The People's COVID Inquiry, set up by campaign group Keep Our NHS Public and chaired by Michael Mansfield QC, warns that 111 'should not have replaced primary care for COVID-19 patients'.
A report on the inquiry's findings says patients were 'told very strongly' to ring NHS 111 and not to trouble their GP practice - effectively 'bypassing one of the best primary care systems in the world’.
But it says 'inexperienced, undertrained staff' carrying out COVID-19 triage for the 111 service 'were unable to safely interpret patient symptoms'.
The report says: 'GPs were wrongly sidelined and could have played a greater and vital role in caring for patients, working with local public health, and assisting with measures to control the spread of infection. This was a grave error.'
It warns that in future, 'GPs and primary care must be resourced and empowered to look after their own patients in a future pandemic or health crisis, working closely with local public health', adding that 'GPs and local public health teams must be put at the heart of any pandemic response and given the necessary funding to fulfil this role'.
The report hits out at the 'centralised' test and trace system set up in the pandemic, which was not integrated with primary care and resulted in 'unimaginable costs'.
It highlights cases of patients being asked to travel 'hundreds of miles' for tests and the failure to pass on results to GP practices.
Primary care funding
One witness told the inquiry: 'Several multiples of funding of what primary care gets in a year have gone to test and trace, which doesn’t seem to have helped at all.'
The report added: 'Witnesses including GPs felt that primary care, together with public health partners, could have taken on [test and trace] if properly resourced. GPs are trusted by their communities and thus understand how to reach them and what messaging to use, especially with immigrant and lower socioeconomic groups. They would also have had a better understanding of who to test when capacity was low.'
It highlights concerns over inadequate PPE supplies - warning of an 'abject failure' to protect frontline workers. Concerns are also raised that the government failed to respond quickly enough, demonstrated a lack of trust in professionals, and produced inconsistent messaging that forced local authorities and transport providers to step in to try to clarify.
Concerns are also highlighted over awarding of contracts during the pandemic, prioritisation of private providers over NHS services, and the disproportionate impact of the pandemic on key groups of the population - including children and young people, people in ethnic minorities, women and frontline staff.
People's COVID Inquiry
People's COVID Inquiry chair Michael Mansfield QC, said: 'This report is unequivocal - dismal failure in the face of manifestly obvious risks. This Inquiry performed a much-needed and urgent public service when the nation was hit by a catastrophic pandemic coincident with an unprecedented period of democratic deficiency. It afforded an opportunity for the beleaguered citizen to be heard; for the victims to be addressed; for the frontline workers to be recognised; and for independent experts to be respected. When it mattered most and when lives could have been saved, the various postures adopted by government could not sustain scrutiny.
'It was plain to Keep Our NHS Public (the organisers of the People’s Covid Inquiry) that government words were bloated hot air, hoping to delay and obfuscate. Within this narrative lies a theme of behaviour amounting to gross negligence by the government, whether examined singularly or collectively.
'There were lives lost and lives devastated, which was foreseeable and preventable. From lack of preparation and coherent policy, unconscionable delay, through to preferred and wasteful procurement, to ministers themselves breaking the rules, the misconduct is earth-shattering.'
BMA chair Dr Chaand Nagpaul said: 'This report makes clear that the NHS went into this pandemic woefully underprepared and under-resourced, and the only reason the health service was able to provide care and services at the level it did was because of the unwavering dedication of frontline workers who gave their all - including their lives.
'It is clear that the government failed to properly plan for a pandemic, with the disastrous lack of PPE supplies leading to an inability to protect frontline staff being exposed to the virus without adequate protection.'
Dr Nagpaul added: 'More than 144,000 people have died from COVID-19 in the UK since the start of the pandemic, and that death toll continues to rise, albeit more slowly. But we still have to understand why so many lost their lives, what mistakes were made, and even more importantly, how to prevent them from happening again.
'This review should compel the government into taking action and beginning the full statutory public inquiry, today, not next spring, in order to act on lessons learnt now and avoid further needless deaths and an unimaginable impact on the NHS.'
A government spokesperson said: 'COVID-19 is an unprecedented pandemic which has challenged health systems around the world. Thanks to our collective national effort, our preparedness plans, and our frontline NHS workers, we have saved lives, vaccinated tens of millions of people and prevented the NHS from being overwhelmed.
'We prepared for a range of scenarios, and by deploying key elements of our flu preparedness plans we were able to develop new means to tackle the virus quickly such as by setting up our national testing programme and rolling out millions of vaccines.
'Every death from this virus is a tragedy and we have always said there are still lessons to be learnt from the pandemic, which is why we have committed to a full public inquiry in spring.'