Superhuman efforts of staff saved Welsh NHS from collapse - inquiry finds

The Welsh NHS came "close to collapse" during the pandemic, according to the Covid-19 public inquiry, as healthcare systems across the UK "coped, but only just".

The inquiry's chair, Baroness Hallett, said "on a number of occasions they teetered on the brink of collapse and only coped thanks to the almost superhuman efforts of healthcare workers".

The report, which looks at the impact the pandemic had on the NHS in all parts of the UK, recommended capacity be increased in urgent and emergency care in Wales.

The findings come as the latest waiting times figures for Wales showed a record drop, but remain 54% higher than they were pre-pandemic.

The inquiry added there had been "wide variation" across the UK in addressing the treatment backlog.

The report said that Wales, as well as Northern Ireland, were "clearly struggling" with "very substantial waiting lists" because all parts of the UK paused non-emergency care during the pandemic.

The report added that where post-pandemic waiting times were more than one year in England and more than two years in some parts of Scotland, they were "consistently over two years" across Wales and Northern Ireland.

Figures out on Thursday show just over 5,200 pathways were waiting more than two years in Wales.

The inquiry heard from Wales' Chief Medical Officer at the time of the pandemic, Sir Frank Atherton, who said the NHS had not had "enough capacity to be able to respond in a way that we needed it to".

He also said that Wales had been "behind the curve on digital records", making it more difficult to identify vulnerable people.

Baroness Hallett's third report also found that:

• There were concerns around the availability of personal protective equipment (PPE) for NHS staff in Wales in early 2020, with one Welsh consultant telling the inquiry "no PPE was provided"
• Letters advising vulnerable people to shield were delayed by two weeks due to IT limitations and 13,000 letters were then sent to wrong addresses, as well as children with Down's syndrome receiving letters in error
• The Welsh government should have clarified visiting rules for fathers and birthing partners "much earlier"
• In December 2020 Prince Charles Hospital in Merthyr Tydfil came close to declaring the highest level of pressure
• One critical care doctor in Wales said that some patients who otherwise may have been admitted to intensive care were not, as there was "not enough space to 'give people a go' who had a very remote chance of getting better"

According to Baroness Hallett, the UK entered the pandemic "ill-prepared and with its healthcare systems in a parlous state".

"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.

"Despite these efforts, some patients did not get the level of care they would usually receive.

"The enormous strain placed upon the healthcare systems was unprecedented."

The report makes a total of 10 key recommendations including "increasing capacity in urgent and emergency care and ensuring that hospitals have the ability to implement surge capacity".

First Minister Eluned Morgan welcomed the report and said: "The pandemic placed significant pressures on health and care services in Wales and across the UK.

"We acknowledge the considerable impact this had on patients, staff, the wider workforce and families affected by Covid-19."

She added that the Welsh government would continue to engage with the inquiry in an open and constructive manner.

Jenny Hughes-Cooke said she waited 13 years for exploratory surgery to confirm suspicions that she had endometriosis.

She was given the go-ahead for that surgery in November 2019.

At that stage there were more than 26,000 women waiting to see a specialist in gynaecology in Wales and she was told to expect a six-month wait.

The pandemic meant in reality her wait was 28 months.

"I didn't really consider how the pandemic would have an effect on gynaecology - it's a totally different discipline.

"I expected maybe a bit of a delay, but not to that extent."

She finally had her surgery in March 2022, but in the meantime she said her symptoms had spiralled.

"Every two weeks I was having to deal with a period," she said.

"I was in pain every single day and it was exhausting. I couldn't be there for my son or partner like I wanted to.

"It was really, really difficult to manage being a mum, a partner, having a career and being me at the same time."

The number of women referred to gynaecology in Wales peaked in November 2024 at nearly 53,000 - double the figures when Jenny was first diagnosed.

They have gradually fallen since, but still hovered at 46,289 according to the most recent figures for January.

Hughes-Cooke said her pain impacted her ability to work and she went through "three or four different jobs" while waiting for surgery.

When she was finally given a date for surgery, she was told to self-isolate for eight weeks beforehand, which put "a huge strain" on her relationship with her area manager.

"Two days after my surgery I had a phone call to say they couldn't justify me having any more time off."

As she was in a probation period for the role, she said she had to leave.

Hughes-Cooke needed additional surgery in January 2026, but said the knock-on effect of the pandemic is still felt, with follow-up appointments, scans and treatment plans all involving joining the bottom of another waiting list.

She said three years after being referred for pain management, she is yet to start treatment, adding it was a common theme among the Endometriosis UK support group that she runs in west Wales.

"It's exhausting and I feel as though I'm letting my family down."

Prof Jon Barry, director in Wales of the Royal College of Surgeons, said the system was still under a lot of pressure.

"We've got very high numbers of patients waiting at home hoping to be called in for surgery and these patients are in pain," he said.

"They're at the end of their tether, they want things to happen more quickly and unfortunately we're not delivering that at pace at the moment."

While he acknowledged the pandemic had a "massive influence on the NHS" across the UK, he said: "We must be mindful that the waiting lists were high before the pandemic."

Pre-pandemic figures from February 2020 showed there were 463,402 patient pathways waiting for NHS treatment in Wales.

At their peak in the autumn of 2024 they rose to more than 800,000, but have since dropped to 713,048 (January 2026).

He welcomed the downward trend in those numbers but said "we need to be more ambitious".

"My concern is that if we don't act more ambitiously here, the waiting lists are only going to get worse.

"If we don't introduce surgical hubs and look at our surgical workforce - and across the NHS - that waiting list will deteriorate."