nhs sbs business plan

NHS Business Services Authority Launches Strategy for 2024-2029

The NHS Business Services Authority (NHSBSA) has published a five-year business strategy for 2024 to 2029, outlining our key priorities for the coming years.

The strategy aims to chart a course towards excellence and supports the vision of the NHSBSA; to be the provider of national, at scale business services for the health and social care system, transforming and delivering these services to maximise efficiency and meet customer expectations.

Our focus will be on four values which serve as the foundation for our strategic choices, ensuring that we do the right thing in the right way for our people and our customers. These values - Collaborative, Adventurous, Reliable, Energetic – will form our moral compass to shape our culture and influence behaviours at all levels.

Aligned with the evolving landscape of the health and social care system, we have outlined our strategic goals and measures to provide us with a framework for improving service. Our goals are set out under four themes: customer, our people, value and efficiency, and environmental, social, and governance.

Michael Brodie, Chief Executive, said: “Our platforms, systems and services touch countless lives, facilitating the flow of around £100 billion in NHS funds annually and supporting over three million present, past and future NHS colleagues throughout their careers.

“At the core of all we do is a profound commitment to improving the health and wellbeing of every individual we serve and a belief that providing excellence in business services – for the NHS by the NHS – will ultimately help people to live longer and healthier lives.”

The strategy covers our key areas of focus for delivering the vision, including:

Delivering the future NHS workforce solution
Developing modern, secure and scalable digital services and technology platforms
Investing in a transformed pension service
Setting the organisation up to deliver for the customer
Focusing on efficiency and taxpayer value in all that the NHSBSA does
Collaborating with stakeholders to design services which meet user needs
Being a data-driven organisation
Developing the future workforce

For more information, visit: Strategy, Business Plan and Annual Report | NHSBSA .

Contact Information

Rosie moorhouse.

Media and Campaigns Officer

NHS Business Services Authority

[email protected]

Healthcare and NHS IT

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NHS SBS to launch £1.5bn digital workplace solutions framework

Nhs shared business services is planning on a second iteration of its digital workplace solutions framework before the current one expires in august 2024.

Lis Evenstad

NHS Shared Business Services has issued a prior information notice (PIN) to inform the market of its plans for a second iteration of its digital workplace solutions framework and to begin engaging with suppliers.

The framework, valued at £1.5bn, is due to go live before the current framework agreement expires on 9 August 2024.

The current digital workplace services framework aims to provide NHS and social care organisations with a procurement route for end-to-end IT services, as well as individual elements.

This can include datacentre infrastructure, servers and storage, networking products, end user computing hardware and software, bespoke software, professional services, and training.

NHS SBS proposes that the new framework includes infrastructure management services, communication services and information systems and services.

The framework aims to help the NHS invest in improving NHS IT systems to make sure staff have the right technology to do their jobs, and that systems are interoperable and able to share information at the point of care.

This is in line with the NHS Long Term Plan, published by the government in 2019 with a goal of bringing the health service into the digital age.

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NHS SBS tenders for new £1.5B Digital Workplace Solutions contract

NHS Shared Business Services (NHS SBS) has issued a Prior Information Notice (PIN) signalling its intention to start negotiating with suppliers on a Framework Agreement for the provision of Digital Workplace Solutions.

Valued at £1.5 billion, Digital Workplace Solutions 2 is expected to go live before the expiry of NHS SBS’s existing Framework Agreement on 9 August 2024.

The NHS Long Term Plan underpins the importance of technology in the future NHS; setting out the critical priorities that will support digital transformation and provide a step change in the way the NHS cares for citizens. In keeping with this, the NHS is investing in improving NHS IT systems to make sure staff have the technology they need to do their jobs, and that systems talk to each other and share vital information to support the delivery of care.

Designed for use by NHS SBS approved organisations , the scope of the intended Framework Agreement is wide and proposes to include, Infrastructure Management Services, Communication (voice & data) Services and Information Systems and Services, to name a few.

NHS SBS intends to hold market engagement sessions with industry experts and prospective suppliers during September and October 2023.

More information about the proposed Framework Agreement and how to become a participant in the market engagement exercise are available at: https://www.find-tender.service.gov.uk/Notice/024620-2023

The deadline for submissions in response to NHS SBS’s Request for Information from interested parties is 12:00 noon on Tuesday 19 September 2023.

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Our 2023/24 business plan

August 2023

Foreword from our chair

We are creating a new organisation following the legal merger of NHS England with NHS Digital on 1 February 2023, and Health Education England on 1 April 2023. This new NHS England will be smaller, more efficient and joined up, and speak with one voice to systems.

NHS England operates under a mandate from government and has a duty to seek to achieve the objectives set out within it, which are under four headings:

Cut NHS waiting lists and recover performance.
Support the workforce through training, retention and modernising the way staff work.
Deliver recovery through the use of data and technology.
Continue work to deliver the NHS Long Term Plan to transform services and improve outcomes.

This business plan incorporates the actions we will take to meet the 2023 mandate objectives and deliver on our purpose to lead the NHS in England to deliver high-quality services for all. The NHS England Board will oversee its implementation to ensure we make real progress for the patients and populations we serve.

The NHS resource budget for 2023/24 is £168.8 billion and the Government expects NHS England to ensure that overall financial balance is delivered for the NHS each and every year. We will continue to support the NHS in making the most effective use of this public money.

This is an ambitious programme made possible through the extraordinary efforts of NHS staff across England and I wish to place on record my appreciation for their engagement.

Richard Meddings, NHS England Chair.

Introduction from our chief executive

The NHS Operating Framework sets out our purpose to lead the NHS in England to deliver high-quality services for all. We must do that by supporting colleagues and leaders to deliver for patients, in what is a challenging context and environment.

The NHS Operating Framework also sets out our six longer-term aims that inform our near-term objectives. These aims are:

Longer healthy life expectancy.
Excellent quality, safety and outcomes.
Excellent access and experience.
Equity of healthy life expectancy, quality, safety, outcomes, access and experience.
Value for taxpayers’ money.
Support to society, the economy and environment.

In 2023/24 the NHS has three key tasks. The immediate priority is to recover our core services and productivity. Second, as we recover, we need to make progress in delivering the key ambitions in the NHS Long Term Plan . Third, we need to continue transforming the NHS for the future. Delivery of these three tasks depends on continuing to strengthen collaboration across the NHS and with partner organisations.

This business plan sets out NHS England’s work in leading and supporting the NHS to respond to these three key tasks. It also describes our fourth key task of completing the creation of our new organisation and continuing to improve how we work in line with our NHS Operating Framework.

This plan doesn’t describe everything we will do, but highlights our key commitments for 2023/24 under 12 headline objectives:

Improve ambulance response and A&E waiting times.
Reduce elective long waits and cancer backlogs and improve performance against the core diagnostic standard.
Make it easier for people to access primary care services, particularly general practice.
Improve mental health services and services for people with a learning disability and autistic people.
Improve maternity and neonatal services.
Prevent ill health and narrow health inequalities in access, outcomes, and experience.
Recover productivity, increase efficiency and deliver a balanced financial position.
Build and develop the workforce for now and the future.
Build an improvement culture and drive improvements in quality.
Transform care through harnessing data, information and technology.
Change how we work, empowering and supporting local system partners to deliver on their responsibilities.
Create a simpler, smaller, high-performing organisation through the New NHS England programme.

In delivering against these objectives, we will ensure that we continue to support the delivery of safe, high-quality care in everything we do, and meet the statutory duties of the new organisation.

The establishment of integrated care boards (ICBs) within integrated care systems (ICSs) and the new statutory framework means that NHS England is changing the way it works to best support and empower local system partners to deliver on their responsibilities. The Hewitt Review highlights the enormous promise of ICSs and the need to create the context within which they can thrive and deliver. We welcome the acknowledgement within the report of changes NHS England has already made to support system working, including:

Coproduction and implementation of the NHS Operating Framework.
Work to streamline and reduce the number of national priorities, as evidenced by a more focused 2023/24 Priorities and Operational Planning Guidance .
Commitment to the co-development of national policy and strategy with ICB and ICS leaders.

We also recognise the need to go further and faster in some areas, giving system leaders the space, time and flexibility they need to deliver for their local communities, accompanied by robust accountability. We will use the Hewitt Review’s findings to inform our ongoing work to implement the new NHS England structures and NHS Operating Framework, as well as continuing to identify further opportunities to develop and implement ways of working that will support improvements to health outcomes, care quality, access and efficiency.

Amanda Pritchard , NHS Chief Executive.

Our plan on a page 2023/24

Our purpose: we are here to lead the NHS in England to deliver high quality services for all.

Our 6 longer term aims, also referred to as our ambitions: 1 longer healthy life expectancy, 2 excellent quality, safety and outcomes, 3 excellent access and experience, 4 equity of healthy life expectancy, quality, safety, outcomes, access and experience, 5 value for taxpayers money and 6 support to society, the economy and environment. We have 4 tasks for 2023/24.

Task 1. We must recover our core services and productivity by improving ambulance response and a and e waiting times; by reducing elective long waits and cancer backlogs and improving performance against the core diagnostics standard; by making it easier for people to access primary care services.

Task 2. We must make progress in delivering the key ambitions in the NHS Long Term Plan by improving mental health services and services for people with a learning disability and autistic people,; by improving maternity and neonatal services and by preventing ill health and narrow health inequalities in access, outcomes, and experience.

Task 3. We must continue transforming the NHS for the future by transforming care through harnessing data, information, technology and innovation.

Task 4. We will create the new NHS England and continue to change how we work by empowering and supporting local system partners to deliver on their responsibilities; by creating a simpler, smaller, high performing, organisation through the new NHS England programme.

Our final 3 objectives span all 4 tasks.

We will recover productivity, increase efficiency and deliver a balanced financial position.

We will build and develop the workforce for now and the future.

We will build an improvement culture and continue to drive improvements in quality.

1. Improve ambulance response and A&E waiting times

Urgent and emergency care services have been under growing pressure in recent years, and since the start of the pandemic have had to deal with a combination of issues affecting the flow of patients into, through and out of hospital.

The impact of these pressures is most visible in A&E performance, but also felt across the whole health and care system.

In January 2023, we published the Delivery plan for recovering urgent and emergency care services . That plan set out a range of measures to be taken by systems and providers to support recovery, with the key ambitions that:

Patients should be seen more quickly in emergency departments: with the ambition to improve to 76% of patients being admitted, transferred or discharged within four hours by March 2024.
Ambulances should get to patients who need them quicker: with improved ambulance response times for Category 2 incidents to 30 minutes on average over 2023/24.

Our priorities for 2023/24

Increase capacity, to help deal with increasing pressures on hospitals.
Grow the workforce, as increasing capacity requires more staff with the right skills, who feel supported and able to deliver the care patients need.
Speed up discharge from hospitals, to free up more beds for those who need to be admitted.
Expand and better join up health and care outside hospital, as up to 20% of emergency admissions can be avoided with the right care in place.
Make it easier to access the right care, as 111 should be the first port of call and reduce the need for people to go to A&E.

We will also tackle unwarranted variation in performance in the most challenged local systems.

How we will deliver

Increase capacity.

Provide dedicated funding of £1 billion to pay for additional capacity, including 5,000 new beds as part of the permanent bed base for next winter; and work with local areas to ensure that the new beds are put in place as sustainably as possible.
Work with ambulance services and wider systems to increase capacity and ensure patients receive the most appropriate care, supported by dedicated additional funding of £200m.
Provide £150 million to build 150 new facilities to support mental health urgent and emergency care services.

Grow the workforce

Launch a new targeted campaign to encourage retired clinicians, and those nearing retirement, to work in 111 rather than leaving the NHS altogether.
Make recruitment easier by reviewing the training and NHS Pathways licence requirements.
Increase the number of emergency medical technicians to support the planned expansion of ambulance capacity.

Speed up discharge

Continue to support implementation of the best practice interventions set out in the 100-day discharge challenge across NHS settings.
Develop a new planning framework and national standard for rapid discharge into intermediate care, building on the learning from the frontrunner sites.

Make it easier to access the right care

Provide national support and targeted funding to the continuing roll out of urgent community response (UCR) teams.
Work with systems, building on the experience of ‘Getting it right first time’ (GIRFT), to establish a data-driven approach to peer review that supports implementation of new models of virtual wards.
Roll out paediatric clinical assessment services to ensure specialist input for children and young people is embedded within 111.
Work to integrate 111 online with the NHS App, and expand advice offered through NHS.UK and NHS 111 online .
Undertake an extensive review of 111 services, including intensive trials of 111 First following lessons learnt in the 2019 pilot.

Reduce unwarranted variation by improving processes and standardising care

Establish a new improvement programme, supported by national improvement collaboratives, to help standardise care.
Set out priorities for local areas and acute providers in the delivery of acute frailty services and Same Day Emergency Care.
Work with integrated care systems to fully embed year-round the system control centres.

2. Reduce elective long waits and cancer backlogs

As a direct consequence of the pandemic, many patients are waiting longer for the treatments they need. We are committed to delivering more planned hospital activity and improving performance for the longest waiting patients across elective care and cancer in line with the Delivery plan for tackling the COVID-19 backlog of elective care . We aim to ensure that by March 2024 no one waits longer than 65 weeks (except where patients choose to wait longer or in specific specialties).

Our national cancer awareness campaigns have successfully encouraged more people to come forward, resulting in a record number of urgent GP referrals. We have asked local systems to increase the percentage of cancers diagnosed at stages 1 and 2, meet the cancer faster diagnosis standard by March 2024, and continue to reduce the number of patients waiting over 62 days.

Timely access to diagnostics is critical to providing responsive, high-quality services and supporting elective recovery and early cancer diagnosis. We have asked local systems to deliver diagnostic activity levels that support plans to address elective and cancer backlogs as well as the diagnostic waiting time ambition (the ambition is that 95% of patients that receive a diagnostic test do so within six weeks by March 2025).

Increase capacity and transform the way we provide elective care, to improve access and patient experience, and reduce long waits.
Improve information and support for patients, to offer meaningful choice at the point of referral and at subsequent points in the pathway.
Streamline cancer pathways and roll out targeted case-finding, to diagnose and treat cancer earlier and faster.
Maximise the pace of roll-out of additional diagnostic capacity, to support the delivery of required diagnostic activity levels.
Ensure the targeted investment fund (TIF) for elective recovery is committed to protecting and increasing elective activity.
Develop and implement a new outpatient productivity programme that focuses on freeing up capacity to increase the number of first appointments for long waiters.
Continue to develop patient-facing information on waiting times and how those on waiting lists can help manage their condition through My Planned Care .
Target improvement/transformation support to the most challenged providers, and clinical specialty pathways.
Develop a Patient Initiated Digital Mutual Aid System (PIDMAS) which will offer patients the ability to opt-in to move provider when they have been waiting over 40 weeks for care.
Provide over £390m in cancer service development funding to cancer alliances to support delivery of early diagnosis and key operational priorities.
Continue the rollout of non-specific symptoms pathways.
Support the rollout of targeted lung health check sites and increase capacity through investment in computerised tomography scanner capacity.

Diagnostics

Provide funding to support the development of pathology and imaging networks and the development and rollout of community diagnostic centres (CDCs) (£2.3bn of capital funding to 2025 has also been allocated to support diagnostic service transformation, including to implement CDCs, endoscopy, imaging equipment and digital diagnostics).
Support the rollout of CDCs and associated workforce growth to increase diagnostic pathway capacity.
Support the development of diagnostic networks and digital diagnostics infrastructure.
Work with systems to improve service utilisation, productivity and patient throughput.

