The second report of the UK's COVID-19 inquiry confirmed that the UK was ill-prepared for a pandemic of the nature and scale of COVID-19. Blurred lines of responsibility and poor communication between the UK's four nations have stymied the response to the pandemic. Decision-makers at the center of the UK were not properly prepared for the role at the center of government power. For the next pandemic, the investigation's findings need to be used to build a clearer, more resilient and properly funded response system. This system must have a clear framework for operational accountability at all levels of response. Accountability involves steps between local public health teams, integrated care councils, national public health agencies, the chief medical officer and central government.