A story of inadequate funding, policy neglect and unintended consequencesby Anita Charlesworth and Sarah Deeny / May 16, 2020 / Leave a comment
The change from the “stay at home” to “stay alert” messaging on Covid-19 has caused much controversy. The original messaging also included “protect our NHS,” and thankfully the position in NHS hospitals is now steadily improving. But it is telling that the mantra was never “protect our care system.” Was much of the crisis in social care avoidable?
The latest data for social care is, as we know, deeply concerning. In England and Wales, figures show that over 8,300 care home residents have now died from Covid-19 and this is likely to be an underestimate. While the epidemic in the wider community peaked around early April, it continued to spread in care homes for almost another month. This was not unexpected. Italy, France and Spain, ahead of the UK in the pandemic, reported Covid-19 deaths in their care homes from the start.
Lockdown measures and changes to services intended to protect NHS capacity may have had unintended consequences for social care. In care homes, we are seeing a high level of excess deaths—around 20,000 more than one would expect for this time of year. New research from the LSE has estimated that care home residents may account for around half of total excess deaths this year in England and Wales. The 8,300 deaths directly linked to the virus explain around 40 per cent of the excess. But what of the other 60 per cent? These 12,000 additional deaths may reflect undiagnosed Covid-19, but there is also a risk that people with complex health and care needs may not be getting all the help required. As we ease lockdown, and the NHS attempts to expand its capacity for normal business, we need to ensure that those receiving social care are also receiving high quality NHS care.
Still hidden is the virus’ full impact on the more than half a million people receiving long-term social care support in their own homes. We now know there were 3,161 deaths of people receiving domiciliary care in England in April this year, over twice as high as the three-year average (1,171 deaths) for the same period. We also have anecdotes of services struggling to provide the same number of visits to vulnerable patients, and care workers without the PPE necessary to prevent transmission. But we still have no data to properly track and…