Care homes were ‘afterthought’ with devastating coronavirus consequences

Years of failed efforts to integrate NHS and social care hampered the response to the coronavirus crisis, according to the first independent report into preparations for the pandemic.

This article is based on a National Audit Office (NAO) report published today. Owl publishes the NAO press release separately.

Meanwhile Dr Cathy Gardner’s Judicial Review takes another step forward.

Kat Lay, Health Correspondent 

The National Audit Office report into the work done to prepare services showed that care home residents were “an afterthought”, Meg Hillier, the chairwoman of the Commons public accounts committee, said last night.

The report said that 25,000 hospital patients had been discharged to care homes at the height of the pandemic. It said: “Due to government policy at the time, not all patients were tested for Covid-19 before discharge, with priority given to patients with symptoms.” It also found that one in three homes for the elderly had suffered virus outbreaks.

Ms Hillier said: “Care homes were at the back of the queue for both PPE and testing so only got a small fraction of what they needed from central government. Residents and staff were an afterthought yet again: out of sight and out of mind, with devastating consequences.”

The report highlighted a “problematic” relationship between social care and the NHS. It said: “We have reported on successive efforts to integrate the two sectors: there have been 12 government white papers, green papers and consultations, and five independent reviews on integration over the past 20 years.

“Going into the pandemic, meaningful integration was still to occur, however, and the lack of it has made responding to the crisis more difficult in a number of ways.”

Issues included a lack of clear data available from social care because of its fragmented nature, with about 20,000 independent providers.

The report found that only a fraction of necessary PPE reached care homes and hospitals from central stocks, and that calls for gowns and eye protection to be added to government pandemic stockpiles had not been heeded.

Central stocks had supplied only 20 per cent of the gowns, 33 per cent of the eye protection and 50 per cent of aprons that models had suggested were needed in health settings under a “reasonable worst-case scenario”, the report said. It added: “Central stocks distributed to social care accounted for 15 per cent or less of the modelled requirement for any item of PPE, apart from facemasks.”

Ms Hillier said frontline health workers had been “badly let down by the government’s failure to prepare properly”. She added: “Shockingly, the government squandered the last opportunity to add to the central PPE stockpile, even after the NHS had gone to the highest level of alert.”

The report, which covers the period since the NHS moved to its most severe incident level in January, also found that despite testing being available for health staff in some form since the end of March, ministers still did not know how many NHS or care workers had been tested in total.

Jeremy Hunt, chairman of the Commons health and social care committee and a former health secretary, said: “It seems extraordinary that no one appeared to consider the clinical risk to care homes despite widespread knowledge that the virus could be carried asymptomatically. Places like Germany and Hong Kong took measures to protect their care homes that we did not over a critical four-week period.”

A Department of Health and Social Care spokeswoman said: “We have delivered over 1.7 billion pieces of PPE and continue to ensure supplies reach the frontline. The modelled PPE requirements presented in this report are theoretical worst-case estimates — it is misleading to compare them to figures on centrally procured PPE which do not account for equipment supplied through other routes or existing local stocks.”