Covid deaths in care homes could have been avoided if sector wasn’t treated as ‘afterthought’, finds report

‘The tragic scale of loss was among the worst in Europe and could have been mitigated,’ MPs find

The ‘lack of priority’ afforded to social care during the initial phase of the pandemic is ‘illustrative of a broader and longer-standing issue’, say MPs (PA)

The number of coronavirus deaths in UK care homes was among the highest in Europe, which could have been avoided if they had not been mistakenly treated as an “afterthought”, a new report has found.

A joint inquiry by the Science and Technology Committee and the Health and Social Care Committee  found that an “inadequate initial focus on social care” in the early stages of the pandemic led to the “seeding of infections” in care homes, where more than 41,000 residents died of Covid in the 13 months to April 2021.

The report, which examines the government’s initial response to the pandemic, states that while the UK was “not alone” in suffering significant loss of life in care homes, the “tragic scale of loss was among the worst in Europe and could have been mitigated”.

It continues: “The lack of priority that witnesses said was [afforded] to social care during the initial phase of the pandemic was illustrative of a broader and longer-standing issue in the health and social care system.”

The inquiry cites evidence provided by Professor David Oliver, a consultant geriatrician and Nuffield Trust fellow, who said: “‘Protect the NHS’ essentially meant protect the acute hospital bed base, with everything else a bit of an afterthought. That was a mistake.”

In total, 41,675 care-home residents were recorded as having died of Covid between 16 March 2020 and April 2021 – accounting for more than one in four deaths from all causes among care-home residents.

The number of deaths of people receiving domiciliary care between April and June 2020 was over 120 per cent higher than the three-year average over the same period between 2017 and 2019, with 13 per cent of the total involving a confirmed case of Covid.

The most “damaging” way in which the “prioritisation” of the NHS over social care manifested itself during the first wave of the pandemic was in the “rapid discharge” of people from hospitals to care homes without adequate testing, according to the report, which drew on evidence from over 50 witnesses.

In order to free acute hospital beds in anticipation of the first wave of the pandemic, NHS providers were instructed to urgently discharge all medically fit patients as soon as it was clinically safe to do so, and care-home residents were not tested on their discharge from hospital.

Around 25,000 people were discharged from hospitals into care homes between 17 March and 15 April 2020.

The report states that, in practice, there was “no expectation” that patients should be tested before being discharged, with the government’s first set of guidance including no reference to testing except to state that, “where applicable”, test results should be included in a patient’s discharge documents.

It notes that guidance on testing was issued on the basis that care homes would be able to safely isolate people who were admitted from hospital, but that, in reality, many care homes lacked the facilities to safely isolate such patients.

The risk in care homes was further compounded by poor access to PPE during the early period of the pandemic, says the report.

Caroline Abrahams, charity director at Age UK, said the report correctly observed that social care was treated as “something of an afterthought” during the early months of Covid-19, which “inadvertently resulted in older people and staff in care homes being badly let down”.

Karolina Gerlich, chief executive of the Care Workers Charity, said: “The pandemic served to once again highlight the discrepancy between the treatment and regard of the health and social care sectors. As protection of the NHS was prioritised, care workers were effectively abandoned with little to no government support, as well as an appalling lack of PPE.”

Ms Gerlich said she couldn’t “begin to comprehend” the content of Boris Johnson’s social care statement last month, in which he introduced a health and social care tax to pay for reforms to the care sector alongside NHS funding.

Analysis by Policy in Practice has found that by April 2022, the combination of the new health and social care levy and the removal of the £20-a-week uplift to universal credit will mean care workers are £1,035 per year worse off.

“It will leave care workers out of pocket – with an increase in income tax, and no prospect of a pay rise. Recognition shown to the social care sector and its workforce continues to be poor,” Ms Gerlich added.

Responding to the parliamentary report, a spokesperson for the Association of Directors of Adult Social Services (ADASS), said: “Years of austerity and a failure of recognition of people needing social care, caring for others and working in social care contributed to Covid’s devastating impact.

“We see no evidence that lessons have been learned, and are deeply worried about what may happen this winter.”

A government spokesperson said: “Throughout the pandemic we have been guided by scientific and medical experts and we never shied away from taking quick and decisive action to save lives and protect our NHS, including introducing restrictions and lockdowns.

“Thanks to a collective national effort, we avoided NHS services becoming overwhelmed [...] As the Prime Minister has said, we are committed to learning lessons from the pandemic and have committed to holding a full public inquiry in Spring.”