3. Make it easier for people to access primary care services, particularly general practice

GPs and their growing teams continue to deliver more appointments for patients; in the 2022/23 financial year they provided an average of 28 million appointments every month, 1.3 million more than in 2021/22. More than two thirds of appointments are face-to-face, and more than half are held on the same day as booking, or the day after.

However, demand for appointments remains high, and many patients report issues with contacting their practice or securing appointments when they want them.

In May 2023, we published our Delivery plan for recovering access to primary care , which set out our ambitions to tackle the 8am rush and make it easier and quicker for patients to get the help they need from primary care. The plan sets out how we will do this by:

Empowering patients, so they can more effectively manage their own health.
Implementing modern general practice access , so patients know on the day how their request will be handled.
Building capacity , so practices can offer more appointments from more staff than ever before.
Cutting bureaucracy , to give practice teams more time to focus on their patients’ clinical needs.

ICBs are accountable to NHS England for the commissioning of general practice services and delivery against the contract. From April 2023, all ICBs have accountability for commissioning community pharmacy, dental and optometry services. NHS England will ask and support ICBs to develop their own system level access improvement plan.

Empowering patients

Improve information and NHS App functionality, so that patients registered with over 90% of practices have access to health information they can trust and can manage routine appointments.
Expand community pharmacy services, to give people easy access to more health services in the heart of their communities.

Implementing modern general practice access

Transition practices to digital telephony, so patients get a better experience when they call their practice.
Simplify online requests and improve care navigation, to make it easier for people to contact their practice and to make getting a response the same day standard procedure.

Building capacity

Continue to support the growth of larger multidisciplinary teams, to optimise the use of the full practice team and help manage more patient requests.
Continue to support the recruitment and retention of doctors in general practice, to address the gap between capacity and demand.
Transform the NHS App to support the ambition for 75% of all adults in England to be registered on the NHS App by March 2024.
Expand the information available through NHS.uk on local services and improve the existing monitoring tools.
Launch Pharmacy First (subject to a DHSC led consultation with Pharmaceutical Services Negotiating Committee) enabling pharmacists to supply prescription-only medicines to treat common health conditions where clinically appropriate.
Improve the digital infrastructure between general practice and community pharmacy to streamline referrals.
Support the transition to digital telephony (for practices that commit by 1 July 2023 to the move), including procurement, contract negotiation and financial support for new equipment, buy out costs and training.
Make high quality online consultation, messaging and booking tools available to general practice, alongside guidance on the relative strengths of the tools in different areas.
Invest in a new National Care Navigation Training Programme for up to 6,500 staff.
Continue to provide systems with £4 million of System Development Funding (SDF) which they can use to recruit and retain general practice nurses, and make up to a further £385 million available in Additional Roles Reimbursement Scheme (ARRS) funding to continue to grow capacity.
Publish guidance, developed with frontline staff, to help practices make best use of ARRS roles.
Work with partners to facilitate ways in which doctors other than GPs can work in general practice as part of a multidisciplinary team to help increase practice capacity.
Continue to invest in GP retention schemes and run a campaign to encourage GPs to return to general practice or to support NHS 111.

From May 2023, NHS England will introduce a National General Practice Improvement Programme with three tiers of support to help general practice deliver change.

We will also develop and begin to implement dental reform proposals targeted at improving access, provision, workforce and prevention.

4. Improve mental health services and services for people with a learning disability and autistic people

The COVID-19 pandemic has had a significant impact on the physical and mental health of people with a learning disability and autistic people, and increased the prevalence, acuity and complexity of mental health needs.

We have asked local systems to continue to focus on delivering our core NHS Long Term Plan commitments to improve mental health services and services for people with a learning disability and autistic people.

Expand access to NHS Talking Therapies, and children and young people’s (CYP), community, and perinatal mental health services.
Drive quality of services through transformation of models of care.
Support the recovery of the Urgent and Emergency Care pathway.
Improve the physical and mental health of people with a learning disability and autistic people.
Improve the quality and reduce the reliance on inpatient care for people with a learning disability and/or autistic people.

Mental health

Promote the rebrand of NHS Talking Therapies to increase access to services.
Expand the roll out of mental health support teams in schools and support systems to increase access to perinatal and maternal mental health services.
Publish updated guidance for the Children and Young People Eating Disorder Standards, Crisis provision and dementia diagnosis patient pathways.
Support the delivery of new models of community mental health services integrated with primary care.
Work across all systems to support demand and capacity management in light of increased prevalence.
Create a strategy for integrating digital health technologies in mental health settings and pathways.
Support the development of new and expanded roles, such as peer support workers and allied health professionals in mental health to increase the size of the mental health workforce.

Learning disability and autism

Publish best practice toolkits/guidance to improve uptake of learning disability annual health checks and improve the quality and access to health and social care for autistic people.
Publish guidance and design and implement a support offer for systems to deliver the Localising Care Commitment.
Support implementation of the Dynamic Support Register and Care, Education, and Treatment Review.

5. Improve maternity and neonatal services

In March 2023 we published the Three year delivery plan for maternity and neonatal services . The plan sets out how the NHS will make care safer, more personalised, and more equitable. This consolidates the improvement actions committed to in Better Births, the NHS Long Term Plan, the Neonatal Critical Care Review, and reports of the independent investigation at Shrewsbury and Telford Hospital NHS Trust and the independent investigation into maternity and neonatal services in East Kent.

Improve equity for mothers and babies and deliver care that is personalised.
Retain, grow and invest in our workforce.
Support a culture of safety, learning, and support.
Support the implementation of best practice and use of data.

Equity and personalised care

Pilot and evaluate new service models designed to reduce inequalities, including enhanced midwifery continuity of carer.
Publish national postnatal care guidance, setting out the fundamental components of high-quality postnatal care.
Publish a national service specification and implementation guidance for perinatal pelvic health services.
Act on findings from the evaluation of independent senior advocate pilots as set out in the interim Ockenden report.
Invest to ensure the availability of bereavement services seven days a week.

Retain, grow and invest in our workforce

Fund a retention midwife in every maternity unit during 2023/24.
Strengthen neonatal clinical leadership with a national clinical director for neonatal and national neonatal nurse lead.
Provide funding to establish neonatal nurse quality and governance roles within trusts.
Assist trusts with their workforce plans by providing direct support, including through operational delivery networks for neonatal staffing.
Work with the Royal College of Obstetricians and Gynaecologists to develop leadership role descriptors for obstetricians to support job planning, leadership and development.
Provide tools to support implementation of the maternity support worker competency, education, and career development framework.

Culture of safety, learning, and support

Offer the perinatal culture and leadership programme to all maternity and neonatal leadership quadrumvirates.
Support the transition to the patient safety incident response framework through national learning events patient safety incident response framework.
Provide nationally consistent support for trusts that need it through the Maternity Safety Support programme.
Support trust board assurance, oversight of maternity and neonatal services through delivery of the maternity and neonatal board safety champions programme.

Best practice and data

Keep best practice up to date through version 3 of the Saving Babies Lives Care Bundle.
Convene a taskforce to progress the recommendation from the Kirkup report for an early warning system to detect safety issues within maternity and neonatal services.

6. Prevent ill health and tackle health inequalities

Prevention is a crucial part of the NHS’s approach to improving overall population health and reducing health inequalities, helping people to make healthier lifestyle choices and treating illness at an early stage, so they can live longer, healthier lives. In 2023/24 we will continue to support the delivery of evidence-based NHS prevention programmes to optimise care for cardiovascular disease (CVD) and diabetes, and reduce smoking, obesity and alcohol intake.

Under the agreement made between the Secretary of State and NHS England under section 7A of the National Health Service Act 2006, we are responsible for the commissioning of national screening and immunisation programmes, including those for bowel and breast cancer, cervical screening, childhood immunisations and the influenza vaccination. In 2023/24, we will continue to work to expand eligibility, improve the detection of cancers and implement plans to address health inequalities in uptake.

The COVID-19 pandemic has highlighted and exacerbated existing health inequalities, with its disproportionate impact on people and communities already at highest risk. In 2023/24, we will continue to support the NHS to realise the ambition of reducing healthcare inequalities through equitable access, excellent experience and optimal outcomes for all.

Support improved clinical management of cardiovascular disease, respiratory disease and diabetes, to prevent avoidable ill-health and reduce health inequalities.
Optimise the impact of healthcare on the population through the prevention of ill health, enabling longer healthier lives for all.
Increase uptake and coverage in vaccination and screening, reducing unwarranted variation and disparities.
Support delivery of the NHS’s five strategic priorities for tackling healthcare inequalities (they are (1) restore NHS services inclusively; (2) mitigate against digital exclusion; (3) ensure datasets are complete and timely; (4) accelerate preventative programmes; (4) strengthen leadership and accountability), to reduce unfair and avoidable differences in health across the population.

Major conditions and public health

Develop cardiac and pulmonary rehabilitation resources to support local decision making and improve access.
Complete a secondary prevention review with systems and publish evidence and resources to support local decision making.
Deliver national services to support improvements in Type 2 diabetes prevention and remission services and national digital structured education support for Type 1 and Type 2 diabetes.
Develop a digital tobacco dependency service and begin to implement it, with an initial focus on NHS staff.
Provide support to key NHS England programmes to maximise their health impact, with a focus on health and care inequalities and improving healthy life expectancy.

Screening and vaccinations

Develop and publish a vaccination strategy and start implementation in partnership with regional teams and ICSs.
Develop strategies for NHS screening and Child Health Information Services (CHIS) and develop a plan for potential future delegation of elements of screening commissioning to ICBs.
Enhance the vaccinations digital platform, developing a national vaccination record, extending the use of the NHS App and establishing the foundations for a lower cost base.
Implement the digital transformation of screening, to deliver new digital products for the invitation of, and communication with, eligible members of the public for the breast and diabetic eye programmes.

Health inequalities

a healthcare inequalities strategy, with supporting resources including a new system accountability framework and framework for NHS action on inclusion health
an updated Healthcare Inequalities Improvement Dashboard with a new measurement framework and indicators to support improvement and drive local accountability
a framework to support focused NHS action on digital inclusion and develop a two-year implementation plan
a handbook to support Core20PLUS5 implementation.
Fund the recruitment of 350 connector roles (connectors are those with influence in their community who can help engage local people with health services, including vaccine champions, peer advocates and social prescribing link workers) to support Core20PLUS5 implementation.
Support the continued roll out of High Intensity User services.

7. Recover productivity, increase efficiency and deliver a balanced financial position

NHS England’s revenue and capital resource limits for 2023 to 2024 are published in the 2023 to 2024 Financial Directions to NHS England . The Government expects NHS England to ensure that overall financial balance is delivered for the NHS every year.

To deliver a balanced net system financial position for 2023/24 and achieve our core service recovery objectives, we must meet the 2.2% efficiency target agreed with government and improve levels of productivity. Most of this will need to be delivered via local ICBs and provider organisations. Local systems will be supported in this by a national efficiency programme that reports into the National Productivity Board.

Support ICSs to transform care pathways and embed continuous improvement (see objective 9)
Support NHS providers to reduce their agency staff bills and encourage workers back into substantive and bank roles.
Drive efficiencies from the NHS’s investment in medicines.
Drive commercial excellence and efficiencies in NHS procurement and corporate running costs.
Improve NHS estates productivity and efficiency.
Provide the NHS with access to near real-time data to support the identification of barriers to improved productivity delivery.
Address unwarranted variation across clinical pathways through delivery of the GIRFT programme.
Develop a workforce productivity diagnostic tool to support the identification of service level productivity gaps.
Develop, negotiate and implement a new Voluntary scheme for branded medicines pricing and access (VPAS) framework to secure value for money of overall branded medicines expenditure.
Deliver a medicines efficiency programme to maximise value from medicines procurement.
Deliver a commercial efficiency programme to maximise value from non-clinical NHS procurement.
Create system wide strategies for priority non-pay spend categories to support innovation and deliver efficiencies.
Support the development of robotic process automation and other technologies that reduce the transactional administrative burden on the NHS.
Support delivery of a capital programme across the NHS estate, improve long term planning and drive savings through a reduction in non-clinical space.

8. Build and develop the workforce for now and the future

The NHS workforce is at the heart of providing high quality patient care, and investment in staff is key to delivering the improvements in services needed for patients.

In July 2023 we published our NHS Long Term Workforce Plan , which includes independently verified forecasts for the number of doctors, nurses and other professionals that will be needed in 5, 10 and 15 years’ time, taking full account of improvements in retention and productivity, and details the actions that will be taken to train, retain and reform the NHS workforce.

Recruit more staff, domestically and internationally, to respond to local needs and reduce NHS vacancy rates.
Increase the number of qualified healthcare professionals, through quality education and training, reflecting local need.
Review and reform education and training , to better meet patient and student needs.
Support the use of digital technology, innovation and workforce transformation, to help increase the time to care and respond to changing population needs.
Improve NHS leadership, talent and management practices.
Improve staff retention and experience and ensure equality, diversity and inclusion for all staff.
Support expansion of the workforce and development of new roles aligned to key service development priorities.
Implement the global health workforce strategy.
Deliver the 2023/24 METIP (Multi-Professional Education and Training Investment Plan, the annual investment planning process developed by Health Education England) plan for medics, and clinical professions and develop the Clinical Placement Management System.
Develop and deliver an implementation plan to accompany the new Educator Workforce Strategy to create a sustainable supply of clinical educators.
Develop more flexible routes into training such as apprenticeships that will help to grow and diversify the talent pool.
Improve the quality of healthcare education and training and reduce course leaving rates.
Expand trailblazer learner cohorts to enhance the generalist skills of postgraduate doctors.
Increase the number of adult nurse and midwife students on blended learning degrees.
Develop plans to improve the medical education and pharmacy training programmes.
Develop a national learning hub to promote the growth of our educational resources and learning opportunities.
Develop and roll out digital solutions (staff app, digital staff passport) to support flexible working practices and flexible deployment of staff across organisational boundaries.
Maximise opportunities for new ways of working by upskilling, enhanced, advanced and consultant practice.
Co-produce management, talent and leadership development products, taking account of the Messenger review.
Develop and support implementation of interventions to deliver on the People Promise, improving staff experience and retention.
Provide leadership and interventions to improve health and wellbeing.
Implement the Kark recommendations and the Fit and Proper Persons test.
Publish and support implementation of a five-year NHS Equality Diversity and Inclusion Improvement Plan.
Implement national and regional Workforce Race Equality Standard (WRES) and Workforce Disability Equality Standard (WDES) action plans.
Provide leadership in developing the future of NHS HR and OD and support capability building.

9. Build an improvement culture and continue to drive improvements in quality

In April 2023, we published the findings of the NHS delivery and continuous improvement review , which explores how the NHS can develop a culture for continuous improvement while focusing on its most pressing priorities. We will take the actions from the review forward as part of our wider programme to support improvements in care quality and outcomes.

