A simulation exercise three years ago had a ‘sobering impact’, and warned about lack of NHS capacity to deal with an outbreak

The government is under pressure to reveal how it responded to four key recommendations made three years ago after a major simulation exercise found the NHS would not cope in the face of a flu pandemic.

The recommendations are revealed in the June 2017 minutes of the New and Emerging Respiratory Virus Threats Advisory Group – Nervtag – which advises the government on pandemics.

They were made after Exercise Cygnus, a three-day simulation involving national, regional and local government bodies, conducted in October 2016. Little is known about the exercise – or the confidential recommendations that followed from it – other than it confirmed alarming gaps in the country’s preparedness.

Phillip Lee, the former Liberal Democrat MP who was a Conservative minister at the time of Cygnus, said the exercise had a very sobering impact on government. “We knew we were not prepared for a pandemic from the Cygnus report,” Lee said. “It was a mistake not to publish it at the time. If we were not going to act on the lessons, then what was the point of the exercise?”

One former government source familiar with the exercise told the Daily Telegraph that officials were reluctant to discuss much about what Cygnus had revealed as it was “terrifying”.

A key recommendation discussed by Nervtag at its June 2017 meeting was the need for the government to develop “a pandemic influenza concept of operations” to improve coordination between the “complex network of partners” involved in a pandemic response.

We knew we were not prepared from the Cygnus report – if we weren't going to act on its lessons, what was the point? Former MP Phillip Lee

When asked whether this concept had been developed, a spokesperson for the Department of Health said: “As the public would expect, we regularly test our pandemic plans and what we learned from previous exercises has helped us to rapidly respond to Covid-19.”

The government was also urged “to conduct planning for legislative easements which would come into effect during a pandemic”. It is understood work in this area prepared the way for the Covid bill which was produced in a matter of days. But civil liberties groups and some MPs have complained it was drafted too hastily and without sufficient scrutiny.

The Cygnus exercise highlighted the need “for a better understanding of the public reaction to a reasonable worst-case pandemic”. The government was told the exercise “was based on assumptions of public reaction which were generally unsubstantiated. More research in this area could assist the development of emergency plans, and communication strategies.” It has since been claimed that the government has been surprised by how readily people have obeyed the lockdown.

Crucially, the government was advised to “strengthen the surge capability and capacity in operational resources in certain areas. If demand outstrips local supply, there will be a need to scale up the response, for example to regional level. This was particularly true for excess deaths, social care and the NHS.”

Lee said: “The question I would very much like to ask the health secretary, Matt Hancock, and Michael Gove, who has responsibility in the Cabinet Office, is when did they read the Cygnus report that has not been published and, having read that report, why did they conclude not to increase testing, PPE and ventilator capacity in January?”

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He added: “There has been really good work by outstandingly brave doctors, nurses and care workers but the fact that we have this situation, that we have to panic and build Nightingale hospitals that I suspect will never be properly filled, all of these panic decisions were made in extremis instead of in a calm, authoritative way in advance. The responsibility for that rests with senior politicians and senior civil servants.”

A Department of Health spokesman said the UK was “one of the most prepared countries in the world for pandemics”. He added: “We have followed a science-led action plan to contain, delay, research and mitigate the outbreak and acted swiftly to save lives and support our NHS, including prioritising access to testing and PPE for the frontline.”