New analysis published by the Health Foundation reveals the significant impact COVID-19 has had on social care in England.
The Health Foundation finds that policy action on social care has focused primarily on care homes and that this has risked leaving out other vulnerable groups of users and services, including those receiving care in their own homes. It also notes that the shortcomings of the Government’s response have been made worse by longstanding political neglect and chronic under funding of the social care system.
Since March, there have been more than 30,500 excess deaths among care home residents in England and 4,500 excess deaths among people receiving domiciliary care. Excess deaths measure the additional deaths in a given time period compared to the number usually expected and does not depend on how COVID-19 deaths are recorded. In this case, the analysis uses a measure that compares the weekly deaths in 2020 with average deaths during same period in 2017-2019. The figures include all death notifications made to CQC for care home residents and those receiving domiciliary care, irrespective of location of death.
While high numbers of excess deaths of people living in care homes have been well reported, the analysis shows there has been a greater proportional increase in deaths among domiciliary care users than in care homes (225% compared to 208%). And while deaths in care homes have now returned to average levels for this time of year, the latest data (up until 19 June) shows that there have continued to be excess deaths reported among domiciliary care users.
The Health Foundation says that decades of inaction by successive governments have meant that the social care system entered the pandemic underfunded, understaffed, and at risk of collapse. Any response to COVID-19 would have needed to contend with this legacy of political neglect. As the UK prepares for potential future waves of the virus, the Health Foundation warns that social care must be given equal priority to the NHS, including a greater focus on domiciliary care, and that more fundamental reform of the social care system is needed to address the longstanding policy failures exposed by COVID-19.
Dr Jennifer Dixon, Chief Executive at the Health Foundation, said, 'The pandemic has had a profound impact on the lives of people receiving and providing social care. The social care system has lacked adequate investment for decades and successive governments have not faced up to the issues facing the sector. COVID-19 has highlighted the extent of this neglect, with tragic consequences.
'Government must learn now from the first phase of the pandemic to invest in and support social care. In the next year we must see long-overdue reform which should include action to improve pay and conditions for staff, stabilise the care provider market, increase access to publicly funded services, and provide greater protection for people against social care costs.
'The Health Foundation’s analysis also highlights potential unmet health need among social care users over the course of the pandemic and presents new evidence around the factors that might have contributed to the spread of the virus in care homes.
'During March and April, there was a substantial reduction in hospital care use among care home residents, with elective admissions reduced to 58% of previous years and emergency admissions to 85% of previous years. The Health Foundation says that by reducing hospital admissions, care home and NHS teams may have reduced the risk of COVID-19 transmission.
'The analysis also found that discharges from hospitals to residential care homes decreased in England during March and April. However, over the same period, discharges from hospitals to nursing homes increased to 120% of the historic average, though we don’t know whether these led to subsequent outbreaks of COVID-19. Decisions to discharge patients from hospitals were made in part to reduce the risks of exposure to COVID-19 for those medically fit and stable, and in part to free up space in hospitals for an expected surge of new patients with COVID-19.'
The Health Foundation reveals its full analysis of COVID-19's impact on social care here.