Support the development of capacity and capability, to continuously improve quality and transform care.
Deliver improvement and transformation, across whole pathways.
Support ICSs to manage and improve the quality of their services, and deliver their statutory quality duties.
Support the ongoing implementation of the Patient Safety Strategy and delivery of patient safety statutory duties.
Establish a National Improvement Board to support the implementation of improvement approaches across the NHS.
Continue to establish NHS Impact – Improving Patient Care Together – as a shared approach to purposeful improvement across the NHS.
Support providers and systems to develop the leadership behaviours, culture, capability, capacity and management systems to use a comprehensive approach to continuous quality improvement to address variation in performance, productivity, quality and staff experience.
Develop a strategy for NHS England’s clinical effectiveness programmes to improve patient outcomes and increase the impact of clinical effectiveness information.
Deliver improvement across care pathways and reduce unwarranted variation through the GIRFT programme, the Outcomes and Registries programme, national clinical audits and the National Consultation Information Portal.
Deliver the radiotherapy transformation programme through networks and cancer alliances.
Publish and implement an Operating Model for Quality, working with systems, regulators and other partners.
Provide guidance, best practice and peer support to ICSs to manage the quality of services, and support delivery of their statutory quality duties.
Pilot System Quality Accounts to support improvement of care quality through ICSs.
Embed the quality framework across all specialised service governance and programmes.
Lead transformation of how the NHS responds to patient safety incidents by implementing the new Patient Safety Incident Response Framework (PSIRF), with all secondary care providers transitioned.
Replace the legacy National Reporting and Learning System with the new Learn from patient safety events (LFPSE) service, supporting all providers to transition to the new system.
Launch training in levels 3 and 4 of the Patient Safety Syllabus for all patient safety specialists in the NHS.

10. Transform care through harnessing data, information and technology

The merger of NHS England with NHS Digital from 1 February 2023 provides us with the opportunity to accelerate the digitally enabled transformation of the NHS, adopting effective technologies and building on insights from data and cutting-edge research.

NHS England will continue to work with systems to level up digital infrastructure, drive greater connectivity and support the development of a digital first option for the public, helping patients identify their needs, manage their health, and get the right care in the right setting. Our work will focus on three areas:

Digitise, ensuring that digital foundations are in place everywhere.
Connect , helping the different parts of the NHS to work together through improved useability, connectivity and interoperability.
Transform, using digital products and leveraging innovation and research to transform health and care.
Ensure that 90% of trusts have an electronic patient record (EPR).
Deliver technology upgrades across primary care, widen access to GP record data, and support delivery of the Primary Care Access Recovery Plan.
Continue to develop a portfolio of core digital products and services, to support improved outcomes and address legacy technology constraints.
Develop the NHS App as the digital front door of the NHS.
Accelerate the uptake of the most promising Artificial Intelligence (AI) technologies.
Extend access to molecular diagnostics and genomic testing, to over 100,000 patients newly diagnosed with cancer.
Develop and deploy a support offer to trusts undertaking EPR-related transformation and publish Minimum Digital Foundations guidance.
Provide practices with the digital tools to support Modern General Practice Access, and fund transition cover (for those that commit to adopt this approach before March 2025).
Procure a Federated Data Platform, available to all ICSs, with nationally developed functionality including tools to help maximise capacity, reduce waiting lists, and coordinate care.
Ensure healthcare professionals can view, access and import a patient’s full GP clinical record irrespective of their care setting or organisation.
Accelerate the ambition of reducing the reporting burden on providers and addressing the need for more timely automated data, so that all acute NHS trusts are using Faster Data Flows.
Deliver new functionality for the NHS App, to help people take greater control over their health and their interactions with the NHS.
Pilot an Artificial Intelligence deployment platform.
Support rapid cancer genomics through the Genomic Pathology Accelerator Programme.

We will also support local NHS and social care organisations to manage cyber risk and ensure compliance with national cyber standards in each ICS and NHS region.

11. Change how we work, empowering and supporting local system partners to deliver on their responsibilities

The establishment of ICSs and the new statutory framework means that NHS England is changing the way it works (our operating framework) to best empower and support local system partners to deliver on their responsibilities. This requires a cultural and behavioural shift towards partnership-based working; creating NHS policy, strategy, priorities and delivery solutions with national partners and with system stakeholders; and giving system leaders the agency and autonomy to identify the best way to deliver agreed priorities in their local context.

We will support local decision making, empowering local leaders to make the best decisions for their local populations and focus on what we are uniquely placed to do as a national organisation, increasingly using our resources to provide practical support to colleagues within systems.

Embed the ways of working and leadership behaviours set out in the NHS Operating Framework, to best empower and support local system partners to deliver on their responsibilities.
Set national direction, strategy and evidence-based policy, to support the continued development of ICSs.
Support the development of mature, collaborative ways of working within ICSs at system, place and provider level, to create the environment for sustainable, ongoing peer-led system development.
Complete the successful transfer of new delegations from NHS England to ICSs, to enable local systems to design and deliver more joined-up care for their patients and communities.
Design, test and implement a new approach to the co-production of strategy and policy with systems and national partners.
Update the NHS Oversight Framework and work with ICBs to ensure oversight and performance management arrangements within their ICS area are proportionate and streamlined.
Agree a wider accountability framework for ICSs with DHSC, CQC and other national partners.
Deliver the second phase of the Place Development Programme, supporting systems to design and test new integrated ‘at scale’ care models.
Deliver the provider collaboratives innovator scheme and publish updated guidance to help accelerate the development of collaboratives.
Implement statutory joint committees of ICBs and NHS England to oversee commissioning of appropriate specialised services across multi-ICB populations ahead of ICBs taking on this delegated responsibility in April 2024.
Provide ICBs with tools and resources to support transformation, and to further develop their understanding of specialised services and enable them to realise the benefits of integration.

12. Create a simpler, smaller, high performing organisation through the new NHS England programme

The creation of ICSs; the merger of NHS England, with NHS Digital on 1 February 2023, and Health Education England on 1 April 2023; and the need to resize our organisation following the Covid-19 pandemic mean we must create a new NHS England. Our aim is to create a simpler, smaller, high performing, organisation that leads the NHS more effectively and is a better place to work. We will be more joined up and efficient, speaking with one voice to the service.

We expect that, by April 2024, our new single organisation will be at least 30%, and up to 40%, smaller than the previous combined size of NHS England, Health Education England and NHS Digital.

Design the new NHS England, including how we will organise ourselves to deliver the new organisation’s priorities.
Complete the successful implementation of the new staffing structure, including the transfer of NHS England staff working in the delegated NHS England commissioning functions.
Complete all merger-related activities, including the harmonisation of policy, process, and corporate functions and infrastructure across the new organisation.
Shape our new culture, to make NHS England a great place to work for our people and help us achieve our inclusion, diversity and wellbeing ambitions.
Continue to develop and implement our operating framework.
Complete staff consultations and the process for filling of posts.
Deliver a full set of harmonised corporate policies.
Develop a new Risk Management Framework including operational and clinical risk management.
Establish appropriate data safe haven processes and governance in line with statutory requirements and guidance.
Develop and implement a culture change plan.

Our funding

Our commissioning budget for 2023/24 is £168.8 billion. We are responsible for using this money wisely, fairly and transparently to secure the best possible outcomes for both patients and the taxpayer.

We allocate most of this funding – £114.3 billion – to integrated care boards for commissioning local health services. A further £32.3 billion is spent on directly commissioning services including some primary care services, specialised services and public health. £4.9 billion is spent on educating and training the health workforce through an annual investment planning process called the Multi-Professional Education and Training Investment Plan (METIP). The remaining funds are allocated to the delivery of service development and improvement programmes, in line with our corporate priorities (the large majority of the Service Development Fund and Elective Recovery Fund is allocated directly to ICBs for commissioning local health services), and NHS England’s core administration and programme costs. Figure 1 shows how we distribute our mandate funding.

Figure 1: 2023/24 NHS England mandate revenue funding (£168.8 billion)

* ‘Other System Funding’ includes £3.6bn for increased employer pension contributions.

Image alternative text: Integrated Care Boards £114.3 billion. Direct Commissioning £32.3 billion. Service development fund £4.6 billion. Elective services recovery fund £3.1 billion. NHS England central admin and programme £3.4 billion. Multi-professional education and training plan £4.9 billion. Other system funding £6.2 billion, including £3.6 billion for increased employer pension contributions.

Our programme costs are focused on the delivery of our corporate priorities and this year we have a funding envelope of £2.3 billion. The central administration budget for NHS England in 2023/24 has been set at £0.7 billion.

Figure 2: 2023/24 NHS England central admin and programme revenue funding (£3.4 billion)

Publication reference: PRN00201

NHS Resolution publishes business plan for 2023/24

Date published: 22nd June 2023

We’re pleased to announce the publication of our 2023/24 business plan . In it, we set out our focus for the next twelve months, as we enter the middle year of our three-year corporate strategy: Advise, Resolve and Learn: Our Strategy to 2025.

We will continue to focus on progressing our four strategic priorities:

Strategic priority 1: Delivering fair resolution All of our services will focus on achieving fair and timely resolution, keeping patients and healthcare staff out of formal processes wherever possible to minimise distress and cost.

Strategic priority 2: Sharing data and insights as a catalyst for improvement We will ensure that our unique datasets help derive usable insights that benefit patients and the healthcare and justice systems.

Strategic priority 3: Collaborating to improve maternity outcomes We will build on our role as a system integrator in maternity, bringing together key parties to determine what further improvements can be made within our areas of expertise to support the system’s plans in the area of maternity safety.

Strategic priority 4: Investing in our people and systems to transform our business We will develop our services to support the changing needs of the NHS by investing in our people, systems and services to continue delivering best value for public funds. This includes continuing to progress our two change programmes, the Claims Evolution Programme and the Core Systems Programme while continuing to support staff in building their expertise and skills.

In the context of an NHS experiencing acknowledged pressure and structural change, we’re focused on making our interactions with the NHS as easy as possible to aid NHS staff who are facing extreme pressures.

We also continue to remain committed to promoting compassion and fairness when addressing shortcomings within the NHS, whilst remaining dedicated to delivering savings and efficiencies to the overall system.

We thank our partners and colleagues across the NHS and health and care system and will continue to work with them to deliver solutions rapidly across the system as needed. As well as this, we will continue to build our external relationships and partnerships to drive our strategic priorities forward. Now, more than ever, our plans remain flexible so that we can respond quickly to any unforeseen requirements of our organisation. Helen Vernon, Chief Executive, NHS Resolution

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62020 - Information technology consultancy activities

NHS Shared Business Services

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COVID-19 Response: Living with COVID-19

Cabinet Office

Updated 6 May 2022

Applies to England

This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected] .

Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.

This publication is available at https://www.gov.uk/government/publications/covid-19-response-living-with-covid-19/covid-19-response-living-with-covid-19

1. Introduction

The Government’s aim throughout the COVID-19 pandemic has been to protect the lives and livelihoods of citizens across the United Kingdom (UK). This document sets out how the Government has and will continue to protect and support citizens by: enabling society and the economy to open up more quickly than many comparable countries; using vaccines; and supporting the National Health Service ( NHS ) and social care sector. It also sets out how England will move into a new phase of managing COVID-19. The Devolved Administrations will each set out how they will manage this transition in Scotland, Wales and Northern Ireland.

The global pandemic is not yet over and the Government’s Scientific Advisory Group for Emergencies ( SAGE ) is clear there is considerable uncertainty about the path that the pandemic will now take in the UK. [footnote 1] This document therefore also sets out how the Government will ensure resilience, maintaining contingency capabilities to deal with a range of possible scenarios.

COVID-19 response: Roadmap to the present day

Vaccines have enabled the gradual and safe removal of restrictions on everyday life over the past year, and will remain at the heart of the Government’s approach to living with the virus in the future. The Government and the NHS , with the help of volunteers, has delivered one of the largest vaccination programmes in history.

Figure 1: Vaccines: UK Cumulative vaccinations [footnote 2]

Area chart of the percentage of the UK population aged 12+ who have received first doses, second doses and booster doses of a COVID-19 vaccine. On the 14 of September 2021, 84% of the population had had a first dose, 77% had had a second dose, and the booster programme had not yet started. On 16 February 2022, this had increased to 91% of the over 12 population who had received a first dose, 85% who had received a second dose and 66% who had received a booster dose.

The speed of the vaccine rollout put the UK in a strong position. The UK was the first country in the world to authorise and deploy the Pfizer and Oxford / AstraZeneca COVID-19 vaccines. [footnote 3] The UK was the first major European economy and first G20 member to vaccinate 50% of its population with at least one dose, [footnote 4] and to provide boosters to 50% of the population. [footnote 5] Moreover, on JCVI advice, the UK prioritised those at highest risk from COVID-19 for vaccination early in the roll-out. Although other countries now exceed the UK’s proportion of the total population vaccinated, the speed and highly targeted nature of the vaccination programme had a direct impact on the Government’s ability to open up the economy and ease social restrictions sooner than other comparator countries, without placing the NHS under unsustainable pressure.

As a result of the vaccine rollout, the Government was able to ease restrictions in England through the first half of 2021 - following the plan set out in the Roadmap in the Government’s ‘COVID-19 Response: Spring 2021’ publication. [footnote 6] The nationwide lockdown introduced in January 2021 was lifted in four steps, with decisions to progress based on data not dates. Each step was taken at least five weeks apart, allowing time to assess the impact of the previous step against four key tests before taking the next step.

On 19 July 2021, the Government removed most restrictions in England at step 4 of the Roadmap and, in doing so, opened up earlier than many other comparable countries. The Government made a deliberate choice to do so at this point as it coincided with the end of the school term and meant that restrictions were removed over the summer period when more activities take place outdoors and there is less pressure on the NHS .

In September 2021 the Government published its ‘COVID-19 Response: Autumn and Winter Plan’, setting out a comprehensive plan for managing the virus over the colder months. [footnote 7] Plan A for England relied on booster vaccinations, testing and isolation, guidance on safer behaviours and measures at the border. The publication also outlined a Plan B which could be deployed later in the winter if the situation deteriorated. The measures in Plan B – mandatory face coverings, working from home guidance and COVID-19 certification – were designed to reduce transmission while minimising economic and social impacts.

From September to November 2021, the Government:

a. Extended the vaccine programme to children aged between 12 and 15 and started the booster campaign for those 50 and over and in high risk groups;
b. Maintained a lower level of restrictions than most European comparator countries; and
c. Managed relatively high levels of Delta infections without placing the NHS at risk of unsustainable pressures.

On 24 November, scientists in South Africa reported a new variant with troubling yet uncertain characteristics to the World Health Organization ( WHO ). This was subsequently named the Omicron variant. [footnote 8] The UK was one of the first countries to respond, initially through travel restrictions, then through accelerating and extending the COVID-19 vaccine booster campaign. The Government was in a position to implement Plan B measures in England at short notice as a result of the plans developed for managing the virus over the autumn and winter period.

Although the Omicron variant drove prevalence of the virus to an unprecedented high, adherence to Plan B, wider behaviour change and large-scale testing appeared to slow the growth sufficiently to buy time for the extended booster campaign. This trend was improved by high and sustained vaccine-induced protection in the population against severe disease, and a decrease in severity found in the Omicron variant, which meant that hospitalisation rates remained lower than in previous waves. In particular, the proportion of patients being admitted to intensive care and requiring mechanical ventilation remained lower, with rates declining even when prevalence had increased. [footnote 9] This was in part also due to better clinical understanding of the disease.

During this period, the public continued to show willingness to get vaccinated and boosted, to test and self-isolate if they had symptoms or tested positive, and to follow behaviours and actions that limit methods of transmission.

The people of the UK also owe much to the NHS and its brilliant staff - as well as to providers and staff in adult social care - who throughout the pandemic have drawn deeply on their professionalism, skills and training to do their very best for patients and care recipients. This includes hugely ramping up the booster campaign last winter in response to the Omicron variant. This response played a key role in avoiding the kind of stringent restrictions seen in other countries this winter. Against this backdrop, the Government reverted to Plan A on 27 January, maintaining England as one of the most open countries in Europe.

