Senior figures in the health service, local government and emergency services raised concerns that NHS was too stretched to plan for a future pandemic, according to a follow-up to the 2015 Silver Swan flu pandemic exercise.

Delegates at a December 2016 conference said there was a conflict between the pressures in ‘all parts of the NHS’ and ‘the ability to plan effectively for a pandemic’.

Pre-covid preparations, which focused mainly on the possibility of a flu pandemic, have come under criticism for focusing too much on hospitals, with the omission of care providers and representatives from the 2015 Silver Swan exercise as a ‘major error and oversight’.

Representatives had gathered to review progress against 17 recommendations to prepare for a flu pandemic from a report circulated in April that year.

At the time pandemic influenza was considered the “highest risk faced in the UK” and the “single most disruptive event facing Scotland.

The exercise took place in the second half of 2015, with findings circulated in April 2016.

But a follow-up review that took place seven months later, published yesterday by the Scottish Government, reveals concerns that planning was being compromised because health boards were grappling with high demand and ongoing reforms.

Many at the conference, held at Police Scotland’s Tulliallan College, said ‘resource pressures and competing priorities were having a significant impact on the ability to properly plan and prepare for a pandemic,’ the review states. 

In 2016, 30 health and social care partnerships were created across the country to oversee the integration of health and social care services, described at the time as ‘the most significant change’ to services since the creation of the NHS in 1948.

Health and social care partnerships are described as ‘too busy with day to day pressures’ to spend time planning for a future outbreak.

A review of acute services and the establishment of health and care partnerships, which brought together the NHS and local government and was carried out at a similar time to when pandemic planning was being carried out, was felt to have ‘detracted from the ability’ to prepare for a large-scale outbreak.

‘’Widespread concerns’ about the capacity of GPs and primary care to devote time to preparations were also recorded.

In response, a Scottish Government spokesperson said: “Frontline NHS and social care organisations in Scotland were involved in a pandemic flu table top exercise, called Exercise Silver Swan, in 2015 to inform our approach to resilience planning including responding to the covid-19 pandemic.

“The learning points from Exercise Silver Swan were circulated to all health boards, local authorities and regional resilience partnerships to be incorporated into ongoing planning for situations such as this. This included plans for distribution of PPE and prioritisation of key staff.”

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