Read on Twitter
1/ New paper with @RichardnotatKF @LucindaRAllen @HealthFdn (+ the great Phoebe Dunn) assessing government policy on social care during the first stage of the pandemic:
https://www.health.org.uk/publications/reports/adult-social-care-and-covid-19-assessing-the-policy-response-in-england
Short thread with the main bits:
https://www.health.org.uk/publications/reports/adult-social-care-and-covid-19-assessing-the-policy-response-in-england
Short thread with the main bits:
2/ the impact of covid on social care has been grim. 30,500 excess deaths in care homes in England, 4,500 in domiciliary care, and social care staff—mostly women—have been more likely to die of covid than other adults
3/ see this great paper from @SarahDeeny @KarenHodgePodge @fiona_grimm and others for more detailed analysis on covid impacts on social care in England (including flow in and out of hospitals): https://bit.ly/2X9edz0
4/ We reviewed a tonne of policy docs, guidance, speeches, letters, committee evidence, other official docs. Matt Hancock’s claim that the government has ‘tried to throw a protective ring’ around care homes since the start of the pandemic does not appear to be grounded in reality
5/ govt support for social care came too late. Some policy happened in March, for sure. But govt’s action plan wasn’t published until April 15—a month after country-wide social distancing had been introduced, and two weeks after the NHS opened its first new nightingale hospital
6/ another month passed before govt announced a dedicated fund for infection control in care homes (good, but late)—around a month after excess deaths in care homes peaked. There has also been a delay between policies being announced and being implemented…
7/ and when policies have arrived, they’ve faced major and widespread problems. Big issues with access to testing and PPE, leading to a lack of protection for people using and providing care. LAs report that emergency govt funds have not been enough to cover extra covid costs
8/ protecting social care has been given far lower priority by national policymakers than protecting the NHS. This has been simultaneously unsurprising and completely devastating
9/ policy action has also been focused primarily on care homes and risks leaving out other vulnerable groups and services. This includes people receiving care in their own homes, younger adults, and unpaid carers. Social care is more than older people in care homes
10/ unmet need for both health care (again, see @SarahDeeny et al's paper) and social care is likely to have increased. In some areas, emergency legislation has been used so that social care needs assessments do not need to happen and basic care needs do not need to be met
11/ the failure of successive govts to reform social care is being laid bare here. The system that entered the pandemic was underfunded, understaffed, and providers at risk of collapse. No policy action would have been enough to undo decades of political neglect
12/ various structural factors have made the crisis worse. Lack of funding. Chronic workforce issues. Fragmentation and lack of coordination. Complex accountabilities
13/ Lack of data has also been an issue. Eg Matt Keeling of SAGE SPI-M told the Science & Tech Cttee in June that: ‘I remember asking at some point, probably late March, what we knew about care homes, and we did not even know how many people were in care homes at that point’
14/ rather than a blame game between national agencies (which appears to still be unfolding), govt needs to commit to learning from the first stage of the pandemic to better prepare for future waves of the virus
15/ short term, this means giving the same priority to protecting social care as the NHS, better involvement of social care leaders in policy decisions, ensuring enough support for people receiving care in their own homes, better access to testing and PPE, etc
16/ but more fundamental reform of social care is also needed to address the longstanding policy failures exposed by covid. That must be comprehensive, incl action to improve staff pay and conditions, overdue reform of social care funding (see https://bit.ly/3379mSQ ), and more
17/17 (it doesn’t mean exploring policy zombies like giving responsibility for social care to the NHS…)
(tl;dr--too little, too late, but things we can do to make it better)