COVID-19: Future outlook

There are a range of possible futures for the course of the pandemic. SAGE has recently considered four scenarios describing plausible outcomes, though these are not predictions. [footnote 10] All scenarios assume that a more stable position will eventually be reached over several years. In the ‘reasonable best case’ there may be a comparatively small resurgence in infections during autumn/winter 2022-23, and in the ‘reasonable worst case’ a very large wave of infections with increased levels of severe disease. The ‘optimistic central’ and ‘pessimistic central’ scenarios are considered the most likely.

The emergence of new variants will be a significant factor in determining the future path of the virus. New variants of COVID-19 will continue to emerge. [footnote 11] This could include variants that render vaccines less effective, are resistant to antivirals, or cause more severe disease. [footnote 12] The pathway to greater stability will also be affected by the use of vaccination and available treatments.

The term ‘endemic’ is sometimes used to denote when a more steady or more predictable state has been reached but it does not mean that a virus will necessarily circulate at low levels or that outbreaks cannot or will not occur. Given the uncertainty, the Government will need to continue to monitor how COVID-19 is behaving and be ready to respond to resurgences and new variants.

Once COVID-19 becomes endemic it should be possible to respond to the virus in a similar way to other existing respiratory illnesses, through sustainable public health measures. The transition to an endemic state will be highly dynamic and affected by the international situation. It will occur at different times globally due to differences in the spread of the disease and access to vaccines.

The Government expects that the population’s defences against new variants will continue to strengthen as immunity increases through advances in vaccine technology and repeated exposure to the virus. As with other human coronaviruses, children will very likely be exposed to COVID-19 during their childhood and future generations are likely to become progressively more protected by the combination of vaccination and infection.

Studying other infectious diseases can offer insights into the future of COVID-19, though comparisons are imperfect. While a different disease to COVID-19, the most common comparison is to influenza. Both viruses can result in severe illness and complications and are thought to spread in similar ways. The virus that causes COVID-19 is far more contagious and can cause more serious illness, even in otherwise healthy people. Influenza is managed through ongoing surveillance, annual vaccination and annual public messaging, including campaigns to increase vaccine uptake and the ‘Catch it, Bin it, Kill it’ campaign to reduce transmission from coughs and sneezes. Influenza still produces regular winter epidemics, causing pressure on the NHS every winter. The interaction of future COVID-19 waves with other respiratory infections, like influenza, will be important to monitor. Co- or sequential circulation could lead to an increased or longer period of pressure on healthcare services.

Over time, though hard to predict, it is likely that COVID-19 will become a predominantly winter seasonal illness with some years seeing larger levels of infection than others. This may take several years to occur and waves of infection may occur during winter or at other times in the year.

COVID-19: Future response

The Government’s objective in the next phase of the COVID-19 response is to enable the country to manage COVID-19 like other respiratory illnesses, while minimising mortality and retaining the ability to respond if a new variant emerges with more dangerous properties than the Omicron variant, or during periods of waning immunity, that could again threaten to place the NHS under unsustainable pressure.

To meet this objective, the Government will structure its ongoing response around four principles:

a. Living with COVID-19: removing domestic restrictions while encouraging safer behaviours through public health advice, in common with longstanding ways of managing most other respiratory illnesses;
b. Protecting people most vulnerable to COVID-19: vaccination guided by Joint Committee on Vaccination and Immunisation ( JCVI ) advice, and deploying targeted testing;
c. Maintaining resilience: ongoing surveillance, contingency planning and the ability to reintroduce key capabilities such as mass vaccination and testing in an emergency; and
d. Securing innovations and opportunities from the COVID-19 response, including investment in life sciences.

Vaccines underpin all of these principles and form the basis of the Government’s strategy for living with COVID-19. Effective vaccines have allowed the economy and society to reopen and the country’s ability to live with the virus in the future will continue to depend on deeper and broader population immunity conferred by vaccines and infections. In line with this:

a. The Government will continue to be guided by JCVI advice on deploying vaccinations. This includes the recent decision to offer vaccination to all 5-11 year olds later in the spring. Subject to JCVI advice, further vaccinations (boosters) may be recommended for people who are most vulnerable to COVID-19 this autumn and, ahead of that, a spring booster for groups JCVI consider to be at particularly high risk.
b. To enable any further vaccination programme, if necessary, the Government has procured enough doses of vaccine to anticipate a wide range of possible JCVI recommendations. The UK’s procurement approach will continue to consider a range of long term contingency plans to ensure adequate protection is always available for those who need it and to respond quickly in an emergency.
c. The Government has secured contracts with vaccine manufacturers that secure UK access to the most up-to-date vaccines - including protection against emerging variants. The UK remains an attractive destination for life sciences investment, and the Government is committed to supporting UK resilience for future pandemics, by considering how to support research, development and manufacturing capability.
d. The Government will help build global resilience to COVID-19 by meeting its commitment to donate 100 million vaccine doses by June 2022 and by continuing to support the ACT Accelerator. The Government is also working domestically and with the G7, G20, and international partners to reduce the impact of future pandemics through the 100 Days Mission. [footnote 13]

Work is underway across the health and care system to consider how vaccines will be procured, prioritised and deployed in the future. The Government’s aim is to capture the best learning from the pandemic response.

2. COVID-19: Data and impacts

Vaccination, infection and hospitalisation rates.

Booster doses of a COVID-19 vaccine provide good protection against severe disease and hospitalisation for the Omicron variant. Following two doses of the Pfizer or AstraZeneca vaccines, a Pfizer booster initially gives around 90% protection against hospitalisation, though this effect wanes over time. [footnote 14] Similarly, a Moderna booster gives 90 to 95% protection against hospitalisation up to 9 weeks after vaccination. [footnote 15]

Vaccine uptake

In England, over 65% of all those aged 12 and over have received a booster, increasing to 66% across the UK. [footnote 16] [footnote 17] Vaccination rates are even higher among those most vulnerable to COVID-19 - who were prioritised for vaccination - and in England, over 93% of those aged 70 and over have received a booster. [footnote 18]

Figure 2: UK population COVID-19 vaccine coverage, by dose, of those aged 12 and over as of 16 February 2022 [footnote 19]

Pie chart showing the percentage share of the population over 12 years old who are unvaccinated or received one, only two or three doses of a COVID-19 vaccination. As of 16 February 2022, 9% of the over 12 population were unvaccinated, 6% had received only one dose, 19% had received only two doses and 66% had received a booster dose.

Since the start of September 2021 over 1.5 million adults over the age of 18 in England have come forward for a first dose of COVID-19 vaccine, long after receiving an initial offer. [footnote 20] As a result, the percentage of the population aged over 18 in England who have received at least one dose has increased from 88 to 92%. [footnote 21] However, over 3.4 million people in England aged 18 and older remain unvaccinated. [footnote 22]

Whilst vaccine uptake has increased across many groups, it remains considerably lower amongst certain communities. The UK Health Security Agency ( UKHSA ) data show booster uptake was lowest amongst Black and Pakistani adults (below 35%). [footnote 23] Data also shows that adults living in the most deprived areas of England also had lower booster uptake (53%) than those living in the least deprived areas (84%). [footnote 24] Analysis also shows that disparities in vaccine uptake are also present in younger age groups: only 39% of 18 to 24 year olds in England have received a booster dose, much lower than for older age groups. [footnote 25]

The proportion of 12 to 15 year olds who have received at least one dose of vaccine is lowest in Gypsy/Roma, Traveller Irish, Black Caribbean and Black African groups (all below 30%), with a 63 percentage point difference between the most and least vaccinated ethnic groups. [footnote 26] There is also large variation in vaccine coverage by deprivation in 12 to 15 year olds. In the least deprived areas in England 70% of this age group have received at least one dose, compared to 36% in the most deprived. [footnote 27]

Overall, the accumulation of immunity, as well as the use of effective treatments, means the link between COVID-19 infections and progression to severe disease is substantially weaker than in earlier phases of the pandemic. Patients in hospital per 100 infections have remained low over the last six months, with less than 1 hospitalisation per 100 infections compared to above 4 per 100 infections during the Alpha variant peak. [footnote 28] [footnote 29] Lower hospitalisation is partly due to improved treatments but also in part attributable to the lowered virulence of the Omicron variant.

Figure 3: UK: Patients in hospital with COVID-19 per 100 infections using ONS COVID-19 Infection Survey estimates [footnote 30] [footnote 31]

Line chart of the ratio of patients in hospital per infection. In early 2021 there were nearly 5 patients for every 100 infections, this has dropped to less than 0.5.

The ratio is lagged by 8 days (the difference in the peak infections to peak admissions), reflecting the estimated number of infections that occurred 8 days ago that went on to be admitted to hospital on a given date.

Reporting on COVID-19

As testing reduces and the Government’s approach to managing COVID-19 further evolves, UKHSA will keep the content and frequency of reporting on COVID-19 under close review - including the Gov.uk Dashboard - to ensure that statistics are being produced with the appropriate level of quality and transparency, and remain useful and relevant as per the Code of Practice for Statistics.

Impact of COVID-19 response to date on the economy and society

Since March 2020, to reduce transmission, protect the NHS from unsustainable pressure and to reduce mortality, the Government has had to introduce stringent measures by restricting social and economic activity.

The measures introduced were necessary because COVID-19 was a new disease to which the population had no immunity, and for which there was no readily available treatment. However, the measures introduced had extraordinarily high social and economic costs with unprecedented impacts on individuals and families, public services and private businesses.

In particular, the health and education sectors have been significantly affected, as well as the provision of other public services such as the court system. The pandemic has also caused a period of unparalleled global economic uncertainty. Restrictions to control the virus - including social distancing, business closures and reduced international travel - on top of voluntary behaviour change, had significant economic costs, and disrupted the delivery of critical private and public sector services.

Impacts on health, education and public services

During the pandemic, over 720,000 patients have been admitted to hospital with COVID-19, [footnote 32] and over 160,000 people have now died within 28 days of a positive test in the UK. [footnote 33] Caring for this number of patients has restricted the ability of the NHS to provide other types of care. As a result the NHS elective backlog has reached a record high and waiting times for ambulances and emergency care have substantially increased.

The provision of other public services has also been significantly affected. The court backlog increased substantially during the pandemic [footnote 34] and restricting face-to-face education has had significant adverse impacts on children and young people’s learning, development and mental health. Pupils and students from disadvantaged backgrounds experienced greater losses in learning than their more affluent peers as a result of the pandemic. [footnote 35] There is clear evidence that time out of education can be detrimental to children and young people’s future prospects and earning potential, with implications also for long-term productivity.

Mental health and well-being have also been negatively impacted. Self-reported measures of personal well-being dropped to record lows during the first and second waves, with some groups experiencing particularly poor or deteriorating mental health - including women, young people, disabled people, those in deprived neighbourhoods, certain ethnic minority groups and those who experienced local lockdowns. [footnote 36] There was a marked increase in the number of under 18s referred to specialist care for issues such as self-harm and eating disorders in 2021. [footnote 37] Reports of domestic abuse increased during lockdown periods. [footnote 38]

Impacts on the economy

The pandemic and associated non-pharmaceutical interventions ( NPIs ) created significant economic disruption and drove the largest recession on record, with the UK economy contracting by 9.4% in 2020. [footnote 39]

As experience allowed for improved understanding of the impact of restrictions, businesses, consumers and the Government adapted. For example, the Government was able to deploy more targeted interventions. Compared to pre-pandemic levels (February 2020), output was 25% lower during the first lockdown (April 2020), and 7% lower in November 2020, coinciding with much of the second lockdown and 8% lower at the height of the third lockdown (January 2021). [footnote 40]

The Government took unprecedented steps to support the economy through the pandemic. The Government has provided around £400 billion of direct support for the economy through the pandemic to date. [footnote 41] This has helped to safeguard jobs and businesses in every region and nation of the UK, and underpinned the faster than expected economic bounce back that occurred when restrictions were lifted. The Coronavirus Job Retention Scheme succeeded in supporting 11.7 million jobs and 1.3 million employers across the UK and the Self-Employment Income Support Scheme supported nearly 3 million self-employed individuals. [footnote 42]

As restrictions were lifted in 2021, supported by the vaccine rollout, consumer activity increased, driving recovery across the economy. As uncertainty declined, business confidence and investment also began to recover. 2021 saw faster than anticipated growth, with the economy regaining its pre-pandemic size in November 2021. [footnote 43] The emergence of the Omicron variant, workforce absences from illness and isolation, and Plan B measures in England impacted economic activity in recent months, with GDP falling 0.2% in December 2021. [footnote 44]

Workforce absences due to illness and self-isolation have weighed on economic growth in periods of particularly high prevalence during the Delta and Omicron waves. Workforce absences disproportionately impacted those less able to work from home, who were more likely to be young, on lower incomes, or from certain ethnic minority groups. [footnote 45] Changes to self-isolation policy helped to mitigate these impacts while accepting a higher risk of transmission.

Government action has supported a strong recovery in the labour market. The number of payrolled employees in January 2022 was 436,000 above February 2020 levels. [footnote 46] Vacancies remained at a record level in the 3 months to January 2022, standing at 1.3 million. [footnote 47]

Following the easing of restrictions in summer 2021, supply pressures due to COVID-19 have acted as a constraint on output in many countries including the UK. This has been a result of: restrictions on people’s ability to work; factory closures globally; and elevated consumer demand for goods. While supply pressures remain acute, there are some initial signs of easing with shipping costs falling from October 2021. However, the possibility of further outbreaks internationally and different approaches to COVID-19 taken by different countries could present further risks to the UK economy.

3. Living with COVID-19

The past 2 years have seen many necessary restrictions imposed on everyday life to manage COVID-19, but these have come with a huge toll on wellbeing and economic output. Scientists (including virologists, epidemiologists, clinicians, and many others) and the Government now understand more about COVID-19, how it behaves and how it can be treated. As the virus continues to evolve, it will be important to continue to add to this understanding.

Living with and managing the virus will mean maintaining the population’s wall of protection and communicating safer behaviours that the public can follow to manage risk. The Government will move away from deploying regulations and requirements in England and replace specific interventions for COVID-19 with public health measures and guidance.

The Government is able to take this step now because of the success of the vaccination programme, and the suite of pharmaceutical tools the NHS can deploy to treat people who are most vulnerable to COVID-19 and the most severely ill (see chapter 4). The Government can only take these steps because it will retain contingency capabilities and will respond as necessary to further resurgences or worse variants of the virus (see chapter 5).

Removing the last domestic restrictions

The Government will remove remaining domestic restrictions in England, subject to appropriate parliamentary scrutiny.

From 24 February, the Government will:

a. Remove the legal requirement to self-isolate following a positive test. Adults and children who test positive will continue to be advised to stay at home and avoid contact with other people. After 5 days, they may choose to take a Lateral Flow Device ( LFD ) followed by another the next day - if both are negative, and they do not have a temperature, they can safely return to their normal routine. Those who test positive should avoid contact with anyone in an at risk group, including if they live in the same household. There will be specific guidance for staff in particularly vulnerable services, such as adult social care, healthcare, and prisons and places of detention.
b. No longer ask fully vaccinated close contacts and those under the age of 18 to test daily for 7 days, and remove the legal requirement for close contacts who are not fully vaccinated to self-isolate. Guidance will set out the precautions that those who live in the same household as someone who has COVID-19, or who have stayed overnight in the same household, are advised to take to reduce risk to other people. Other contacts of people with COVID-19 will be advised to take extra care in following general guidance for the public on safer behaviours.
c. End self-isolation support payments and national funding for practical support. The medicine delivery service will no longer be available. People who were instructed to self-isolate before this date will still be able to claim support payments within the next 42 days.
d. Revoke The Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations. Local authorities will continue to manage local outbreaks of COVID-19 in high risk settings as they do with other infectious diseases.

