Tenth Report
Contents

Appendix 1: Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021

Additional material from the DHSC following the oral evidence session on 13 July 2021

Q1: The latest vaccination uptake data (data for 4 July was cited - we would be grateful if you could confirm the figures given.)

A1: The figures Minister Zahawi quoted for 4th July were the latest available public figures. Data is published each Thursday afternoon correct to the previous Sunday and can be found here: Statistics » COVID-19 Vaccinations (england.nhs.uk)

Q2: Any information you have about the percentage of care home staff who are medically exempt from vaccination ( the example figures for Barchester 78 of 16,000 related to those who left the firm rather than accept vaccination which is a slightly different point.)

A2: The Department does not collect data on the number of staff who are medically exempt from vaccination. However, the Impact Statement will include our current best estimate of the proportion of workers in CQC-regulated care homes who will be medically exempt from the regulation, but the committee should note that this is a judgement partly based on census and demographic data, supported by the findings of the Driving Uptake survey.

Q3: A “stratification” of the care home sector by size of firm. It was explained that ‘the big four’ firms represent 15%. To explain why there are localised difficulties with vaccine take up, you offered a better breakdown of the small and very small homes that form the bulk of the sector, and which these Regulations target.

A3: Please find below:

An excel spreadsheet giving the number of care homes, care home beds, the breakdown of the care homes by their size and the average care home size in each LA and nationally;
A pie chart of the national figures.

The committee should note that this data is up to date as of 1 July 2021.

Q4: At one point the existence of an equality impact assessment was mentioned - is that published anywhere? If so may we have the link to make it available to the House.

A5: The Public Sector Equality Duty is available here Making vaccination a condition of deployment in care homes: public sector equality duty impact assessment - GOV.UK (www.gov.uk)

Q5. An Impact Assessment/Statement - covering all the issues about the potential effect on the sector raised in our report and in questions. (The Committee would prefer to see an Impact Assessment - which follows a standardised format.)

A5: We are intending to lay the Impact Statement on Monday ahead of the Lords debate on Tuesday. The impact statement will outline analysis from the Department of Health and Social Care of the number of current staff who we estimate may not be vaccinated or exempt by the end of the 16-week grace period, and therefore the numbers that may need to be recruited by the sector to replace workers who may choose to leave the workforce rather than be vaccinated.

Q6: The Minister mentioned that the ability to provide suitable evidence on the NHS App would be provided “soon” - do you have any more precise date to offer?

A6: The NHS App currently enables people to provide confirmation of their vaccination status and there is a non-digital alternative in place. We are working to enhance the functionality of the app and ensure a non-digital alternative is in place for those who will need to confirm their vaccination status to enter care homes. We are finalising the exemptions process with NHSX and engaging with external stakeholders in the NHS. We will set out further detail on this in the operational guidance which we intend to publish at the end of July.

Number of care homes by bed category (All ages): England

Pie chart showing perecentage of care homes by bed category

Source: DHSC’s CQC Registration Data Tracker, current at 1 July 2021.

