NHS England’s most senior doctor has said he was “personally horrified” that hospitals could be overwhelmed in the early stages of the pandemic.

Professor Sir Stephen Powis said Covid inquiry officials have prepared a draft document advising on whose care should be prioritized if the NHS finds itself unable to cope with the surge of patients.

The ‘COVID-19 Decision Tool’ gave scores based on the patient’s age, frailty and underlying conditions. A high score meant they could not be admitted to intensive care if services were overwhelmed.

This tool was never released publicly, as it became clear that infections would have already peaked in March 2020.

Sir Stephen, who still serves as national medical director of NHS England, said senior doctors who were asked to draw up plans at short notice had “done a fantastic job” which “nobody should ever do. Want”.

He said, “But it became absolutely clear to me that it was going to be controversial, (and) that it had not had the opportunity to be discussed with patient groups, (or) the public more broadly.”

The draft document advised doctors to score Covid patients based on three criteria using a scale of frailty.

It detailed that people with a total score of more than eight points should not be admitted to intensive care if services were overwhelmed.

Patients aged 70 to 75 were to be automatically given four points, while those over 80 would get six points.

Additional points will be added for chronic conditions such as heart disease or diabetes.

People who were terminally ill, with a life expectancy of less than six months, would automatically be given nine points.

Sir Stephen said work on the guidance document began early in the pandemic, at a time when the number of patients in intensive care in England was doubling every 5-7 days.

He said, “It was not clear that the public would respond to the lockdown – they did amazing – but (at the time) it was not clear.”

“To be honest, I was personally terrified that the NHS was going to be overwhelmed.”

The project was halted on 28 March 2020, when it became clear that the peak of the first Covid wave was approaching and the health service would not “breach capacity”.

Sir Stephen said there was also a danger that the point-scoring system could be “inappropriately used” to replace doctors’ individual clinical judgment.

“My recommendation to the inquiry is that we should not attempt to develop any of these devices in the midst of a pandemic in the future,” he said.

He said this was work that would need to be done in consultation with the public “in normal times”.

“In my view, this is a discussion that should not be led by government, it should not even be led by the profession, it needs to be situated within society.”