From 24 March, the COVID-19 provisions within Statutory Sick Pay and Employment and Support Allowance regulations will end. People with COVID-19 may still be eligible, subject to the normal conditions of entitlement.

From 1 April, the Government will update guidance setting out the ongoing steps that people with COVID-19 should take to minimise contact with other people. This will align with the changes to testing set out later in this chapter.

Testing, tracing and certification

Testing and tracing have been important throughout the response to COVID-19. The Government’s provision of LFDs enabled people to take a test before meeting family, friends and colleagues, allowing them to protect themselves and others, and breaking chains of transmission. This was particularly important during the period of exceptionally high prevalence driven by the Omicron variant towards the end of 2021. Access to LFDs also enabled contacts of positive cases to test daily in lieu of isolation, reducing the workforce impacts of isolation while identifying positive cases.

However, the Government’s free provision of testing at scale has come at a very significant cost to the taxpayer during the pandemic response. The Testing, Tracing and Isolation ( TTI ) budget in the financial year 2020-21 exceeded that of the Home Office, and the programme cost £15.7 billion in the financial year 2021-22. This level of spending was necessary due to the severe risk posed by COVID-19 when the population did not have a high level of protection.

The population now has much stronger protection against COVID-19 than at any other point in the pandemic, due to the vaccination programme, natural immunity, access to antivirals, and increased scientific and public understanding about how to manage risk. For this reason, the Government now assesses that it is time to transition to focus its COVID-19 response towards guidance, while targeting protection on individuals who are most at risk from the virus. Government spending on COVID-19 will reduce significantly in line with this change.

As immunity levels are high, testing and isolation will play a less important role in preventing serious illness. Some changes to testing have already begun. In January, the recommendation for a confirmatory polymerase chain reaction ( PCR ) test following a positive LFD was changed, and the testing regime in adult social care was also changed to a LFD regime.

The Government will implement further changes to the availability of testing in the coming months.

From 21 February, the Government is removing the guidance for staff and students in most education and childcare settings to undertake twice weekly asymptomatic testing.

From 1 April, the Government will no longer provide free universal symptomatic and asymptomatic testing for the general public in England.

Over 2 billion lateral flow tests have been provided across the UK since 2020. UKHSA continues to have good stock levels and will manage these to provide flexibility in future. Ahead of the end of free universal testing in England, it will be necessary for UKHSA to cap the number of tests distributed each day to manage demand. Given that advice to test has and continues to reduce, the Government urges people only to order what they need.

The Government will help enable COVID-19 tests to be made available for those who wish to purchase them through the private market. Private markets are established in many European countries - including France, Germany, Italy and Spain - and the United States of America. The Government is working with retailers and pharmacies to help establish the private market in testing.

From 1 April, there will be some limited ongoing free testing:

a. Limited symptomatic testing available for a small number of at-risk groups - the Government will set out further details on which groups will be eligible.
b. Free symptomatic testing will remain available to social care staff

Contact tracing

From 24 February, routine contact tracing will end. Contacts will no longer be required to self-isolate or advised to take daily tests. Instead, guidance will set out precautions that contacts can take to reduce risk to themselves and other people - and those testing positive for COVID-19 will be encouraged to inform their close contacts so that they can follow that guidance.

Local health teams continue to use contact tracing and provide context-specific advice where they assess this to be necessary as part of their role in managing infectious diseases.

COVID-status certification

From 1 April, the Government will remove the current guidance on domestic voluntary COVID-status certification and will no longer recommend that certain venues use the NHS COVID Pass. The NHS COVID Pass will remain available within the NHS App for a limited period, to support the use of certification in other parts of the UK. The NHS App will continue to allow individuals access to their vaccination status for international travel, as well as their recovery status for travel to those overseas destinations that recognise it.

Safer behaviours

Throughout the pandemic, Government advice and information has been informed by the best scientific evidence available from health agencies, academics, and experts. [footnote 48]

People will continue to be advised that there are safer behaviours they can adopt to reduce the risk of infection. Precautions remain particularly important to those who are at higher risk if they catch COVID-19, although due to advances in vaccination and therapeutics, this group is now better protected. The majority of people previously considered clinically extremely vulnerable are now advised to follow the same general guidance as everyone else as a result of the protection they have received from vaccination.

Individuals can still reduce the risk of catching and passing on COVID-19 by:

a. Getting vaccinated;
b. Letting fresh air in if meeting indoors, or meeting outside;
c. Wearing a face covering in crowded and enclosed spaces, especially where you come into contact with people you do not usually meet, when rates of transmission are high;
d. Trying to stay at home if you are unwell;
e. Taking a test if you have COVID-19 symptoms, and staying at home and avoiding contact with other people if you test positive; and
f. Washing your hands and following advice to ‘Catch it, Bin it, Kill it’.

From 1 April, guidance to the public and to businesses will be consolidated in line with public health advice. There will continue to be specific guidance for those whose immune system means they are at higher risk of serious illness from COVID-19 despite vaccination.

Businesses and other organisations

Employers and businesses have also taken significant steps over the pandemic to mitigate the risks of COVID-19 within their settings. The Government has lifted the majority of legal requirements on businesses, and continues to provide ‘Working Safely’ guidance setting out the steps that employers can take to reduce risk in their workplaces.

From 24 February, workers will not be legally obliged to tell their employers when they are required to self-isolate. Employers and workers should follow Government guidance for those with COVID-19.

From 1 April, the Government will remove the health and safety requirement for every employer to explicitly consider COVID-19 in their risk assessments. The intention is to empower businesses to take responsibility for implementing mitigations that are appropriate for their circumstances. Employers that specifically work with COVID-19, such as laboratories, must continue to undertake a risk assessment that considers COVID-19.

From 1 April, the Government will replace the existing set of ‘Working Safely’ guidance with new public health guidance. Employers should continue to consider the needs of employees at greater risk from COVID-19, including those whose immune system means they are at higher risk of serious illness from COVID-19. The Government will consult with employers and businesses to ensure guidance continues to support them to manage the risk of COVID-19 in workplaces.

Ventilation

The Government will continue to promote and support good ventilation. Employers and businesses should continue identifying poorly ventilated spaces and take steps to improve fresh air flow.

There is increasing evidence of the importance of circulating fresh air in reducing the risk of COVID-19 transmission. Ventilation also helps with reducing transmission of other respiratory infections such as influenza, with some research showing that being in a room with fresh air can in some cases reduce the risk of airborne transmission of COVID-19 by over 70%. [footnote 49] There are also potential wider benefits of good ventilation, for health, concentration, and lower absence rates. [footnote 50] The Government has responded to this evidence through:

a. Public communications campaigns and comprehensive business guidance on ventilation and fresh air;
b. Providing over 350,000 CO2 monitors to state-funded education settings backed by £25 million of funding, [footnote 51] and up to 9,000 high efficiency particulate air ( HEPA ) cleaning units for the small number of education settings where poor ventilation could not be quickly rectified; [footnote 52]
c. Enabling local authorities to use their allocations from the £60 million Adult Social Care Omicron Support Fund, at their discretion, to audit and improve fresh air in adult social care; [footnote 53] and
d. Completing a ventilation audit of the central government estate.

The Government is also carrying out further ventilation research and the Government’s Chief Scientific Adviser has commissioned a report from the Royal Academy of Engineering on how our built environment could be made more infection resilient, to be published this May. The Government will carefully consider its recommendations, alongside the ongoing research.

Changes at a glance

Today, 21 February the Government is:

Removing the guidance for staff and students in most education and childcare settings to undertake twice weekly asymptomatic testing.

From 24 February the Government will:

Remove the legal requirement to self-isolate following a positive test. Adults and children who test positive will continue to be advised to stay at home and avoid contact with other people for at least 5 full days and then continue to follow the guidance until they have received 2 negative test results on consecutive days.
No longer ask fully vaccinated close contacts and those aged under 18 to test daily for 7 days, and remove the legal requirement for close contacts who are not fully vaccinated to self-isolate.
End self-isolation support payments, national funding for practical support and the medicine delivery service will no longer be available.
End routine contact tracing. Contacts will no longer be required to self-isolate or advised to take daily tests.
End the legal obligation for individuals to tell their employers when they are required to self-isolate.
Revoke The Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations.

From 24 March, the Government will:

Remove the COVID-19 provisions within the Statutory Sick Pay and Employment and Support Allowance regulations.

From 1 April, the Government will:

Remove the current guidance on voluntary COVID-status certification in domestic settings and no longer recommend that certain venues use the NHS COVID Pass.
Update guidance setting out the ongoing steps that people with COVID-19 should take to minimise contact with other people. This will align with the changes to testing.
No longer provide free universal symptomatic and asymptomatic testing for the general public in England.
Consolidate guidance to the public and businesses, in line with public health advice.
Remove the health and safety requirement for every employer to explicitly consider COVID-19 in their risk assessments.
Replace the existing set of ‘Working Safely’ guidance with new public health guidance.

4. Protecting people most vulnerable to COVID-19

Since March 2020, the medical and scientific community has learned a lot more about COVID-19, what makes someone more or less vulnerable to it, and how to manage the virus in higher risk settings.

At the start of the pandemic very little was known about risk factors from COVID-19 and vaccines were unavailable, so the Government took a precautionary approach and advised ‘clinically extremely vulnerable’ groups to follow shielding advice. These measures were extremely restrictive and often had a significant impact on individuals’ lives and their mental and physical wellbeing, meaning people and their families made considerable sacrifices to stay safe.

Data on COVID-19 related deaths and admissions between December 2020 and June 2021 showed that COVID-19 mortality increased with age (when controlled for vaccination status and other key factors). This same analysis showed that the risk was higher for people with specific clinical conditions such as Down’s syndrome, solid organ transplantation, Dementia, Parkinson’s disease, and neurological conditions. Those living in more deprived areas and from certain ethnic minority groups were also at higher risk of COVID-19 mortality. [footnote 54]

As a result of the success of the Government’s strategy to invest in scientific and medical innovation, the Government has been able to rely more on vaccines and medical treatments, and gradually remove restrictive guidance for those at an increased risk of COVID-19. The shielding programme ended on 15 September 2021.

The Government prioritised those at highest risk from COVID-19 for vaccination by following JCVI advice, and using the COVID-19 Population Risk Assessment. Vaccination has proved to be the most effective way to protect those at increased risk from COVID-19 and everybody should be encouraged to get all doses of the vaccination and boosters for which they are eligible. The Government and UKHSA will continue to communicate to people most vulnerable to COVID-19 about available clinical interventions, including vaccination and treatments, and also testing and public health advice (see previous chapter).

COVID-19 vaccines remain the most important and effective way the public can protect themselves and others from becoming seriously ill or dying from the virus. Vaccines have built a wall of defence around communities across the country, saving countless lives and allowing a phased return to normality. A recent review by UKHSA also showed that people who have had one or more doses of a COVID-19 vaccine are less likely to develop long COVID symptoms than those who remain unvaccinated. [footnote 55]

The UK’s vaccination programme, which prioritised the most vulnerable to COVID-19 for early receipt of vaccines, has now protected tens of millions of people and prevented many hospitalisations and deaths. [footnote 56] The programme continues to be extended. The NHS has already given a first dose to 60% of 12 to 15 year olds in England and is now offering second doses. [footnote 57] Vaccinations have also started to be offered to at-risk 5 to 11 year olds since week commencing 31 January (2 doses, 8 weeks apart). From April, all 5 to 11 year olds will be able to come forward for a course of COVID-19 vaccine (2 doses, 12 weeks apart). Every parent will have the opportunity to make an informed choice.

The Government will continue to be guided by JCVI advice on the deployment of the vaccination programme. Subject to JCVI advice, further vaccinations (boosters) may be recommended for people who are most vulnerable to serious outcomes from COVID-19 this autumn and, ahead of that, a spring booster for groups JCVI consider to be at particularly high risk.

For people who have yet to take up their initial vaccine offer, the NHS continues to make vaccines available across the UK to ensure that every eligible person who wants a vaccine can get one. The Government will continue to provide flexible delivery models to ensure vaccines remain accessible.

The Government will continue to support communities with lower rates of COVID-19 vaccine uptake, particularly in areas of deprivation and for ethnic minority groups. In December 2021, the Government announced a further £22.5 million in funding for the Community Vaccine Champions Scheme to support 60 local authorities with the lowest COVID-19 vaccine uptake. [footnote 58] Community Champions work with local councils to address barriers to accurate vaccine information and encourage individuals to get vaccinated.

Deploying treatments

The Government has moved quickly since the onset of the pandemic to ensure that those at risk of and suffering from COVID-19 have early access to safe and effective treatments.

In April 2021, the Prime Minister launched the Antivirals Taskforce ( ATF ), in order to identify, procure and deploy novel antiviral treatments for UK patients with COVID-19. Antivirals can be used at the earliest stage of infection to help reduce the development of severe COVID-19 by blocking virus replication.

The ATF has secured a supply of almost 5 million courses of antivirals - more per head than any other country in Europe. [footnote 59] These antivirals are the first medicines which can be given at home to treat people whose immune systems mean they are at higher risk from COVID-19.

In company trials, Paxlovid (nirmatrelvir + ritonavir) reduced the relative risk of COVID-19-associated hospitalisation or death by 88% in unvaccinated patients who received treatment within 5 days of symptoms appearing. [footnote 60] Results from Lagevrio (molnupiravir) company trials show around 30% relative reduction in the rate of hospitalisation in unvaccinated patients. [footnote 61] Both antivirals have now received conditional marketing authorisation from MHRA , making the UK the first country in the world to approve an oral antiviral that can be taken at home for COVID-19. [footnote 62]

People at highest risk of developing severe COVID-19 can now access antivirals should they test positive for COVID-19. UKHSA has sent priority PCR tests to around 1.3 million people to support rapid turnaround of results so they can access the treatments as soon as possible after symptoms begin. [footnote 63] In England, around 14,000 people with weakened immune systems have already been treated with the new antivirals, Lagevrio (molnupiravir) and Paxlovid (nirmatrelvir + ritonavir), and the new monoclonal antibody treatment, Xevudy (sotrovimab).

Therapeutics

The Therapeutics Taskforce was quickly established in April 2020 to ensure that COVID-19 patients in the UK had access to safe and effective treatments as soon as possible. Effective therapeutics have played a vital role in lessening the severity and impact of COVID-19.

The UK has led the way in the testing and deployment of life-saving treatments, which have been made available to patients in the UK and across the world. World-leading clinical trials such as RECOVERY - the world’s largest randomised controlled clinical trial for COVID-19 treatments have helped to discover new effective treatments for COVID-19.

In June 2020, the UK was the first in the world to discover that dexamethasone - a low-cost corticosteroid - reduced the risk of mortality in hospitalised COVID-19 patients requiring oxygen or ventilation by up to 35%. [footnote 64] UK Government-funded trials demonstrated tocilizumab and sarilumab - monoclonal immunomodulatory antibody treatments - reduced the relative risk of mortality by up to 24% when administered to patients within 24 hours of entering intensive care. [footnote 65]

New therapeutics like Xevudy (sotrovimab), a monoclonal antibody, have been authorised for use in people who have mild to moderate COVID-19 infection and at least one risk factor for developing severe illness. In a clinical trial, a single dose of the monoclonal antibody was found to reduce the risk of hospitalisation and death by 79% in high-risk adults with symptomatic COVID-19 infection. [footnote 66]

Supporting the NHS and social care

Throughout the pandemic the Government has provided health and social care services with resources and support to respond to the unique challenges they have faced.

