The COVID-19 outbreak posed severe and immense challenges to health and social care services in England. After the first cases of COVID-19 in England were reported on 31 January 2020, the NHS and the adult social care sector had to act quickly to prepare for the impact of the pandemic within hospitals and care homes. By the end of April, the government had allocated an additional £6.6 billion to support the health and social care response, and £3.2 billion to local government to help with pressures on local services, including social care. On 15 May it announced a further £600m for infection control in care homes. We were told that in mid-March SAGE predicted that in the worst-case scenario more than 4% of the population might be hospitalised, and 30% of those would require critical care and that ICU capacity in London may well be breached by the end of the month, even if additional measures were in place.
Thanks to the commitment of thousands of staff and volunteers and by postponing a large amount of planned work, the NHS was severely stretched but able to meet overall demand for COVID-19 treatment during the pandemic’s April peak. From early March to mid-May, the NHS increased the quantity of available ventilators and other breathing support, which are essential for the care of many COVID-patients. The number of mechanical ventilators rose from 9,600 to 13,200. The number of beds available for COVID-patients also increased from 12,600 to 53,700 between mid-March and mid-April.
Unfortunately, it has been a very different story for adult social care, despite the hard work and commitment of its workforce. 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.
Reflecting on the Government’s response to the pandemic so far, we are also particularly concerned by its failure to provide adequate PPE for the social care sector and testing to the millions of staff and volunteers who risked their lives to help us through the first peak of the crisis. The Government needs to work urgently now to ensure that there is enough capacity—including both testing and PPE—and continued support for staff and volunteers so we are ready for future COVID peaks.
There are many lessons that the government must learn, not least giving adult social care equal support to the NHS and considering them as two parts of a single system, adequately funded and with clear accountability arrangements. No-one would expect government to get every decision right first-time round during such an emergency. 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.
This is our first examination of the health and social care response to COVID-19. The committee will be examining the ventilator challenge and the procurement of PPE in more detail in the autumn.
1 4% of the population is 2.7 million people based on the current Office of National Statistics estimated UK population of 66.7 million.
Published: 29 July 2020