Table: Care Home Market Stratification July 2021

Region	Local authority name	# of care home beds	# of care homes	# of care homes without nursing	# of care homes with nursing	% of care homes with 1 to 10 beds	% of care homes with 11 to 25 beds	% of care homes with 26 to 50 beds	% of care homes with 51 to 75 beds	% of care homes with 76+ beds	Average care home size
London	Barking and Dagenham	718	22	14	8	45%	9%	23%	9%	14%	32.64
London	Barnet	2636	82	61	21	32%	18%	27%	12%	11%	32.15
Yorkshire and The Humber	Barnsley	2326	76	61	15	26%	16%	42%	13%	3%	30.61
South West	Bath and North East Somerset	1700	59	36	23	32%	17%	36%	12%	3%	28.81
East of England	Bedford	1666	79	66	13	42%	25%	25%	4%	4%	21.09
London	Bexley	1571	31	19	12	16%	26%	13%	16%	29%	50.68
West Midlands	Birmingham	7596	286	210	76	42%	19%	22%	12%	6%	26.56
North West	Blackburn with Darwen	1090	36	27	9	14%	36%	33%	11%	6%	30.28
North West	Blackpool	1721	70	53	17	21%	39%	33%	6%	1%	24.59
North West	Bolton	1821	59	40	19	37%	7%	41%	7%	8%	30.86
South West	Bournemouth, Christchurch and Poole	4748	156	117	39	31%	28%	17%	18%	6%	30.44
South East	Bracknell Forest	476	15	11	4	20%	33%	27%	13%	7%	31.73
Yorkshire and The Humber	Bradford	4180	115	75	40	14%	23%	44%	11%	8%	36.35
London	Brent	1123	59	49	10	68%	10%	8%	7%	7%	19.03
South East	Brighton and Hove	2079	88	61	27	27%	34%	33%	2%	3%	23.63
South West	Bristol, City of	2932	104	67	37	40%	23%	15%	14%	7%	28.19
London	Bromley	1533	52	31	21	25%	23%	35%	13%	4%	29.48
South East	Buckinghamshire	4517	130	90	40	29%	18%	24%	20%	8%	34.75
North West	Bury	1838	55	41	14	31%	16%	38%	5%	9%	33.42
Yorkshire and The Humber	Calderdale	1416	51	34	17	31%	31%	22%	10%	6%	27.76
East of England	Cambridgeshire	4615	129	84	45	24%	19%	29%	19%	9%	35.78
London	Camden	359	10	7	3	10%	30%	30%	30%	0%	35.90
East of England	Central Bedfordshire	1841	57	37	20	30%	18%	26%	23%	4%	32.30
North West	Cheshire East	4329	99	52	47	15%	11%	38%	24%	11%	43.73
North West	Cheshire West and Chester	3005	81	40	41	16%	10%	53%	19%	2%	37.10
London	City of London	0	0	0	0
South West	Cornwall	5244	223	168	55	30%	29%	35%	4%	2%	23.52
North East	County Durham	5206	146	84	62	25%	12%	37%	21%	5%	35.66
West Midlands	Coventry	2096	77	62	15	27%	23%	39%	6%	4%	27.22
London	Croydon	3052	128	93	35	44%	24%	17%	9%	5%	23.84
North West	Cumbria	4392	146	111	35	24%	21%	40%	12%	3%	30.08
North East	Darlington	1224	32	22	10	28%	13%	22%	28%	9%	38.25
East Midlands	Derby	2174	69	42	27	12%	28%	51%	9%	1%	31.51
East Midlands	Derbyshire	7615	264	175	89	23%	18%	48%	8%	1%	28.84
South West	Devon	8076	322	257	65	20%	38%	34%	8%	1%	25.08
Yorkshire and The Humber	Doncaster	2427	80	55	25	29%	18%	36%	10%	8%	30.34
South West	Dorset	3909	122	85	37	11%	34%	34%	20%	1%	32.04
West Midlands	Dudley	2497	95	76	19	33%	27%	28%	7%	4%	26.28
London	Ealing	1607	48	29	19	35%	17%	25%	10%	13%	33.48
Yorkshire and The Humber	East Riding of Yorkshire	4604	148	129	19	17%	30%	39%	11%	4%	31.11
South East	East Sussex	8180	307	234	73	28%	30%	26%	13%	2%	26.64
London	Enfield	1858	81	68	13	49%	19%	19%	7%	6%	22.94
East of England	Essex	12512	409	329	80	37%	18%	24%	12%	8%	30.59
North East	Gateshead	2021	54	30	24	19%	22%	26%	28%	6%	37.43
South West	Gloucestershire	6126	218	140	78	33%	20%	31%	12%	4%	28.10
London	Greenwich	909	43	31	12	67%	5%	7%	19%	2%	21.14
London	Hackney	331	15	11	4	60%	13%	20%	0%	7%	22.07
North West	Halton	836	26	17	9	27%	19%	27%	27%	0%	32.15
London	Hammersmith and Fulham	442	9	5	4	44%	11%	0%	11%	33%	49.11
South East	Hampshire	14121	492	346	146	35%	22%	23%	15%	5%	28.70