The approach to managing COVID-19 in NHS and adult social care services will continue to evolve in the coming months, but will continue to focus on providing care for those that need it and supporting people who are most vulnerable to COVID-19, including people receiving social care and people receiving treatment in hospitals.

A key objective for the NHS over the last two years has been to keep patients and staff safe and limit the spread of COVID-19 within hospitals. Enhanced Infection Prevention Control ( IPC ) measures have been required in NHS settings, including:

a. Asymptomatic testing for patients and for staff;
b. Enhanced personal protective equipment ( PPE ) to protect healthcare workers and the patients they come into contact with;
c. COVID-19 specific bed management and clinical pathways; and
d. Evaluation of ventilation in line with the latest guidance. [footnote 67]

In the next phase of managing COVID-19, the NHS will continue to:

a. Deliver and support specific programmes to manage the risk of COVID-19, including the deployment of vaccines (see chapter 4).
b. Support patients with Long COVID, where the UK is leading the way in research, treatment and care. Specialist services have been established throughout England for adults, children and young people experiencing long-term effects of COVID-19 infection, underpinned by a £100 million plan for 2021-22, and further investment for 2022-23.
c. Work to better understand COVID-19 and the long-term health impacts it may have, supported by £50 million in research funding.
d. Use and develop measures to restore and recover elective services and reduce backlogs for treatments.
e. Providing access to free PPE to the end of March 2023, or until the IPC guidance on PPE usage for COVID-19 is amended or superseded (whichever is sooner).

Adult social care

Care home residents, and those in receipt of adult social care at home and other care settings, are often among the most vulnerable in society to COVID-19. To protect these people, the Government introduced additional protective measures, including:

a. Free PPE for adult social care workers;
b. Prioritisation of staff and residents for vaccinations;
c. Designated settings to ensure that those who need residential care but are still likely to be infectious with COVID-19 at the point of discharge from hospital can complete a period of isolation before moving to their care home;
d. Introducing visitor restrictions at times of particularly high risk; and
e. In recognition of the challenges facing the sector, the Government published its first ever set of winter plans for adult social care.

The Government will continue to support the adult social care sector with the following protections:

a. Supporting and encouraging the take-up of vaccines amongst care recipients and staff, including any further doses that may be recommended by JCVI for COVID-19 and other infections;
b. Guidance on precautions for visitors and workers in adult social care; and
c. Providing access to free PPE to the end of March 2023 or until the UK IPC guidance on PPE usage for COVID-19 is amended or superseded (whichever is sooner).

The role of the Government in managing the COVID-19 response in adult social care has been unprecedented. As a part of living sustainably with COVID-19, by 1 April the Government will publish updated IPC guidance. This will replace current COVID-19 IPC guidance for care homes, home care and other adult social care services. The Government will continue to work with local authorities and care providers to respond to outbreaks in care settings and manage local workforce pressures.

Tackling health inequalities

COVID-19 has also exacerbated pre-existing socio-economic and health inequalities, driving poorer outcomes amongst those who were already disadvantaged. Since the start of the pandemic, the NHS has accelerated its preventative health programmes which proactively engage those at greatest risk of poorer health outcomes to address health inequalities.

The Government will continue to support communities with lower rates of COVID-19 vaccine uptake, particularly in areas of deprivation and for ethnic minority groups as part of its approach to both reducing health disparities as and living with COVID-19, but also to support the wider health and social care system.

The recent ‘Levelling Up the United Kingdom’ white paper also aims to reduce geographical inequalities by investing in health, local infrastructure and leadership, and improving education and skills. [footnote 68] The Government will set out a strategy to tackle the core drivers of inequalities in health outcomes in a new white paper on health disparities in 2022.

The Government has provided significant additional funding to respond to the pandemic on an emergency basis through additional borrowing. As the country moves to living with COVID, the Government must ensure that the cost of resilience and contingency measures are met in a responsible and sustainable manner. The Government is already asking taxpayers to make an additional contribution through the Health and Care levy. The Government will meet the cost of living with COVID-19 within this and other existing funding streams.

5. Maintaining resilience

As set out in the introduction, the future path and severity of the virus is uncertain and it may take several years before the virus becomes more predictable. During this period further resurgences will occur, it is possible more severe variants will emerge and there will sadly be more hospitalisations and deaths. As a result, the Government is taking steps to ensure there are plans in place to maintain resilience against significant resurgences or future variants and remains ready to act if a dangerous variant risks placing unsustainable pressure on the NHS .

The Government’s aim is to manage and respond to these risks through more routine public health interventions. As such, the NHS has developed a range of interventions to respond to COVID-19 demand while protecting NHS activity to the fullest possible extent. In future, pharmaceutical capabilities will be the first line of defence in responding to COVID-19 if risk threatens to place unsustainable pressure on the NHS .

The Government will retain surveillance to monitor the virus, understand its evolution and identify changes in characteristics, enabling the Government to make informed decisions. The Government will prepare and maintain the capabilities to ramp up testing and other tools such as laboratory infrastructure to be used as a line of defence against a new variant.

Monitoring and mitigating risks

The UK has been a global leader in sequencing and monitoring, at times uploading the highest number of sequences of any country on the Global Initiative on Sharing Avian Influenza Data ( GISAID ) platform. [footnote 69] UKHSA will continue to sequence some infections and monitor a range of data.

Domestic surveillance

The Government will continue to monitor cases, in hospital settings in particular, including using genomic sequencing, which will allow some insights into the evolution of the virus. UKHSA will maintain scaled down critical surveillance capabilities including the COVID-19 Infection Survey ( CIS ) population level survey, genomic sequencing and additional data. This will be augmented by continuing the SARS-CoV-2 Immunity & Reinfection Evaluation ( SIREN ) and Vivaldi studies.

UK monitoring mechanisms during the pandemic

The Office for National Statistics ( ONS ) has continued to keep pace with the changing evidence needs of the Government and the public in tracking the spread of COVID-19 and understanding its impact. This includes official statistics on health, society, the labour market and the economy.

The COVID-19 Infection Survey was established in April 2020 to measure:

How many people across England, Wales, Northern Ireland and Scotland test positive for a COVID-19 infection at a given point in time, regardless of whether they report experiencing symptoms;
The average number of new positive test cases per week over the course of the study; and
The number of people who test positive for antibodies.

The results of the survey contribute to UKHSA ’s estimates of the rate of transmission of the infection, often referred to as “R”. The survey provides important information about the socio-demographic characteristics of the people and households who have contracted COVID-19.

The SIREN study was established in June 2020. The purpose of this study is to understand whether prior infection with SARS-CoV2 (the virus that causes COVID-19) protects against future infection with the same virus.

The Vivaldi Study was also established in June 2020. The purpose of this study is to investigate COVID-19 infections in care homes, to find out how many care home staff and residents have been infected with COVID-19, and inform decisions around the best approach to COVID-19 testing in the future.

Preparing to respond

In order to be prepared for further resurgences and new variants, the Government will maintain resilience and infrastructure required to scale up a proportionate response.

NHS and social care resilience

The NHS has developed a range of interventions to respond to COVID-19 demand while protecting urgent and elective care activity to the fullest possible extent, including during the peaks of demand seen in April 2020, January 2021, and at the present time. These interventions include:

a. Tried and tested plans to expand general and acute and critical care bed capacity as needed, learning the lessons from previous waves of COVID-19. This includes surging capacity within hospital trusts’ existing footprints, across Integrated Care System footprints and clinical networks, and patient transfers between regions if required.
b. Maximising patient discharge, working with local authorities and partners to ensure that all medically fit patients can be safely discharged as soon as possible, supporting improved patient outcomes and freeing up beds for elective surgery.
c. Making full use of non-acute beds in the local health and care system as necessary, including in hospices, hotels, community beds and the independent sector. At points throughout the pandemic NHS England has contracted with independent providers to secure additional surge capacity and prevent the NHS from becoming overwhelmed due to COVID-19 infections. The Increasing Capacity Framework streamlines central procurement processes and allows the NHS to effectively secure the capacity it needs to meet patient needs on a local level.
d. The use of ‘virtual wards’ and ‘hospital at home’ models of care have ensured that patients can be safely cared for in their own homes and that additional bed capacity can be freed up in hospitals. The NHS operational planning guidance sets out that, by December 2023, systems should complete the comprehensive development of virtual wards towards a national ambition of 40 to 50 virtual beds per 100,000 population.
e. Implementing a range of workforce interventions, including increasing staffing numbers, temporary local adjustments to staffing ratios, with flexible redeployment of staff including training for roles in critical or enhanced care.
f. Ensuring continued improvements to the urgent and emergency care pathway to avoid emergency department crowding. Interventions include using NHS 111 as the first point of triage for urgent care services, which increases the ability to book patients into the full range of local urgent care services, including urgent treatment centres; same day emergency care; speciality clinics; and urgent community and mental health services.

While significant uncertainty remains, the NHS will continue to closely monitor COVID-19 demand and keep the use of these interventions under review, deploying them as necessary to protect the delivery of health services to the fullest extent possible.

Local authorities will have their own contingency plans for maintaining care services in the event of acute workforce supply challenges. In the event that a local authority – having deployed all its contingency measures – is unable to cope, a request for further support could be made via the Local Resilience Forums ( LRFs ).

The Government will continue to work closely with the health and care sectors to identify and understand capacity risks, in the event of another challenging winter and/or new variant of concern.

Pharmaceutical interventions and medical countermeasures

The Government already has experience in successfully deploying a contingency response based on medical countermeasures. During the response to the Omicron variant, the NHS administered a booster programme to all adults and met the surge in demand for vaccines at short notice. The Government will ensure that there are sufficient procurement plans in place to make certain that the UK has access to the most effective vaccines on the market, and that these are available to the health care system and the public when needed.

Testing: Contingency capabilities

The Government will retain core infrastructure and capabilities in England to scale up testing in the case of a new dangerous variant.

Local outbreak management

Local partners have significantly stepped up to support local outbreak management. In future the Government expects COVID-19 to be managed regionally and locally as part of a wider all hazards approach, using existing health protection frameworks.

The Government will revise current COVID-19 outbreak management advice and frameworks, to set out the support that local authorities and other system partners (such as LRFs , regional health protection teams, the NHS and others) can expect from regional and national stakeholders and the core policy and tools for contingency response. The Government will continue to provide guidance via UKHSA engagement with local partners.

Approach at the borders

Last month the Government announced its new system for international travel, underpinned by a commitment to see a return to unrestricted travel and to support recovery across all sectors. There are now no requirements on eligible vaccinated travellers apart from the need to complete a simplified Passenger Locator Form. Travellers who do not qualify as eligible vaccinated also need to take a pre-departure test and an arrival test on or before day 2, but no longer need to isolate or take a day 8 test.

The Government also committed to developing a contingency toolbox of options. The Government recognises that border measures have carried very high personal, economic, and international costs. The Government will only consider implementing new public health measures at the border in extreme circumstances where it is necessary to protect public health.

Contingency measures would only be used where they are proportionate to the threat faced by a COVID-19 variant and effective in slowing ingress to avert pressure on public services such as the NHS . There may be scenarios where border measures are not appropriate and will not form part of a contingency response. The approach will be underpinned by three important principles:

a. The bar for implementation of any measures is very high;
b. Any measure will be tailored and proportionate to the threat posed and will seek to minimise economic and social impacts; and
c. In the event any measures were deemed necessary they would be time limited and not be in place any longer than needed.

Given the current state of the pandemic and a move towards global travel volumes returning to normal, the infrastructure for hotel quarantine will be fully stood down from the end of March and the Government is developing options to increase compliance with home isolation in its place should quarantine measures need to be reintroduced. Previous global responses to variants of COVID-19 that targeted travel from specific countries may not always be appropriate given how quickly the virus can spread, and tailoring measures to the nature of the threat can improve their effectiveness and proportionality. As such, the Government will have in reserve a more agile toolbox tailored depending on the nature and source of the threat, and deployed only where that high bar is crossed. The default will be to first consider whether less stringent measures are appropriate so as to minimise the impact on general travel where possible.

The Government will set out the contingency approach and toolbox of measures in more detail ahead of Easter when reviewing The Health Protection (Coronavirus, International Travel and Operator Liability) (England) Regulations 2021. The Government will continue to work with industry on contingency planning.

6. Securing innovations and opportunities from the pandemic

The COVID-19 pandemic has been a unique challenge for governments, communities and businesses across the world. These challenges have brought with them opportunities for innovation, as new approaches were developed and deployed at scale and pace. The Government is committed to securing the innovations and opportunities which have emerged during the pandemic, where there is long term benefit to wider Government priorities.

In addition, the COVID-19 public inquiry chaired by Baroness Hallett starts this spring and is intended to enable the Government to learn lessons about its response.

The Government will also remember those that have lost their lives during the COVID-19 pandemic, and commemorate the enormous efforts and sacrifices of all those who have supported the country throughout. On 12 May 2021, the Prime Minister announced that a UK Commission on COVID Commemoration would be established to consider how the country should remember those who have lost their lives and recognise those involved in the response. The Government will set out the Commission’s membership and terms of reference in due course.

Innovation, opportunities and learning

Life sciences.

Over the course of the pandemic the scientific community has made extraordinary scientific advances. The Government directly supported several vaccine manufacturers in their research and development. The first COVID-19 vaccines were ready for clinical trials in under a month, which then led to the deployment of the first safe and effective wide-scale COVID-19 vaccination programme. These vaccines have now been used more widely around the world than many medicines, with extraordinarily successful results.

Innovations in vaccines, antivirals and therapeutics will likely play a vital role in the Government’s response against COVID-19 in the future. A number of vaccine suppliers are already trialling new bi-valent vaccines, which would provide protection against COVID-19 variants. The Vaccine Taskforce ( VTF ) will continue to ensure that the UK has access to effective vaccines on the market. The Therapeutics Taskforce will continue to support the eight national priority clinical trial platforms run by the National Institute for Health Research, focused on prevention, novel treatments, and treatments for Long COVID.

The UK remains an attractive prospect for companies to invest in the UK’s life sciences sector, whether it be as part of an established research and innovation network or in the growing biologics manufacturing industry. At the recent Autumn Budget, the Chancellor announced a further £354 million for UK life sciences manufacturing as part of the Global Britain Investment Fund to support investment into the UK economy. The Vaccine Taskforce’s investment into facilities at UKHSA Porton Down has increased the UK’s capacity to test the efficacy of vaccines against emerging variants.

Vaccine Taskforce ( VTF )

The Vaccine Taskforce was set up in April 2020 to drive forward the development, procurement, and production of a COVID-19 vaccine as quickly as possible, bringing together the Government, academia, industry and international cooperation in science and research. Since then, the VTF has had unprecedented success. Using experience and expertise from the private sector has enabled the UK to build a diverse portfolio of vaccines and secure assured supply through to 2023. This has allowed the NHS to run the largest vaccination campaign in its history.

The Government’s longer-term approach to vaccine procurement will seek to build upon the legacy of innovation from the success of the VTF and look to apply the wider lessons from the past two years to other vaccination programmes.

NHS and social care

The Government will implement lessons learnt from the pandemic in the Health and Social Care sector, drawing on what worked well, and on future clinical advice. In particular, the Health and Social Care Integration white paper sets out the Government’s plans to make integrated health and social care a reality for everyone across England and to level up access, experience, and outcomes across the country. [footnote 70]

Improving NHS data

In March 2020, the NHS COVID-19 Data Cell (a partnership between NHS England and NHS Improvement ( NHSEI ) and NHSX) worked with partners to provide a data analysis and modelling platform that brought together multiple complex data sources from across the health and care system into a single, secure location.

