NHS response to COVID-19: stepping down from NHS level 3 incident

Classification: Official
Publication reference: PRN00498


  • Chief executives of all NHS trusts and foundation trusts
  • Integrated care board chief executives
  • GP practices and primary care networks
  • Community health service providers
  • NHS 111 providers


  • NHS regional directors
  • Regional heads of EPRR
  • Chairs of NHS trusts and foundation trusts
  • Local authority chief executives and directors of adult social care
  • Chairs of local resilience forums

Dear Colleagues,

NHS response to COVID-19: Stepping down from NHS level 3 incident

On 19 May 2022, we wrote to you outlining the steps the NHS would need to take to transition from COVID-19 response to recovery. As part of that response, we stepped the national NHS level 4 incident down to a level 3 incident.

Since then, we have continued to see waves of COVID-19 infection. But, partly thanks to the outstanding NHS vaccination programme, none have been as significant in terms of loss of life as those in 2020-21.

Although we continue to treat COVID-positive patients in hospital we are now in a position to move to the next stage in our COVID-19 response.

We in England are not alone in seeing this trend. The World Health Organization has also recently announced that COVID-19 is no longer a Public Health Emergency of International Concern.

We informed the NHS England Board today that the NHS would be stepping down the COVID-19 incident. We outline the changes this decision will make later in this letter.

But first we wanted to take this opportunity to thank you and your teams for the outstanding efforts to deal with the impact of this extraordinary health emergency. Since we first declared a Level 4 incident on 30 January 2020, over a million people with COVID-19 have been treated in hospital, with countless more receiving support in the community, while almost 150 million doses of the vaccine have been given.

Colleagues from primary and community care, mental health and other parts of the NHS have worked tirelessly to deliver these achievements, with partners in local authorities, the voluntary and community sector, social care, the military and public health.

Stepping down the incident is of course done in the knowledge that COVID-19 as a health issue itself, as well as the wider long-term impact of the pandemic, will continue to be significant for years to come. New waves and novel variants will continue to impact on patient numbers, as well as staff absences, and we will also need to continue to provide services for those suffering the effects of ‘long COVID’.

Implications of stepping down the NHS incident

As we move away from incident arrangements for COVID-19, the following will change:

  • COVID-19 Patient Notification System (CPNS): As of 30 June 2023, we will no longer be collecting data where an individual has died from COVID-19 via the CPNS system. Instead, data on individuals who have died with COVID-19 will be recorded using the death certification process which is the same as other infectious diseases.
  • Other COVID-19 data reporting: We have been working with colleagues in the UK Health Security Agency to ensure there are no unintended consequences by changing the way we collect data on COVID-19. The acute COVID-19 data collection process will be stood down with a subset of data incorporated into the existing UEC data collection from June. This will ease the burden on NHS trusts.
  • Outbreak reporting: We are currently reviewing the outbreak reporting process and will be contacting you about this separately.
  • Communications: We have recognised the value of having a permanent operations structure to support you, disseminate information and collect data during declared incidents and/or other periods of heightened risk or disruption, e.g. industrial action and winter pressures. Our National and Regional Operations Centres will continue to operate, but we will review the hours of operation.
    Thank you again for your continued leadership and hard work over this period of unprecedented challenge, and for the commitment that you and your teams continue to show in recovering and improving patient access and the quality of our services.

Yours sincerely,

Amanda Pritchard, NHS Chief Executive
Sir David Sloman, NHS Chief Operating Officer