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During the Covid inquiry, Sir Stephen Powis, the national medical director at NHS England, stated that he was “personally terrified” that NHS hospitals could have been overwhelmed in the early stages of the pandemic. Officials had drawn up a draft document called the ‘Covid-19 decision tool’ that assigned points to patients based on their age, frailty and underlying conditions. Patients with a score of more than eight points were not to be admitted to intensive care if services became overwhelmed. The tool was never issued publicly, after it became clear the infections might have already reached their peak in March 2020.
Sir Stephen stated that the senior clinicians who were asked to draw up the plans at short notice “did a magnificent job” that “nobody ever wants to do”. However, he added that it became clear to him that the draft document was going to be controversial, as it hadn’t had the opportunity to be discussed more widely with patient groups or the public.
The draft document detailed how individuals with chronic conditions, such as heart disease or diabetes, would receive extra points, and people who were terminally ill with a life expectancy of less than six months would automatically be given nine points. Patients aged 70-75 were to be assigned four points, while those aged over 80 would receive six.
Sir Stephen said that work on the guidance document had started early in the pandemic when the number of patients in intensive care in England was doubling every five to seven days. He was personally terrified that the NHS was going to be overwhelmed. The project was halted on 28 March 2020, after it became clear the peak of the first Covid wave was approaching, and the health service would not breach capacity. Sir Stephen stated that the point-scoring system could have been “used inappropriately”, replacing the individual clinical judgement of doctors, and he recommended not developing one of these tools in the future during a pandemic. He also suggested that it was a piece of work that needed to be carried out in consultation with the public “in normal times
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