a precarious state. This fragility had profound consequences once the crisis hit, especially when the numbers of people seeking treatment for Covid-19 started to increase dramatically.

Despite the best efforts of healthcare workers, many Covid patients did not receive the care they would otherwise receive and non-Covid patients had their diagnoses and treatment delayed. Healthcare workers put their lives at risk and the pandemic had a significant and long-lasting impact on their mental health and wellbeing.

In hospitals, visiting restrictions meant some vulnerable patients were left without vital support. Some people died alone. This continues to have a devastating impact on the bereaved.

Chair of the UK Covid-19 Inquiry, Baroness Hallett, is calling for the prompt and thorough implementation of 10 key recommendations, necessary to prevent healthcare systems being overwhelmed in the next pandemic.

In summary, the inquiry recommends:

• increasing capacity in urgent and emergency care and ensuring that hospitals have the ability to implement surge capacity;
• strengthening the body responsible for infection prevention and control guidance, broadening its membership to enhance its decision-making and improving the guidance itself;
• improving data collection, enabling individuals at highest risk of harm from infection to be more easily identified and recording deaths of healthcare workers more accurately;
• promoting a standardised process and documentation for advance care planning, recording patients' preferences for future care and treatment;
• increasing support for healthcare workers, improving retention and increasing resilience; and
• publishing guidance to assist decision-makers, providing clear criteria for clinical decisions if critical care resources become completely exhausted.

A full list of recommendations can be found in the report.

Baroness Hallett said: ‘We cannot know when, but there will be another pandemic. My recommendations, taken as a whole, should mean that the UK is better prepared for that pandemic. In doing so, we shall avoid some of the terrible human cost of Covid-19.

‘I urge governments across the UK to work individually and collectively to implement these recommendations, in full and in a timely manner.'

She considers that all Module 3 recommendations should be 'implemented in full and in a timely manner'. The inquiry will monitor the implementation of the recommendations during its lifetime. 

In addition, Baroness Hallett welcomed the action taken by the four governments of the UK to date and trusts that all remaining recommendations will be implemented promptly and in full. The inquiry expects to receive the next progress update in May 2026.

In response, the director of policy of the NHS Confederation and NHS Providers, Dr Layla McCay, said: ‘The profound impact on staff, patients and families must not be overlooked, including people who experienced severe distress due to visiting restrictions and delays to their treatment.

‘While the NHS is making progress in reducing the backlog and applying lessons from the pandemic, we urge the government to act swiftly on the Inquiry's recommendations, especially as many of the challenges facing the NHS in 2019 still persist today, and some are even more severe.

‘It is vital that these lessons translate into meaningful action, strengthened preparedness, and a more resilient health and care system for the future.'

The inquiry's next report – focusing on the development of Covid-19 vaccines and the implementation of the vaccine rollout programme (Module 4) will be published on 16 April 2026. A further four reports will follow covering Modules 5 to 9, with the final report, Module 10, scheduled to be published no later than Summer 2027.

Reaction

BMA council chair Dr Tom Dolphin said: ‘There is welcome recognition that the NHS went into the pandemic overstretched and understaffed. This has not changed. While there is a recommendation to put in place plans to ‘scale-up' capacity in the event of a new pandemic, when we're running at our limits all the time, this flex cannot happen. The Government must go further, and increase capacity in non-pandemic times. This means more staff, and keeping and supporting the staff we have.

‘The report makes a number of recommendations, but we urge the Government to look beyond just these and reflect properly on the full findings and the stark message they send about how both staff and patients were failed, and what needs to change to stop this happening ever again.'

RCN general secretary and chief executive, Professor Nicola Ranger, said: ‘These findings must mark a moment in time - never again can nursing and the public be failed like this. Our profession was sent to fight a deadly virus short of tens of thousands of nurses, while inadequate protection and ineffectual guidance led to devastating outbreaks among staff. It's clear that all these failings caused services, such as critical care, to become quickly overwhelmed and unable to provide surge capacity. That significantly undermined the pandemic response and cost lives. This will live long in the memory of our profession.

 

‘The government has to grab these recommendations and apply them not only to the hypothetical next pandemic, but the crisis that still engulfs our health system. The shortage of beds and staff leaves people tonight lining corridors without treatment, too often dying there.'

Unison Covid lead and the union's head of health during the pandemic, Sara Gorton, said: ‘The shameful story of Covid is an NHS that had been left ill-prepared, leaders who failed to act and a misspending scandal that allowed Tory friends and cronies to hoover up cash and fail to deliver at the nation's hour of need.

‘All this at a time when staff were giving everything, in some cases their lives, to deliver the care needed. Shamefully, they were all but forgotten, burnt out and exposed to the virus, without even basic safety equipment. This report can give no clearer sign that proper funding and full staffing are vital to ensure public safety.'