The platform proved invaluable in providing a single version of the truth to support data driven decisions. In a matter of months, this system achieved what would have taken years to develop under non-crisis circumstances.

Virtual Wards

To enable patients to be safely discharged as quickly as possible the NHS established “virtual wards”. This allowed clinicians to use technology to remotely monitor COVID-19 and non-COVID-19 patients while communicating with them at home.

Oximetry@Home

This NHS service provides pulse oximeters to patients with COVID-19 who are at a higher risk, along with supporting information to monitor their oxygen saturation levels at home, with 24/7 access to advice and support. It is usually led by general practice working alongside community teams. The service can help ensure more timely hospital treatment if required.

Emergency registers for health professionals

Section 2 of the Coronavirus Act 2020 has enabled thousands of nurses and other healthcare professionals who no longer work for the NHS to be placed on temporary registers, allowing them to work in NHS services to alleviate workforce pressures during times of emergency.

Following the success of these registers, the Department for Health and Social Care ( DHSC ) will amend legislation to enable the Nursing and Midwifery Council ( NMC ) and the Health and Care Professions Council ( HCPC ) to establish temporary registers to support emergency response arrangements in future.

Strengthening health security at home and abroad

The Government is committed to supporting future health security and resilience.

UK Health Security Agency ( UKHSA )

UKHSA was set up in April 2021 to prepare for, prevent and respond to all hazards to public health. UKHSA has been instrumental in delivering the UK’s response to COVID-19:

Testing capacity and diagnostics including the largest network of diagnostic testing facilities in British history. The UK has now registered over 467 million COVID-19 tests. [footnote 71]
Genomic sequencing capabilities where the UK has uploaded over 2 million genome sequences to the international GISAID database, accounting for a quarter of all SARS-CoV-2 genomes shared globally to date. [footnote 72]
Innovation and technology: the development of the Rosalind Franklin laboratory, and use of innovative new techniques - such as reflex assay technology - strengthened our ability to rapidly detect COVID-19 mutations and support the assessment of variants of concern. At its peak, in December 2021, the Rosalind Franklin Laboratory was processing over 400,000 PCR tests a week. [footnote 73]

UKHSA will continue to lead the wider health protection emergency planning and response system, championing health security across the UK.

International learning and innovation

Epidemics and pandemics are not new, but the rate at which they have occurred has increased during the last 20 years. This increase is thought to be driven by a combination of changes to land use and human behaviours that bring people into closer contact with wild animals, coupled with unprecedented levels of global movement of people and trade.

Supporting global COVID-19 recovery

The UK remains committed to equitable global access to COVID-19 tools to help reduce the risk and frequency of variants of concern, and to contribute to global COVID-19 recovery. The UK has played a leading role in global vaccine access and has committed up to £1.4 billion of UK aid to address the impacts of COVID-19 and to help end the pandemic as quickly as possible. The UK’s commitment included £548 million to support the COVAX Advanced Market Commitment ( AMC ) to deliver COVID-19 vaccines for up to 92 low- and middle-income countries.

The UK’s G7 Presidency delivered a shared commitment to provide one billion doses to vaccinate the world over the next year. As part of this commitment, the Government committed to donate 100 million surplus COVID-19 vaccine doses by June 2022, at least 80% of which will go to COVAX to enable it to further support those in need. The Government exceeded its target of 30 million doses donated by the end of 2021.

Building resilience to global health threats

The Government continues to invest in and develop resilience to global health threats via improved health and biosecurity and pandemic preparedness, examples include:

a. Biological Security Strategy: Later this year, the Government will publish a refreshed biological security strategy. COVID-19 has reinforced the need for effective preparation for future biological threats to protect the UK against naturally occurring infections, accidental release and potential deliberate misuse by state and non-state actors, in particular through surveillance, risk monitoring and response planning.
b. The 100 Days Mission and Early Warning Systems: The 100 Days Mission is a global public-private ambition to harness scientific innovation to reduce the impact of future pandemics by making available safe and effective diagnostics, therapeutics, and vaccines within the first 100 days of a future pandemic threat being identified. The Mission was launched as part of the UK’s G7 Presidency in 2021 and the UK is working domestically, with the G7, G20, and international partners to ensure sustainable implementation of the 25 recommendations to ensure the Mission is achieved by 2026.
c. Pandemic preparedness: The UK is hosting a global pandemic preparedness summit in March 2022, (the Coalition for Epidemic Preparedness Innovations ( CEPI ) Summit) which will explore how the world can better prepare for pandemics by harnessing the power of science to revolutionise how new vaccines can be developed, manufactured, and equitably distributed to end pandemics.
d. Engagement and reform of the WHO : The UK is supporting work underway to harness the lessons learnt from the COVID-19 pandemic. A stronger architecture for pandemic preparedness and response includes: sustainably financing the WHO ; supporting improvements to the way outbreaks are investigated and the establishment of a Scientific Advisory Group for Origins of Novel Pathogens; and considering amendments to the International Health Regulations (2005) to improve management of public health emergencies.

Improved international consistency on global travel health policies

International travel has been severely disrupted throughout the pandemic, causing difficulties for businesses and passengers. The Government will work further with international partners to discuss how cooperation and alignment of border and travel health policies can be improved. This approach will identify opportunities for standardisation to support global efforts to detect, manage, and respond to new health threats as well as seek to deliver as smooth an experience as possible for passengers, helping to support the recovery of the international travel sector.

7. Legislation

During the pandemic, the Government has had to introduce regulations and legislation involving unprecedented government intervention in order to protect public health, and support individuals, businesses and public services. As part of the implementation of the living with COVID-19 strategy, the Government will make the following legislative changes, subject to appropriate parliamentary scrutiny.

Domestic Restrictions under the Public Health (Control of Disease) Act 1984

The Government has always said that restrictions would not stay in place a day longer than necessary, and is now able to proceed with removing the last domestic restrictions:

a. The Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020 (“No.3 Regulations”) have been in place since 18 July 2020. These powers will be revoked on 24 February. Local authorities will now be required to manage outbreaks through local planning, and pre-existing public health powers, as they would with other infectious diseases.
b. The Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) Regulations 2020 have been in place since 28 September 2020, and impose a legal duty on individuals who test positive and certain close contacts to self-isolate. As set out in chapter 3, the legal duty to self-isolate will be lifted on 24 February and be replaced by guidance.

Statutory Sick Pay and Employment and Support Allowance

In light of the Government’s decision to end the legal duty to self-isolate from 24 February, on 24 March:

a. The Statutory Sick Pay (General) Regulations 1982 and the Statutory Sick Pay (Coronavirus) (Suspension of Waiting Days and General Amendment) Regulations 2020 will be amended to remove COVID-19 provisions. From this date, Statutory Sick Pay (SSP) will no longer be payable from day 1 if people are unable to work because they are sick or self-isolating due to COVID-19. Pre-pandemic SSP rules will apply.
b. The COVID-19 Employment and Support Allowance provisions within The Employment and Support Allowance and Universal Credit (Coronavirus Disease) Regulations 2020 will automatically expire. From this date, people will no longer be eligible for Employment and Support Allowance because they are self-isolating due to COVID-19. Anyone infected with COVID-19 may, subject to satisfying the conditions of entitlement, still be eligible for Employment and Support Allowance on the basis that they have a health condition or disability that affects their ability to work under the general Employment and Support Allowance regulations.

Vaccines as a Condition of Deployment Regulations

The Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021 making vaccination a condition of deployment were introduced in Care Quality Commission ( CQC ) registered care homes from 11 November 2021. These regulations require that individuals entering the premises are fully vaccinated, unless otherwise exempt. Regulations to extend vaccination as a condition of deployment to health and wider social care settings were approved by Parliament in December 2021, and its main provisions were set to come into force on 1 April 2022. These regulations would require that anyone providing a CQC regulated activity would also be required to be fully vaccinated, unless otherwise exempt.

After reviewing the latest clinical and scientific evidence, the Government announced its intention to revoke both of the above regulations, subject to consultation and appropriate parliamentary procedure. Whilst vaccination remains the country’s best line of defence against COVID-19, the balance of opportunities and risks of the policy have now changed with the dominance of the Omicron variant. The Government therefore assesses that it is no longer proportionate to require vaccination as a condition of deployment through statute. Professional bodies, the Royal Colleges, the Chief Medical Officer, Chief Nursing Officer and others consider it is a professional responsibility for health and care staff to be vaccinated. The Government has asked the professional regulators to review how this responsibility could be strengthened through their guidance, and will also be consulting on doing so through the Government’s guidance for CQC regulated providers.

A public consultation on revocation concluded on 16 February 2022, and the Government will publish its response shortly. Subject to the outcome of the consultation, the regulations will be revoked ahead of 1 April 2022.

International travel regulations

With the intention to continue to facilitate safe travel and sector recovery, and in the context of having significantly reduced travel restrictions, the Government will review The Health Protection (Coronavirus, International Travel and Operator Liability) (England) Regulations 2021 before Easter and ahead of their expiry date of 16 May.

The Coronavirus Act 2020

The Coronavirus Act 2020 was first introduced in March 2020 and has enabled the Government to support individuals, businesses, and public services during the pandemic.

Temporary provisions

The Government will expire all remaining non-devolved temporary provisions within the Coronavirus Act 2020. Half of the original 40 temporary non-devolved provisions have already expired, as the Government has removed powers throughout the pandemic which were no longer needed. Of the 20 remaining non-devolved temporary provisions, 16 will expire at midnight on 24 March 2022. These are:

a. Section 2: Emergency registration of nurses and other health and care professionals.
b. Section 6: Emergency registration of social workers: England and Wales.
c. Section 14: NHS Continuing Healthcare Assessments: England.
d. Section 18: Registrations of deaths and still-births.
e. Section 19: Confirmatory medical certificate not required for cremations: England and Wales.
f. Section 22: Appointment of temporary Judicial Commissioners.
g. Section 38: Temporary continuity: education, training and childcare.
h. Section 39-41: Statutory Sick Pay: funding of employers’ liabilities; power to disapply waiting period limitation; modification of regulation making powers.
i. Section 45: NHS pension schemes: suspension of restrictions on return to work: England and Wales.
j. Section 50: Power to suspend port operations.
k. Section 58: Powers in relation to transportation, storage and disposal of dead bodies.
l. Section 75 (2) and (3): Disapplication of limit under section 8 of the Industrial Development Act 1982.
m. Section 81: Residential tenancies in England and Wales: protection from eviction.
n. Section 82: Business tenancies in England and Wales: protection from forfeiture

The remaining four provisions will be expired within six months. These provisions have enabled innovations in the delivery of public services and the Government is seeking approval to make them permanent through other primary legislation currently before Parliament and due to come into force over the spring and summer. In each case, a final six-month extension is necessary in order to ensure there is no gap in the legislation that enables public service delivery. The relevant provisions are:

a. Section 30: has supported coronial services throughout the pandemic in England and Wales by enabling inquests, where COVID-19 is suspected as the cause of death, to take place without a jury, helping reduce pressures and backlogs. This provision will be made permanent via the Judicial Review and Courts Bill.
b. Sections 53 to 55: have allowed thousands of court hearings to take place using audio and video links. Over 12,000 hearings per week have taken place using remote technology across 3,200 virtual courtrooms, helping courts reduce the backlog in cases and bring more people to justice. The provision for remote hearings will be made permanent via the Police, Crime, Sentencing and Courts Bill.

Permanent provisions and devolved governments

There are a number of permanent provisions within the Coronavirus Act 2020 which would require new primary legislation in order to repeal. Some of these provisions are still necessary to support the recovery from the pandemic, including:

a. Section 11: Indemnity for health service activity: England and Wales. This provision ensures that any gaps in indemnity cover for NHS clinical negligence do not delay or prevent ongoing care. Without this, NHS Resolution would be unable to pay legitimate clinical negligence claims, leaving clinicians exposed to the full cost and patients without compensation.
b. Section 75(1): Disapplication of limit under section 8 of the Industrial Development Act 1982 ( IDA ). This provision ensures that the financial limits set out in section 8 of the IDA do not hinder the allocation of vital Government schemes for businesses such as the Help to Grow scheme, the Automotive Transformation Fund, and the Offshore Wind Manufacturing Investment Scheme ( OWMIS ).

The Government is committed to removing unnecessary provisions from the statute book as soon as possible and will look for opportunities to do so as the Government’s legislative programme proceeds.

Once the Government has received the conclusions of the COVID-19 public inquiry, it will consider whether further changes to public health legislation are needed. The Public Health (Control of Disease) Act 1984 and any outstanding provisions in the Coronavirus Act 2020 would be in scope for this work.

The Government will also work with the Devolved Administrations, who have used their specific powers within the Coronavirus Act during the pandemic, to help transition provisions into devolved legislation where necessary.

Annex: International comparators

Figure 4: proportion of total population of european countries who have received one dose of covid-19 vaccine [footnote 74].

European countries filtered to the top 30 largest by population

Bar chart showing the percentage coverage of first doses of the vaccine in the top 30 most populous European countries. The UK and Sweden are 11th with 77% of their total populations having received a first dose. Portugal has the highest first dose coverage at 95%.

Figure 5: Date at which 50% of the total population of European countries received their first dose of COVID-19 vaccine [footnote 75]

Chart showing the date when the top 20 most populous European countries, reached 50% first dose vaccination coverage of the total population. The UK is first, achieving this vaccine coverage on 29 April 2021.

The speed of the UK’s initial vaccine rollout in early 2021 had a direct impact on the ability to open up the economy, and ease social restrictions sooner than other comparator countries last summer. The success of the rollout also meant that the UK maintained a lower level of restrictions than most other European comparator countries this winter.

Figure 6: Proportion of total population of European countries that are fully vaccinated with a COVID-19 vaccine [footnote 76]

Bar chart showing the percentage of the total population who are fully vaccinated in the top 30 most populous European countries.The UK is 12th, along with Greece, Netherlands, and Austria, with 72% of their total population having received a full vaccine protocol. Portugal has the highest proportion of their population fully vaccinated at 91%.

Data extracted on 20 January 2022, however, differences in reporting mean dates of underlying data vary by a few days.

Figure 7: Date at which 50% of the total population of European countries were fully vaccinated with a COVID-19 vaccine [footnote 77]

European countries filtered to the top 20 largest by population

Chart showing dates at which the top 30 most populous European countries reached 50% coverage of full vaccinations. The UK is second achieving this on 7 Jul 2021, behind Hungary who reached 50% coverage on 27 Jun 2021. Several countries are yet to meet this milestone.

Vaccine protocols vary by country due to use of different manufacturers. Although the initial protocol (full vaccination) is 2 doses for most vaccines, for a few manufacturers this can be 1 or 3 doses. [footnote 78]

Figure 8: Proportion of total population of European countries who have received a booster dose of COVID-19 vaccine [footnote 79]

Bar chart showing the coverage of booster doses in the top 30 most populous European countries The UK is joint 5th with Germany and Ireland at 56% booster coverage. Denmark has the highest coverage with 62% of their total population having received a booster dose.

Figure 9: Date at which 50% of the total population of European countries received a booster dose of a COVID-19 vaccine [footnote 80]

Chart showing dates at which the top 30 most populous European countries reached 50% booster dose coverage. The UK is first achieving this on 1 January 2022, followed by Denmark who achieved this on 4 January 2022. Several countries are yet to meet this milestone.

