Ministers have been accused of a “slow, inconsistent and at times negligent” approach to social care during the coronavirus pandemic that has exposed years of delayed reforms to the sector.
In a damning report, the cross-party Public Accounts Committee said the decision to discharge around 25,000 patients from NHS hospitals into care homes – without first testing them – was “an appalling error” in the initial weeks of the outbreak.
On personal protective equipment for social care staff, the committee chair Meg Hillier said that failure to provide kit for workers and volunteers who risked their lives through the first peak of Covid-19 was “a sad, low moment in our national response”.
“Our care homes were effectively thrown to the wolves, and the virus has ravaged some of them,” she added.
The Alzheimer’s Society said care homes had been “abandoned” at the start of the coronavirus epidemic, allowing outbreaks to spread unchecked and causing “catastrophic loss of life”.
The charity’s director of research Fiona Carragher said: “Right from the start, we raised concerns about discharging patients into care homes hastily and this report sadly vindicates these concerns. Too late for the thousands of people who have died, the largest number of whom have been people with dementia, each death leaving behind a heartbroken family.
“Coronavirus has laid bare the impact of decades of underinvestment in social care. With the threat of a second wave, the government must take action to protect this vulnerable group and ensure another tragedy like this doesn’t happen again.”
And the Age UK charity director Caroline Abrahams said there was now no doubt that “catastrophic mistakes have been made by decision-makers, with tragic consequences for older people, their families and friends, and care staff”.
“Thousands of older people and hundreds of care workers died whose lives might have been saved had we reacted faster to the emerging threat to care homes here, as similar problems played out in other countries a few weeks ahead of the pandemic’s trajectory here,” said Ms Abrahams. “Never again can we let down social care, its staff and the older and disabled people who depend on it like we have done this year.”
According to the latest provisional figures from the Office for National Statistics, there were 19,394 deaths in care homes in England between 2 March and 12 June involving Covid-19 – nearly 30 per cent of all registered deaths of care home residents.
Publishing their report, MPs on the committee said the pandemic had highlighted the “tragic impact” of successive governments delaying widespread reform of the sector and treating social care as the NHS’s “poor relation”.
In their first examination of the health and social care response to the crisis, they added: “Years of inattention, funding cuts and delayed reforms have been compounded by the government’s slow, inconsistent and, at times, negligent approach to giving the sector the support it needed during the pandemic.
“This is illustrated by the decision to discharge 25,000 patients from hospitals into care homes without making sure all were first tested for Covid-19, a decision that remained in force even after it became clear people could transfer the virus without ever having symptoms”.
The report said that “shockingly” the government’s policy of not testing all patients for Covid-19 before discharging them into care homes continued until 15 April, when the government announced everyone would be tested prior to being discharged and regardless of symptoms.
“The Department [of Health and Social Care] says that it took rational decisions based on the information it had at the time, but acknowledges that it would not necessarily do the same thing again,” the MPs said.
Going forward, the committee urged the government to prepare for a potential second wave, and said no one would have expected ministers to get every decision right during the initial months of the pandemic. “Rather than seeking to give the impression that it has done so, the government urgently needs to reflect, acknowledge its mistakes, and learn from them as well as from what has worked,” the report added.
It also said it was concerned about a “scarcity of information on contracts and costs” during the period, when NHS England and Improvement said hundreds of thousands of patient treatments had been secured through independent hospitals.
The committee said it was concerned that NHS England and Improvement had not provided a rough estimate of costs. And it said allowing the Nightingale hospitals to remain empty while the NHS requires additional capacity for routine services “will not be a good use of public money”.
Committee chair Ms Hillier added: “Vulnerable people surviving the first wave have been isolated for months, in the absence of a functional tracing and containment system. Yet there were bold and ambitious claims made by ministers about the rollout of test, track and trace that don’t match the reality.
“The deaths of people in care homes devastated many, many families. They and we don’t have time for promises and slogans, or exercises in blame. We weren’t prepared for the first wave. Putting all else aside, government must use the narrow window we have now to plan for a second wave. Lives depend upon getting our response right.”
Just last week Chris Whitty, the chief medical officer for England, told a Commons committee that major risks in social care settings were not considered early on in the crisis, including staff working in multiple locations and those not paid sick leave.
“I think it is clear that every country that has a care sector has not handled this well,” he told MPs. “The UK is one country that has not handled this well in terms of issues in social care, but the same is true … the numbers are very similar, or even higher, in terms of proportions of deaths in almost every country you look at this.”
In frank remarks, he added: “There are a lot of things we have learnt that we can now do a lot better in social care and I don’t think any of us will look back at what happened in social care and say the ideal advice was given and this was the fault of anyone.”
A spokesperson for the Department of Health and Social Care said: “Throughout this unprecedented global pandemic we have been working closely with the sector and public health experts to put in place guidance and support for adult social care.
“Alongside an extra £1.3bn to support the hospital discharge process, we have provided 172m items of PPE to the social care sector since the start of the pandemic and are testing all residents and staff, including repeat testing for staff and residents in care homes for over 65s or those with dementia.
“We know there is a need for a long-term solution to social care and we will bring forward a plan that puts social care on a sustainable footing to ensure the reforms will last long into the future.”
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