London	Haringey	478	32	30	2	75%	9%	9%	3%	3%	14.94
London	Harrow	1218	56	45	11	48%	27%	11%	7%	7%	21.75
North East	Hartlepool	884	26	17	9	27%	12%	31%	27%	4%	34.00
London	Havering	1801	59	40	19	36%	19%	24%	15%	7%	30.53
West Midlands	Herefordshire, County of	2127	87	58	29	31%	28%	34%	6%	1%	24.45
East of England	Hertfordshire	9669	266	191	75	37%	14%	15%	23%	11%	36.35
London	Hillingdon	1427	47	31	16	32%	17%	30%	17%	4%	30.36
London	Hounslow	819	30	19	11	53%	10%	10%	23%	3%	27.30
South East	Isle of Wight	1923	74	61	13	19%	43%	31%	5%	1%	25.99
South West	Isles of Scilly	14	1	1	0	0%	100%	0%	0%	0%	14.00
London	Islington	565	16	8	8	25%	19%	13%	38%	6%	35.31
London	Kensington and Chelsea	358	11	6	5	27%	18%	27%	27%	0%	32.55
South East	Kent	14838	536	423	113	35%	21%	27%	12%	4%	27.68
Yorkshire and The Humber	Kingston upon Hull, City of	2295	86	73	13	33%	22%	35%	8%	2%	26.69
London	Kingston upon Thames	1216	39	22	17	33%	10%	38%	13%	5%	31.18
Yorkshire and The Humber	Kirklees	3564	132	96	36	31%	23%	33%	11%	2%	27.00
North West	Knowsley	1112	27	16	11	19%	11%	41%	22%	7%	41.19
London	Lambeth	1098	42	31	11	57%	14%	5%	12%	12%	26.14
North West	Lancashire	12800	426	309	117	22%	27%	37%	10%	4%	30.05
Yorkshire and The Humber	Leeds	5598	151	103	48	23%	18%	36%	11%	11%	37.07
East Midlands	Leicester	2862	105	87	18	21%	36%	32%	8%	3%	27.26
East Midlands	Leicestershire	5202	175	143	32	24%	26%	34%	13%	3%	29.73
London	Lewisham	959	56	46	10	57%	21%	14%	4%	4%	17.13
East Midlands	Lincolnshire	8431	291	220	71	22%	25%	40%	10%	3%	28.97
North West	Liverpool	3485	89	48	41	19%	10%	48%	15%	8%	39.16
East of England	Luton	1115	40	33	7	45%	18%	18%	13%	8%	27.88
North West	Manchester	2565	91	54	37	35%	23%	29%	8%	5%	28.19
South East	Medway	1601	70	54	16	43%	21%	24%	9%	3%	22.87
London	Merton	938	38	23	15	45%	18%	18%	13%	5%	24.68
North East	Middlesbrough	1778	44	30	14	20%	16%	30%	25%	9%	40.41
South East	Milton Keynes	1473	47	32	15	36%	15%	28%	15%	6%	31.34
North East	Newcastle upon Tyne	2643	71	35	36	18%	23%	31%	23%	6%	37.23
London	Newham	660	27	21	6	74%	4%	4%	0%	19%	24.44
East of England	Norfolk	9535	342	283	59	28%	24%	35%	11%	3%	27.88
Yorkshire and The Humber	North East Lincolnshire	1774	57	43	14	23%	25%	33%	14%	5%	31.12
Yorkshire and The Humber	North Lincolnshire	1979	59	47	12	7%	34%	44%	10%	5%	33.54
South West	North Somerset	2871	98	64	34	24%	24%	37%	8%	6%	29.30
North East	North Tyneside	1684	44	28	16	18%	20%	34%	23%	5%	38.27
Yorkshire and The Humber	North Yorkshire	6275	205	143	62	28%	23%	28%	16%	5%	30.61
East Midlands	Northamptonshire	6498	249	183	66	39%	18%	26%	13%	4%	26.10
North East	Northumberland	3450	100	64	36	16%	20%	41%	20%	3%	34.50
East Midlands	Nottingham	2009	76	55	21	34%	25%	26%	12%	3%	26.43
East Midlands	Nottinghamshire	8866	287	204	83	32%	19%	28%	14%	7%	30.89
North West	Oldham	1786	44	32	12	2%	23%	59%	5%	11%	40.59
South East	Oxfordshire	5629	131	51	80	14%	14%	34%	34%	5%	42.97
East of England	Peterborough	1334	37	26	11	32%	19%	24%	8%	16%	36.05
South West	Plymouth	2467	99	79	20	31%	23%	35%	10%	0%	24.92
South East	Portsmouth	1147	39	29	10	23%	28%	36%	10%	3%	29.41
South East	Reading	838	32	27	5	53%	16%	13%	9%	9%	26.19
London	Redbridge	1373	80	69	11	64%	18%	11%	4%	4%	17.16
North East	Redcar and Cleveland	1348	46	34	12	22%	30%	33%	11%	4%	29.30
London	Richmond upon Thames	946	44	36	8	59%	11%	16%	7%	7%	21.50
North West	Rochdale	1711	58	43	15	22%	31%	34%	9%	3%	29.50
Yorkshire and The Humber	Rotherham	2331	82	58	24	39%	21%	18%	16%	6%	28.43
East Midlands	Rutland	419	12	9	3	8%	33%	42%	8%	8%	34.92
