Lord Sedwill, who was giving evidence on Wednesday to Lady Hallett's inquiry, was cabinet secretary and head of the civil service until September 2020.

Messages he exchanged with Simon Case - the current cabinet secretary - during the pandemic were shared with the hearing.

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Lord Sedwill told Mr Case that Mr Hancock needed to be removed to "save lives and protect the NHS" - a play on the pandemic-era slogan at the time.

He said this was "gallows humour".

But Lord Sedwill told the inquiry he did not use the word "sack" when speaking to the then prime minister Boris Johnson about Mr Hancock.

Mr Hancock has repeatedly come under fire from people giving evidence to the inquiry - many saying he overpromised and underdelivered when it came to the Department for Health and Social Care's capacity and preparedness for the pandemic.

Mr Johnson's former top aide, Dominic Cummings, said he purposefully excluded Mr Hancock from meetings because he could not be trusted.

Lord Sedwill said that, while he did not formally advise Mr Johnson to sack Mr Hancock, the then PM would have been "under no illusions' about his feelings.

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Mr Johnson told the COVID inquiry previously: "I did not have any concerns regarding the performance of any Cabinet minister including Matt Hancock."

"I do not think that I received any advice from Sir Mark Sedwill that Matt should be removed."

Earlier in his evidence, Lord Sedwill said there had been wide-ranging concerns about Mr Hancock's honesty.

The inquiry's lawyer, Hugo Keith KC, said: "The process by which Mr Hancock's truthfulness, or candour, or lack of candour or general approach, however one describes it… was not an issue that was confined to perhaps one or two individuals, notably Mr Cummings…

"There was a general issue surrounding Mr Hancock, is that a fair summary?"

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Lord Sedwill replied: "Yes and you heard from [former civil servant] Helen MacNamara on that last week."

A spokesperson for Matt Hancock said: "Mr Hancock has supported the inquiry throughout and will respond to all questions when he gives his evidence."

Mr Hancock resigned as health secretary in June 2021 after footage emerged of his embrace with aide Gina Coladangelo.