Distress and heartbreak for millions could have been avoided if the government had not missed opportunities to prepare social care for a pandemic, according to a big investigation into how the first wave of Covid hit care homes.
A review of events in spring 2020, when almost 20,000 care home residents died with Covid in England and Wales, found it was the result of “letting one of our most important public services languish in constant crisis for years”.
A two-year study by the Nuffield Trust health thinktank and the London School of Economics found successive governments failed to respond to risks already exposed by cross-government pandemic planning exercises, didn’t have enough civil servants working on social care, and failed to appreciate the sector’s fragility when sending patients into ill-prepared care homes.
The study is the latest independent assessment to undermine the claim by the former health secretary, Matt Hancock, to have thrown “a protective ring around social care”. It comes before the Covid-19 public inquiry’s investigation into the care sector, the timing of which has yet to be announced.
One social care representative told the study about a meeting hosted by the then prime minister Boris Johnson and Hancock in February 2020 at which “[we] … could not get air time for social care’s issues” unless it was about the NHS’s requirements.
Natasha Curry, deputy director of policy at the Nuffield Trust, said: “Those early months exposed … weaknesses within social care that impacted the shape, speed and effectiveness of the response. Many of these difficult challenges could have been eased had warnings been heeded. Governments of all hues have failed to make social care and those who need it a priority.”
The Covid-19 Bereaved Families for Justice group said the report showed “our loved ones might still be with us if care homes had been properly prepared for and protected during the pandemic”.
The study found:
The government excluded social care from pandemic-planning exercises such as Exercise Alice and after problems were identified by Exercise Cygnus, which did include the sector, action was not taken.
Social care leaders felt invisible at the start of the pandemic because there had been no dedicated director general for social care in government since 2016.
No adult social care representatives sat on the Scientific Advisory Group for Emergencies (Sage) and people leading the UK pandemic response lacked “deep understanding” of social care.
“Had the sector had the tools it needed then some of the confusion and delays that led to so much distress and heartbreak that millions of people faced could have been avoided,” said Curry. “Despite the pain endured during the pandemic, we now have the ominous sight of reforms being yet again delayed.”
The analysis was part-funded by the UK government, through the National Institute for Health and Care Research. No officials at the Department of Health and Social Care agreed to be interviewed.
“The social care sector was underresourced for years and … my mum, who had worked her whole life, needed help but was left with a system woefully unprepared to protect her,” said Deborah Doyle, a spokesperson for the Covid bereaved families group whose mother, Sylvia Griffiths, died in a care home in April 2020. “We cannot allow horrific scenes like this to happen again, and we don’t have time to wait.”
Adelina Comas-Herrera, an academic at the LSE and a report co-author, said: “The evidence suggests that some countries were able to cope better than others. We are seeing how countries such as Ireland, Finland and Spain are using lessons from the pandemic to reform their care systems. Our research shows that social care in England needs a system-wide reform.”
The care minister, Helen Whately said: “During the pandemic we supported social care with £2.9bn in specific Covid funding, sent out more than 230m Covid tests to care homes and prioritised social care for Covid vaccinations. We are committed to learning lessons from the pandemic and are investing up to £7.5bn over the next two years to put social care on a stronger financial footing, help reduce waiting lists and alleviate workforce pressures.”
