Warning ignored: Secret report exposed gaps in flu pandemic plans and demanded urgent action

Scotland’s health boards were warned to take urgent action to prepare for a flu pandemic after a major training exercise exposed gaps in crisis plans five years ago, we can reveal.

The training exercise, called Silver Swan, brought together the Scottish Government, NHS boards, and health and social care partnerships to test the country’s readiness for a major infection outbreak.

Documents seen by The Sunday Post reveal the 2015 exercise, which spanned several days, exposed many of the problems now being faced by NHS Scotland, including concerns over supplies of personal protective equipment (PPE) for workers, staff becoming ill, and the need for surge capacity in hospitals.

The following year health boards were told to act on “key issues” and conduct similar crisis planning exercises every three years.

Since the coronavirus outbreak began, health unions and professional bodies have repeatedly flagged up concerns over insufficient, inadequate and poorly fitting PPE.

A follow-up report by NHS Lanarkshire, one of the health boards taking part in Silver Swan, said: “An influenza pandemic is considered to be one of the highest public health risks for the UK. Its unpredictable nature and potential severity necessitates planning with the development of suitable, flexible plans that require testing on a regular basis.”

As well as NHS boards and the government, participants included Scottish Ambulance Service, NHS 24, the National Distribution Centre and Police Scotland.

Under priorities for action, the report recommended the board: “Should review plans for the distribution of PPE including identification of key staff and groups and ensure fit testing procedures are in place.”

Scotland’s former chief medical officer Sir Harry Burns believes the training exercises have proven to be “prophetic” in the face of the Covid-19 outbreak.

He said: “The NHS could have been better prepared but the problem is people doing these exercises would have to decide how likely it is and whether they were going to invest say £10m in ventilators that they may, but probably wouldn’t, have to use. Hindsight is a wonderful thing.”

The professor, who was chief medical officer for Scotland from 2005 until 2014, also said the UK Government should have moved more quickly to purchase ventilators and PPE when Covid-19 first reached the UK.

Labour MSP Neil Findlay, a former chair of the Scottish Parliament’s health committee, said: “In the interest of transparency and openness exercise Silver Swan must be published to see if it was fit for purpose and if the Scottish Government took on board its findings and used it to prepare for the current crisis.”

Professor Allyson Pollock of the University of Newcastle, a consultant in public health medicine, said: “We could have been manufacturing PPE and ventilators. We have a long history and tradition with tuberculosis and other infectious diseases, of knowing how to manage a communicable disease epidemic and yet we’ve absolutely failed.

“There will be a major public inquiry after this. There has to be. It’s a shambles.”

SNP MSP Alex Neil, who was health secretary until November 2014, said: “We need to be much better prepared than we have been this time, right across the United Kingdom. It’s blatantly obvious we need to do better on that in future.”

But British Medical Association Scotland chair Dr Lewis Morrison defended the Scottish Government.

He said: “This is a virus we are only able to learn about as we go. It is true to say the government was a bit slow off the mark when it came to the distribution of PPE, and we consistently called for a better supply, and clearer guidance on what PPE staff needed under these circumstances.

“They have listened to our concerns and this week we are seeing an improvement in the supply.”

A similar UK-wide drill called Exercise Cygnus took place in 2016.

The Scottish Government said: “Frontline NHS and social care organisations in Scotland were involved in a pandemic flu tabletop Exercise Silver Swan in 2015 which has informed our approach to resilience planning including responding to this pandemic.”

On Exercise Cygnus they said the Scottish Government had “limited involvement”, with no recommendations having been made for Scotland’s NHS.