Adult social care and COVID-19. Assessing the impact on social care users and staff in England so far

Abstract

The coronavirus (COVID-19) pandemic has had a profound impact on people receiving social care. As of July 2020, there have been over 30,500 more deaths among care home residents in England than we would normally expect. A further 4,500 excess deaths have been reported among people receiving domiciliary social care. Briefing: Adult social care and COVID-19 2 • We found that while discharges from hospitals to residential care homes were 75% of the historical average, discharges from hospitals to nursing homes increased to 120% of the historical average. • During March and April, similar to the general population, there was a substantial reduction in hospital admissions among care home residents. Elective admissions reduced to 58% of the 5-year historical average during this period and emergency admissions to 85% of the 5-year historical average. During this time, 14% of admissions had COVID-19 as the primary cause. By reducing admissions, care home and NHS teams may have reduced the risk of transmission. There may have also been an increase in unmet health needs but the data currently available do not allow us to assess whether this was the case. • Long-standing structural issues have exacerbated the crisis in social care and hindered the response to the pandemic. But action is needed to prevent further harm, and this includes the need for data to fill the gaps highlighted in this briefing. Many of the most pressing data gaps concern domiciliary care, as it is not currently possible to track and understand the spread of infection in these settings. We also need more data on the health and care needs accumulated during the pandemic, and how well social care users are able to access essential services. • The Health Foundation is undertaking a wider programme of work to improve social care data. Our work so far has pointed to deep-rooted structural and cultural challenges that impact how data are collected, shared and used. A new data strategy is needed for social care that first and foremost enables the provision of better care. * Proportions have changed substantially since, but in May, this ranged from 26% in England and Wales to 66% in Spain, as reported in Eurosurveillance in a comparison of European/European Economic Area (EEA) countries: www.

Adult social care and COVID-19: Assessing the policy response in England so far

“…Data on the impact of COVID-19 on social care users and staff are from publicly available sources, including the ONS and CQC, and original analysis of linked datasets reported in more detail elsewhere. 13 Differences in local context across England mean there has been significant regional variation in implementation of policies and impact, 14 but our analysis focuses on national level data.…”

“…Hospital discharges to care homes dropped, overall, between 17 March and 30 April. 13 But discharges to nursing homes actually increased compared to the historical average. 13…”

“…Admissions to hospital for care home residents decreased substantially as the pandemic unfolded, with 11,800 fewer admissions during March and April compared to previous years. 13 Elective admissions dropped more dramatically than emergency admissions. And admissions from residential care homes decreased more substantially than from nursing homes.…”

“…We also provide a summary of the latest data on the impact of COVID-19 on social care. 13 In the final part, we make an assessment of the policy response and identify lessons for the future.…”

Did the UK Government Really Throw a Protective Ring Around Care Homes in the COVID-19 Pandemic?

“…During the pandemic, residents experienced reduced access to healthcare, with falls in elective and emergency admissions to hospitals from care homes and a rise in admissions from hospitals to nursing homes (Hodgson et al, 2020). However there were some positive examples of work to improve health care for residents in the full survey report, such as the creation of local multi-disciplinary teams with health and social care working in partnership to find local solutions (Rajan and Mckee, 2020).…”