North West	Salford	1460	44	30	14	20%	23%	39%	14%	5%	33.18
West Midlands	Sandwell	2119	83	56	27	46%	14%	24%	11%	5%	25.53
North West	Sefton	3775	133	95	38	25%	24%	38%	11%	3%	28.38
Yorkshire and The Humber	Sheffield	4253	112	68	44	19%	20%	29%	25%	7%	37.97
West Midlands	Shropshire	3485	117	83	34	30%	17%	36%	12%	5%	29.79
South East	Slough	465	16	11	5	38%	25%	13%	19%	6%	29.06
West Midlands	Solihull	2107	65	49	16	38%	14%	17%	18%	12%	32.42
South West	Somerset	6473	216	158	58	29%	25%	27%	12%	7%	29.97
South West	South Gloucestershire	2202	81	56	25	35%	26%	19%	16%	5%	27.19
North East	South Tyneside	1292	34	22	12	21%	12%	32%	32%	3%	38.00
South East	Southampton	1522	59	49	10	37%	31%	19%	8%	5%	25.80
East of England	Southend-on-Sea	1946	92	78	14	24%	48%	23%	4%	1%	21.15
London	Southwark	580	17	14	3	41%	6%	29%	12%	12%	34.12
North West	St. Helens	1366	38	25	13	8%	32%	39%	16%	5%	35.95
West Midlands	Staffordshire	8028	252	169	83	29%	17%	33%	15%	6%	31.86
North West	Stockport	2443	65	45	20	12%	26%	37%	15%	9%	37.58
North East	Stockton-on-Tees	1971	53	34	19	23%	19%	30%	19%	9%	37.19
West Midlands	Stoke-on-Trent	2388	84	67	17	36%	24%	24%	11%	6%	28.43
East of England	Suffolk	7389	194	129	65	15%	18%	38%	23%	6%	38.09
North East	Sunderland	2483	84	56	28	40%	5%	40%	12%	2%	29.56
South East	Surrey	13865	423	272	151	37%	13%	22%	19%	9%	32.78
London	Sutton	1429	79	58	21	58%	18%	18%	4%	3%	18.09
South West	Swindon	1286	51	37	14	47%	14%	24%	12%	4%	25.22
North West	Tameside	1639	38	26	12	3%	11%	63%	16%	8%	43.13
West Midlands	Telford and Wrekin	1157	39	28	11	38%	13%	26%	21%	3%	29.67
East of England	Thurrock	753	32	26	6	50%	16%	19%	9%	6%	23.53
South West	Torbay	2095	84	69	15	15%	43%	38%	2%	1%	24.94
London	Tower Hamlets	352	10	7	3	40%	10%	20%	20%	10%	35.20
North West	Trafford	1685	57	36	21	35%	21%	25%	11%	9%	29.56
Yorkshire and The Humber	Wakefield	2722	93	73	20	30%	29%	22%	14%	5%	29.27
West Midlands	Walsall	1797	59	43	16	32%	15%	36%	14%	3%	30.46
London	Waltham Forest	927	50	47	3	54%	24%	14%	6%	2%	18.54
London	Wandsworth	1569	32	18	14	34%	13%	13%	16%	25%	49.03
North West	Warrington	1980	56	36	20	38%	7%	29%	20%	7%	35.36
West Midlands	Warwickshire	5417	170	118	52	31%	14%	32%	18%	5%	31.86
South East	West Berkshire	975	46	35	11	61%	13%	7%	17%	2%	21.20
South East	West Sussex	10084	349	232	117	23%	27%	37%	11%	3%	28.89
London	Westminster	371	12	7	5	50%	8%	25%	0%	17%	30.92
North West	Wigan	2262	55	29	26	7%	15%	56%	18%	4%	41.13
South West	Wiltshire	4814	176	131	45	40%	19%	19%	16%	6%	27.35
South East	Windsor and Maidenhead	1722	41	19	22	24%	17%	22%	12%	24%	42.00
North West	Wirral	3636	122	78	44	24%	27%	30%	14%	5%	29.80
South East	Wokingham	1419	53	40	13	45%	19%	13%	15%	8%	26.77
West Midlands	Wolverhampton	2321	71	49	22	23%	30%	24%	15%	8%	32.69
West Midlands	Worcestershire	5789	181	118	63	24%	17%	39%	17%	4%	31.98
Yorkshire and The Humber	York	1565	39	26	13	18%	18%	31%	18%	15%	40.13

National		458459	15321	10947	4374	30%	22%	30%	13%	5%	29.92

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Contents

Appendix 1: Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021

Additional material from the DHSC following the oral evidence session on 13 July 2021

Region

Local authority name

# of care home beds

# of care homes

# of care homes without nursing

# of care homes with nursing

% of care homes with 1 to 10 beds

% of care homes with 11 to 25 beds

% of care homes with 26 to 50 beds

% of care homes with 51 to 75 beds

% of care homes with 76+ beds

Average care home size