Exercise Cygnus
[1][2][3] It aimed to identify strengths and weaknesses within the United Kingdom health system and emergency response chain by putting it under significant strain, providing insight on the country's resilience and any future ameliorations required.
More than 950 workers from those organisations, prisons and local or central government were involved during the three-day simulation, and their ability to cope under situations of high medical stress was tested.
As of October 2016, feedback showed that organisations varied in preparedness, with some relying on corporate memory of the 2009 H1N1 response, and others depending on individual pandemic protocols which may be outdated, missing or incomplete.
NHS England recognises that a variety of sectors are implicated, hence a central administration and unified protocol to oversee the whole strategy is required for organisations to work synonymously.
A suggestion was to implement planning at a regional level as opposed to through local resilience forums for crucial aspects of pandemic influenza response (e.g., excess death).
Logistically, more health workers and resources such as ventilators, personal protective equipment (PPE) and hospital beds are required to face a large pandemic.
[5] This requires a high level of teamwork across several corporations, which was detailed through a provided framework but may not be viable under the pressure and widespread impact of a pandemic.
[19] In 2016, she raised the need to adapt to an increasingly ageing population which will be more susceptible to disease and vulnerable to pandemics, and "welcomes" a larger budget on "public health and prevention fields".
[22] In March 2020, according to The Sunday Times, Downing Street officials found follow-up planning from Exercise Cygnus lacking, with one stating that it "never went into the operational detail".
[23] A version of the report, classified as "Official – Sensitive", was leaked and published (with redaction of some contact details) in The Observer's sister paper The Guardian on 7 May 2020.
[13][3] As of October 2020[update], legal action is in progress to force the Department of Health and Social Care to publish the full report and other supporting documentation related to Exercise Cygnus.
[24][25] In November 2020, Liberal Democrat MP Tim Farron submitted a written question to the Secretary of State for Health and Social Care asking whether the full findings of Exercise Cygnus will be published; no immediate answer was forthcoming.
[27] According to Dr Qureshi, who has experience treating leukemia patients severely impacted by COVID-19, healthcare should be built on transparency and collaborative peer review.
[29] Dr Qureshi, represented by UK solicitor Leigh Day, filed action against Matt Hancock for withholding the reports following Exercise Cygnus.
[29] In response to the UK government's refusal on the grounds of inciting public fear, Dr Qureshi pursued legal action under both the Freedom of Information Act and an application for Judicial Review.
[31] Following publication, and following the Department of Health's confirmation that it held no further reports evidencing the findings of Exercise Cygnus, Dr Qureshi withdrew his legal action for Judicial Review.
[32] However, questions were later raised about whether the Government had disclosed all relevant material,[33] and Dr Qureshi argued that the Department of Health continued to withhold a plan for surge capacity and "refusing NHS care to large numbers of sick patients" in the event of an overwhelming pandemic.
[35] Baron Bethell raised several concerns including persistent lack of medical equipment in United Kingdom during the COVID-19 pandemic, despite it being previously identified as a weakness through Exercise Cygnus.
[35] In November 2020, the Department of Health and Social Care website stated that findings from Exercise Cygnus, coupled with suggestions from scientific experts, have incorporated in the United Kingdom response to COVID-19.
[4] In July 2020, a request under the Freedom of Information Act was filed by an anonymous citizen nicknamed "P Newton" to seek further transparency of Exercise Cygnus.
[21] It was subsequently rejected by the UK government under Section 35(1)(a) of the Freedom of Information Act on the basis that full disclosure of results would affect the ongoing progress of policy making by ministers.
[36] Following Exercise Cygnus and COVID-19, several health professionals working on epidemics and primary care have provided suggestions to help the UK manage pandemics more effectively.
Areas of improvement identified include bridging disease communication by focussing on specific vulnerable demographic groups and relaying layman instructions to control transmission.
[16] Legislation easements drawn from Exercise Cygnus include emergency recruitment and registration of retired healthcare professionals and protection against clinical negligence action for health workers.
