Social care and NHS ‘must be seen as one’ amid rising care home deaths

Gemma Mitchell

Renewed calls have been made for the boundaries between the NHS and social care to be broken down, following another sharp rise in care home deaths.

In the week ending 17 April, 7,316 deaths were registered as having taken place in care homes in England and Wales, according to latest data from the Office for National Statistics.

“We desperately need a new way of thinking in which health and care are seen as one system”

Niall Dickson

Of these deaths, 2,050 involved Covid-19 – a rise from 826 in the previous week, and 195 the week before that.

This brings the total number of care home residents who have lost their lives following a confirmed or suspected Covid-19 diagnosis to 3,096.

While hospital remained the most likely place to die of Covid-19 as of 17 April, the data showed deaths were rising more steeply in care homes than in other settings.

Meanwhile, over the course of the pandemic, social care deaths unrelated to the virus have more than doubled, according to the ONS.

The figures have led to demands for more support for the sector during the crisis and for the divide between social care and the NHS to be abolished going forward.

The calls come amid ongoing concerns that care home staff have faced particular challenges gaining access to personal protective equipment (PPE) and Covid-19 testing.

Under the government’s coronavirus strategy, NHS workers were placed higher in the queue of priority for testing over social care staff, despite the vulnerability of their patient base.

Niall Dickson

Niall Dickson, chief executive of the NHS Confederation, said: “We need to stop thinking they are part of a different system, a different world.

“That means doing everything locally and nationally to support this critical part of our health and care sector with the right PPE, training and support in infection control as well as adequate funding.”

He added: “Radical reform is needed so care homes are not second-class citizens but working hand in hand with the NHS.”

Earlier this month, the government released an adult social care action, laying out how it proposed to support the sector through the coronavirus crisis.

Mr Dickson said this was “welcome” but added that more needed to be done, noting how clinicians in the NHS were taken it upon themselves to support their social care colleagues.

“We desperately need a new way of thinking in which health and care are seen as one system – there is so much to learn from this pandemic but the interdependency of all the parts will be critical if we are to build a new way forward,” he added.

Mike Padgham, chair of the Independent Care Group (ICG), said social care providers were “now on the true front line in the fight against Covid-19”.

He said the sector needed better support in terms of PPE, testing and finance to help providers manage demand.

The government has already pledged £3.2bn for local authorities to help support social care through the crisis but the ICG is asking for more help.

“We need the government to treat social care the same as it is treating the NHS”

Mike Padgham

Mr Padgham said providers were facing “huge increases in costs”, for example due to the need for extra agency staff to cover employees who were unwell, as well as for sickness pay and PPE.

In addition, he said some care homes were seeing a “dramatic reduction in income” due to fewer admissions.

The ICG has written to the chancellor asking for social care to be “zero-rated for VAT”, noting how providers were currenting paying tax for PPE while the NHS and local authorities were not.

“We need the government to treat social care the same as it is treating the NHS,” warned Mr Padgham.

Meanwhile, Paul Edwards, director of clinical services at Dementia UK, said: “The fact that we are only now being made aware of just how significant this pandemic has affected people working and living in care homes is testament to how social care is viewed – nowhere near held in the same regard as healthcare.”

Paul Edwards

He repeated calls for improved access to PPE, Covid-19 testing and funding for care homes and added: “It’s time we see social care as part of healthcare and vice versa.”

The Covid-19 death figures released each day by the Department of Health and Social Care only includes those that occurred in hospital.

The ONS data is able to expand its data by looking at death certificates however this means that a lag in its release.

Andrea Sutcliffe, chief executive and registrar of the Nursing and Midwifery Council, said: “As the numbers of people dying in hospital fall, today’s figures shine a devastating spotlight on the impact of Covid-19 in the wider community and on those living in the most vulnerable of circumstances.

“This pandemic has exacerbated the many issues that care homes, social care nursing and community services were already battling – including high vacancies, increased demand and the impact of a fragmented, disconnected system.

“It’s clear that social care is just as much the frontline of Covid-19 as the NHS,” she said. “The contribution of nurses and nursing associates working in social care is critical and the right support and recognition are absolutely vital.”

Sarah Deeny, assistant director of data analytics at the Health Foundation, said the government needed to take “immediate action to better record cases, deaths and wider health needs in care homes”.

She said work needed to be done to understand the underlying reasons behind the overall increase in deaths in care homes from all causes and to determine the accuracy of the data.

Before the pandemic hit, the government launched an engagement exercise with MPs from all sides in a bid to build a “cross-party consensus” on a new way forward for adult social care in recognition of the challenges facing the sector.

Gemma Mitchell

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