Figure 10: COVID-19 tests administered per 1,000 people: G20 countries [footnote 81]

The UK has administered more tests per 1,000 people than any other G20 country since 13 February 2020 (noting that there is no publicly available testing data for China).

Bar chart of tests conducted per 1000 people in the G20. The UK is first, conducting 6,607 tests per 1000 people since 13 February 2020. France is second with 3584 and the US is 4th with 2397.

The methodology for recording daily testing figures varies from country to country. The UK testing figures display the number of PCR and antigen tests conducted across pillars 1 and 2. [footnote 82]

Figure 11: Excess deaths per million in European countries [footnote 83]

Excess deaths are defined as the difference between total deaths during a crisis and the expected number of deaths in ‘normal’ conditions. [footnote 84]

Bar chart showing the number of excess deaths per million in the 30 most populous European countries. The UK is 12th with 1,983 excess deaths per million. Bulgaria has the most excess deaths with 8,627 per million.

Figure 12: Recorded COVID-19 deaths per million in European countries [footnote 85]

Bar chart showing the number of recorded COVID-19 deaths per million for the top 30 most populous European countries. The UK is 14th with 2,355 recorded COVID-19 deaths per million. Bulgaria has the most recorded COVID-19 deaths with 5,075 per million.

This chart shows the number of deaths recorded with COVID-19 on the death certificate. The guidance for including COVID-19 on death certificates varies between countries. It is anticipated that the true number of COVID deaths is higher than the number recorded so excess deaths can provide a more well rounded picture of the impact of the pandemic [footnote 86]

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Our World in Data, COVID-19 vaccine boosters administered per 100 people , 20 February 2022. ↩

Our World in Data, Daily new COVID-19 tests per 1,000 people 18 February 2022. ↩

Our World in Data, The Our World in Data COVID-19 Testing dataset . 20 February 2022. ↩

Our World in Data, Excess mortality: Cumulative number of deaths from all causes compared to projection based on previous years, per million people , 20 February 2022. ↩

Our World in Data, Excess mortality during COVID-19 . 20 February 2022. ↩

Our World in Data, Weekly confirmed COVID-19 deaths per million people , 20 February, 2022. ↩

Our World in Data, Coronavirus (COVID-19) Deaths . 20 February 2022. ↩

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Election latest: Tories 'facing electoral extinction', says pollster - as candidate says he agrees with Nigel Farage

A new poll suggests the Tories could be left with just 72 seats - less than half the number they won in their worst election in 1906. Amid a growing threat from Reform UK, a candidate told Sky News that it is "crazy" Nigel Farage is not in the Tory party.

Saturday 15 June 2024 20:30, UK

General Election 2024

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Tories 'facing electoral extinction' as two polls show support cratering
Amid Reform threat, Tory candidate says he agrees with Farage on most issues
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Starmer doesn't say where funding for NHS will come from
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Live reporting by Ben Bloch and (earlier) Tim Baker

Election essentials

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Trackers: Who's leading polls? | Is PM keeping promises?
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Read more: Who is standing down? | Key seats to watch | How to register to vote | What counts as voter ID? | Check if your constituency is changing | Your essential guide to election lingo | Sky's election night plans

The bad news keeps on coming for Rishi Sunak, with new polls showing support for the Conservative Party dropping through the floor.

A vast new MRP poll shows the Tories could be left with just 72 seats - while Labour could win a majority of 262 seats.

This poll is of 22,000 people, conducted by Survation, and it uses a method that allows the pollster to predict the result in each individual constituency.

The result would see the Tories left with less than half the number they won in their worst election in 1906, which was 156.

The only good news is that it still would leave the Tories as the main opposition party, with Reform winning just seven seats, and the Lib Dems 56.

Labour: 456 seats
Tories: 72 seats
Lib Dems: 56 seats
Reform UK: 7 seats
Plaid Cymru: 2 seats
Green Party: 1 seat

A second poll published in the last hour shows support for the Tories has dropped four points in the last week.

In fact, it is the lowest vote share recorded for the Conservative Party since May 2019 - the dying days of the Theresa May premiership.

The Savanta poll of 2,045 people for the Sunday Telegraph also shows that Reform UK has risen by three points - and support for Labour has jumped as well.

The full results are:

Labour: 46% (+2)
Tories: 21% (-4)
Reform UK: 13% (+3)
Lib Dems: 11% (+2)
SNP: 2% (-1)
Other: 3% (-1)

Chris Hopkins, political research director at Savanta, said in a statement: "Our research suggests that this election could be nothing short of electoral extinction for the Conservative Party."

By Tom Cheshire, Megan Harwood-Baynes, Mary Poynter, online campaign team

How bad is the Conservative brand?

Bad enough for dozens of its own candidates to avoid using it, according to research from Sky's Online Campaign Team and Who Targets Me.

We looked at the adverts published on Facebook and Instagram by 521 Labour and Conservative candidates from 1 May until 12 June.

Of these, 376 adverts contained official branding (logos and colours), 104 had some form of partial branding, and 41 had no branding at all.

And the vast majority of those with no branding - 38 - were Conservative.

NHS SBS wins at the HSJ Digital Awards 2024!

10 June 2024

Improving Back-Office Efficiencies through Digital Banner 2

NHS Shared Business Services (NHS SBS) is proud to announce it has been named as the winner of the ‘ Improving Back-Office Efficiencies through Digital ’ category at the HSJ Digital Awards 2024 , recognising excellence in digitising, connecting, and transforming health and care.

The HSJ Digital Awards applaud the power of digital products, projects and services to transform care delivery, enhance efficiency, and improve patient outcomes and the award is in recognition of automation projects NHS SBS has undertaken in partnership with trusts, which have proved transformational to their back-office functions, enabling staff time to be diverted to dealing with more complex matters.

NHS Automation – Harnessing Robotic Process Automation (RPA), Driving Positive Change

In partnership with Lewisham and Greenwich Foundation Trust, NHS SBS developed groundbreaking RPA to process invoices for the trust, saving 173 hours of work each month and £40,000/year while improving invoice processing accuracy to 100 per cent. The solution has paid for itself three times.

Similarly, a partnership with Oxford University Hospitals Foundation Trust to automate junior doctor rotas and recruitment administration has delivered a 50 per cent time saving and could realise savings of £500k over the next five years.

James Parker, Head of Automation and Data Consultancy at NHS SBS comments:

We’re so proud to have been selected as the winners of this award which truly acknowledges the inspired efforts and ideas of our team who work so hard to ensure the successfully deliver our projects.

“To be recognised in this way, by the HSJ Digital Awards , really is a great honour felt by all those involved. It encourages us and our colleagues to continue developing, devising, delivering and sharing our knowledge and experience of digital services and innovation, to support the NHS progress along its journey to transformation.

HSJ editor Alastair McLellan adds:

“Digital services and tech innovation remains firmly at the heart of the ongoing evolution of the NHS, and I hope that this specific awards programme will help to focus the minds of decision makers and the wider workforce on the real value of digital within organisations, potentially aiding future investment.

“Once again, the quality of entries was outstanding, presenting our panel of judges with some tough choices and deliberation! It therefore gives me great pleasure to congratulate NHS SBS as winners in the category of ‘ Improving Back-Office Efficiencies through Digital ’ at the 2024 HSJ Digital Awards .”

9_Improving Back-Office Efficiencies through Digital

Recent news

Framework Agreements

25 March 2024

Unique contract to help upskill the NHS workforce

NHS Shared Business Services (NHS SBS), has launched a unique Digital Health Advisory Services framework agreement, the only one of its kind in the UK, designed to help the NHS augment the digital, data and technology (DDaT) skills and capabilities of its workforce.

22 March 2024

Procurement Framework for Consultancy and Advisory Services for Health, launched

Leading corporate services provider, NHS Shared Business Services (NHS SBS) has launched a new Consultancy and Advisory Services for Health framework agreement. It gives the NHS and public sector a compliant route to market for the provision and procurement of consultancy and adv...

NHS SBS completes NHS Evergreen Sustainable Supplier Assessment

NHS Shared Business Services is pleased to have completed the NHS Evergreen Sustainable Supplier Assessment. The Assessment is a self-assessment and reporting tool and resulted in us receiving a Level 4: 2045 net zero targets, independently validated, across the global organisati...

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COMMENTS

NHS SBS: Shared corporate solutions. Reimagined
Shared corporate solutions. Reimagined. Shared solutions designed with you in mind. A proud member of the NHS family, we help NHS organisations achieve more together than they can alone. Whether that's unlocking long-term efficiencies to be reinvested into patient care, or supporting complex transformation programmes, our solutions are co ...
NHS SBS sets a Sustainable Course
In a stride towards reaching Net Zero, NHS Shared Business Services (NHS SBS) has unveiled its first 3-year Green Plan. This initiative marks a pivotal moment in the organisation's commitment to sustainability, aligning with NHS England's Net-Zero goals and setting a precedent for environmental responsibility within the wider healthcare sector.
About Us
NHS SBS In Numbers. We're England's leading supplier of corporate services to the NHS, trusted to distribute over 90% of the country's healthcare funding. We make life easier for NHS staff, patients and suppliers by reimagining shared corporate services for the digital age. The best corporate services.
Strategy, Business Plan and Annual Report
Strategy and Business Plan. NHSBSA Strategy for 2024 to 2029 (PDF: 9MB) This is v1.0 published on 22 April 2024. NHSBSA Business Plan for 2023 to 2024 (PDF: 5MB) This is v1.0 published on 3 April 2023. The documents provided on this page are accurate at the time they were published. If our plans change (for example, due to changes in government ...
PDF NHSBSA Business Plan 2022-23
Provider Assurance: We will implement measures to identify and monitor the beneft of controls currently tackling system weakness across NHSBSA during 2022-23. We will educate customers and colleagues with the aim of reducing (and where possible eradicating) NHS fraud and loss during 2022-23.
NHS Business Services Authority Launches Strategy for 2024-2029
Media and Campaigns Officer. NHS Business Services Authority. [email protected]. The NHS Business Services Authority (NHSBSA) has published a five-year business strategy for 2024 to 2029, outlining our key priorities for the coming years.
NHS Shared Business Services
NHS Shared Business Services (NHS SBS) is a joint venture company in the United Kingdom between the Department of Health (DoH) and the French IT services company Sopra Steria. [1] It provides back office services such as accounting, procurement, payroll and managed IT to NHS organisations. NHS SBS was formed in 2005 to provide a more efficient ...
NHS SBS to launch £1.5bn digital workplace solutions framework
Published: 24 Aug 2023 12:00. NHS Shared Business Services has issued a prior information notice (PIN) to inform the market of its plans for a second iteration of its digital workplace solutions ...
NHS Shared Business Services' Post
In a stride towards reaching Net Zero, NHS Shared Business Services (NHS SBS) has unveiled its first 3-year Green Plan. This initiative marks a pivotal moment in the organisation's commitment to ...
NHS Shared Business Services
Feb 7, 2023, 15:17 PM. Title : NHS Shared Business Services. Created in 2004 by a unique joint venture between the Department of Health and Social Care and Sopra Steria, NHS SBS exists to provide high-quality, innovative, value-for-money, and efficient corporate services to the NHS. Select the type of partner : The world is how we shape it.
New NHS SBS Consultancy Framework Opens for Business
NHS Shared Business Services (NHS SBS) has announced the launch of a major new procurement framework. The new framework - Consultancy and Advisory Services for Health (SBS10197)- is designed to allow public sector organisations to purchase a broad range of consulting services that have a focus on health or care. The framework has 10 lots covering over 100 types of consulting services, and ...
NHS Shared Business Services helps upskills health and care workforce
David Holbrook, senior category manager - digital workforce and IT transformation at NHS Shared Business Services, said: "The NHS Long Term Workforce Plan states that harnessing the opportunities presented by digital and technological innovations requires NHS staff to continue to build digital skills and capabilities.
Sustainability and Social Value
NHS SBS completes NHS Evergreen Sustainable Supplier Assessment. NHS Shared Business Services is pleased to have completed the NHS Evergreen Sustainable Supplier Assessment. The Assessment is a self-assessment and reporting tool and resulted in us receiving a Level 4: 2045 net zero targets, independently validated, across the global organisati...
NHS SBS tenders for new £1.5B Digital Workplace Solutions contract
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NHS Shared Business Services' Post
NHS Shared Business Services welcomes the #NHS Long Term Workforce Plan. Erika Bannerman, Managing Director of NHS SBS, commented: "Despite greater investment than ever before, productivity in the ...
NHS England » Our 2023/24 business plan
In 2023/24 the NHS has three key tasks. The immediate priority is to recover our core services and productivity. Second, as we recover, we need to make progress in delivering the key ambitions in the NHS Long Term Plan. Third, we need to continue transforming the NHS for the future.
NHS SBS Brand Hub
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NHS Resolution publishes business plan for 2023/24
Date published: 22nd June 2023. We're pleased to announce the publication of our 2023/24 business plan. In it, we set out our focus for the next twelve months, as we enter the middle year of our three-year corporate strategy: Advise, Resolve and Learn: Our Strategy to 2025. We will continue to focus on progressing our four strategic priorities:
NHS SHARED BUSINESS SERVICES LIMITED
Charges for NHS SHARED BUSINESS SERVICES LIMITED (05280446) More for NHS SHARED BUSINESS SERVICES LIMITED (05280446) Registered office address Three, Cherry Trees Lane, Hemel Hempstead, Hertfordshire, HP2 7AH . Company status Active Company type Private limited Company Incorporated on 8 November 2004 ...
Nhs Sbs Healthcare Planning, Construction Consultancy and Ancillary
NHS SBS HEALTHCARE PLANNING, CONSTRUCTION CONSULTANCY AND ANCILLARY SERVICES (HPCCAS) (SBS10190) NHS Shared Business Services Limited F03: Contract award notice Notice reference: 2023/S 000-035539 Published: 1 December 2023, 3:27pm Section I: Contracting authority I.1) Name and addresses NHS Shared Business Services Limited Three Cherry Trees Lane
Framework Agreements
07707 279 593. North London. Contact Us. Our framework agreements offer a compliant route to market for NHS and public sector organisations. We manage £1bn of NHS spend annually and can provide typical savings of c.15%.
Careers at NHS SBS
We employ over 1,000 people who embody our aims, approach, mission and vision. We're incredibly proud of the expertise, innovations and support that our teams offer to our clients. From credit controllers to clinical advisors, our people are here to use their extensive understanding of NHS complexities and the challenges you face to improve ...
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Election latest: Most people support NHS funding increase
Election latest: Most people support NHS funding increase - even with tax rises, poll suggests. Rishi Sunak is heading to a Ukraine Peace summit in Switzerland, having spent the past few days at a ...
NHS Shared Business Services welcomes workforce plan
NHS Shared Business Services, the country's leading provider of corporate services to the National Health Service, has welcomed the recently published NHS Long Term workforce plan. The plan, published last week, outlines the actions that will be taken to strengthen the NHS workforce, boost productivity, and address the changing needs of ...
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The overall NHS waiting list climbed to an estimated 7.57 million treatments at the end of April, affecting 6.33 million patients, according to NHS England figures released on Thursday.
NHS SBS wins at the HSJ Digital Awards 2024!
NHS Shared Business Services (NHS SBS) is proud to announce it has been named as the winner of the 'Improving Back-Office Efficiencies through Digital' category at the HSJ Digital Awards 2024, recognising excellence in digitising, connecting, and transforming health and care. The HSJ Digital Awards applaud the power of digital products, projects and services to transform care delivery ...