As the care sector module of the UK COVID-19 Inquiry finally took place in July – five years after the pandemic began – we honour those who lost their lives and the bereaved families whose testimonies have shaped this inquiry’s direction. Their experiences remind us why this investigation matters and why we must never repeat these failures.
Homecare workers – 79% women, 26% from ethnic minority backgrounds – walked through silent streets before dawn, becoming lifelines for those the health system abandoned. They filled the vacuum left by others, often at cost to their own health or lives, yet worked within a system unprepared for crisis.
While Government dithered and delayed – laughing at the Italians and believing in British exceptionalism – South Korea mobilised rapidly with established testing infrastructure and a coherent test-trace-isolate strategy. Because South Koreans minimised community transmission, they did not need to impose a lockdown and maintained healthcare access for over-65s throughout the pandemic. This approach led to many fewer deaths in 2020/21 than in the UK.
International evidence shows a correlation between community transmission of COVID-19 and deaths in care homes and the community. Former ministers sought to blame care workers for spreading infection and proposed draconian regulations to restrict visiting, staff movement and working without vaccination. This was like closing the stable door after the horse had bolted.
The lesson is clear – minimising wider community transmission must be the foundation of any future pandemic strategy. Social care entered the pandemic with over 100,000 staff vacancies, precarious finances following austerity and inadequate digital infrastructure. COVID-19 increased homecare costs by £3.95 per hour (25%) while revenues fell 15% – creating a devastating 35-40% financial hit.
Zero-hours contracts and limited sick pay meant homecare workers suffered financial hardship whilst isolating. When the Infection Control Fund ended in March 2022, financial support for isolating staff collapsed. Nearly half of homecare providers reported care workers seeking alternative employment, while 59% expressed anxiety that staff might work while COVID-19-positive because of financial pressure.
Most damaging was the treatment of social care as the NHS’s ‘poor relation’. Despite employing more people than the NHS, Government excluded it from emergency planning, scientific advice and decision-making. The Inquiry’s evidence points toward critical changes needed before the next pandemic. We must embed social care expertise at every level of emergency planning, creating a standing national social care committee with equal status to the NHS.
Emergency preparedness requires a national test-trace-isolate strategy and infrastructure, adequate PPE stockpiles and automatic emergency funding reaching all providers. We need guaranteed equal access to PPE, testing, vaccines and sick pay across health and social care.
Workforce protection demands sustainable funding for fair pay and training. England needs a professional register for care workers like the other UK nations. Health service access must continue during emergencies, including face-to-face GP and district nurse input supported by telemedicine and clear protocols. Continued regulatory oversight is required.
Modern data infrastructure must capture everyone receiving or delivering home-based care. Only 40% of providers had electronic records when the pandemic started; now it is 80%. Despite overwhelming challenges, the pandemic revealed remarkable resilience. Providers innovated, digital transformation accelerated and stronger collaboration emerged.
Five years after the pandemic began, homecare remains in a challenging position. The Inquiry offers a chance to learn and build the system our communities deserve. The homecare workers who walked those silent streets showed extraordinary dedication. The Government must never again abandon them and those they support in their hour of greatest need.
Dr Jane Townson OBE is Chief Executive Officer at the Homecare Association. Email: [email protected] X: @homecareassn