Covid inquiry: Welsh NHS came close to collapse with projected deficit of more than 1,400 intensive care beds
The Welsh NHS came close to collapse during the Covid-19 pandemic, with projections showing a potential deficit of more than 1,400 intensive care beds at peak demand, a major report published today has found.
The UK Covid-19 Inquiry’s Module 3 report, published on 19 March 2026, examined the impact of the pandemic on healthcare systems across England, Wales, Scotland and Northern Ireland.
Inquiry chair Baroness Hallett concluded that the UK entered the pandemic “ill-prepared and with its healthcare systems in a parlous state” and that the healthcare systems “coped with the pandemic, but only just.”
“On a number of occasions, they teetered on the brink of collapse and only coped thanks to the almost superhuman efforts of healthcare workers and all the staff who support them,” she said.
In Wales, on 15 March 2020, there were 148 intensive care beds available.
The Welsh Government’s own Technical Advisory Cell calculated that peak need would reach 1,595 intensive care beds — leaving a projected deficit of 1,447 beds even if every NHS Wales bed had been made available for Covid-19 patients.
Sir Frank Atherton, Chief Medical Officer for Wales from August 2016 to January 2025, told the inquiry the NHS had not had “enough capacity to be able to respond in the way that we needed it to.”
He added: “We’ve tried to make our NHS, and it’s true in Wales as in the rest of the UK, as efficient as possible, and in some ways efficiency is the enemy of preparedness.”
The report makes 10 recommendations addressed to all four UK governments, covering pandemic planning, infection prevention and control, urgent and emergency care capacity and support for healthcare workers.
In December 2020 and January 2021, health boards in South Wales regularly reported reaching the second highest level of critical care pressure.
Prince Charles Hospital in Merthyr Tydfil was close to declaring the highest level of pressure in December 2020.
A critical care doctor in Wales told the inquiry some patients who might otherwise have been admitted to intensive care were not, because there was not “enough space to ‘give people a go’ who had a very remote chance of getting better.”
The Welsh Ambulance Services NHS Trust declared a critical incident on 3 December 2020.
On 22 September 2021, the trust requested military assistance for 251 drivers, warning that “if action is not taken quickly there is a significant risk to life.”
Military assistance to the ambulance service peaked at 235 personnel on 7 February 2022.
The Royal College of Emergency Medicine found 709 excess deaths in Wales in 2020/21 were associated with long waiting times in emergency departments, a finding cited in the report.
Visiting restrictions were among the most painful experiences of the pandemic for families across Wales.
The report found Wales was the last UK nation to designate fathers and birthing partners as “partners in care” rather than treating them as visitors.
England made that change on 14 December 2020.
Wales did not follow until 9 May 2022 — seventeen months later.
The minister who made that change was Eluned Morgan, then Minister for Health and Social Services and now First Minister of Wales.
Ms Morgan told the inquiry the Welsh Government “took too long to make those changes.”
The inquiry agreed, stating the clarification “could, and should, have been made much earlier.”
On shielding, Wales sent 13,000 of its 91,000 shielding letters to wrong addresses.
Children with Down’s syndrome received letters in error when adults with Down’s syndrome were added to the Shielded Patient List in November 2020.
They were not told of the error until 5 January 2021.
Sir Frank Atherton told the inquiry that data systems needed to identify at-risk people rapidly were still not in place as recently as September 2024, saying Wales was “behind the curve on digital records.”
England, Scotland and Northern Ireland continued to fund medicine delivery for shielding patients through the second wave of the pandemic.
In Wales, that support ended on 16 August 2020 and was never reinstated.
The inquiry found this was “premature” and that “support would have been needed in Wales throughout the second wave of the pandemic.”
On PPE, a consultant in Wales told the inquiry: “At the start, despite knowing of the virus spread, no PPE was provided. Not even masks let alone thinking of level two PPE for aerosol generating procedures. This was when many of my colleagues and I became ill.”
The report also found the Welsh Government did not collect or publish verified data on the number of NHS staff who died from Covid-19 during the pandemic.
Ms Morgan, then Health Minister, told the inquiry the Welsh Government “ought to have been gathering and monitoring data” on healthcare worker deaths.
The inquiry agreed, saying the failure “risked conveying the impression to healthcare workers that they were expendable and not valued.”
No specialist Long Covid clinics were established in Wales.
The inquiry noted that treating Long Covid through primary care, as Wales chose to do, “risks leading to the very outcome that the Welsh Government has sought to avoid” because the condition requires specialist treatments rarely available locally.
On cancer care, between January 2021 and June 2022, only 44% of patients with colorectal cancer in Wales received treatment within the 62-day target, against a target of 75%.
The inquiry found Wales and Northern Ireland were “clearly struggling” with waiting times “consistently over two years,” compared with more than one year in England.
In a written statement today, First Minister Eluned Morgan welcomed the report’s publication.
“The pandemic placed significant pressures on health and care services in Wales and across the UK,” she said.
“We acknowledge the considerable impact this had on patients, staff, the wider workforce and families affected by Covid-19.”
“The Welsh Government continues to engage with the inquiry in an open and constructive manner, as we have done in relation to the first two reports.”
The Welsh Government has six months from today to publish a formal response to the report and its 10 recommendations.
That deadline falls in September 2026 — four months after the Senedd election on 7 May 2026.
The next Welsh Government, not Ms Morgan’s administration, will be the government that formally responds to the inquiry’s findings on how NHS Wales performed during the pandemic.
The full Module 3 report is available at covid19.public-inquiry.uk.
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