ONE of the biggest concerns during the coronavirus crisis has been care homes. We have a number of excellent care homes locally but sadly that has not stopped a number of fatalities. What lessons are there to be learned?
As with the testing, tracking and tracing system being copied from South Korea, there are a number of countries that have demonstrated how the highly-vulnerable patients in care homes can be protected.
While France, Spain and Italy appear to have similar fatality levels to us, in Germany it has been lower and Hong Kong has not had a single death in a care home.
There appear to be a number of vital strands to the approaches taken in other countries. The first is much more widespread testing of any care home residents or staff who show symptoms.
The risk in a care home is not just the physical proximity of residents, but the fact staff are coming to and from work every day.
Quickly testing and isolating anyone with Covid symptoms is essential – and possible now in the UK because of the dramatic expansion of testing we have seen in the past four weeks, for which health secretary Matt Hancock deserves great credit.
Given that nearly half of all transmission appears to happen in the early stages when people may not be showing symptoms, I hope we eventually move to weekly testing of all care-home staff (and NHS staff) to pick up people who might be shedding the virus at the earliest possible stage.
There are other things that can be done to reduce the spread of infection before then. The first is the early banning of outside visitors.
This is something we agonised about for too long here, understandably because of the importance of social contact.
There have been many reports of people with dementia feeling confused and dismayed that visits from loved ones have stopped, so any such decision can only be taken with a heavy heart. However challenging, though, it is nonetheless essential for the safety of staff and patients.
The second is to look again at the way protective equipment (PPE) is supplied to the social care sector. The NHS had many of its own challenges but at least benefited from a central supply chain able to put in large orders that were invariably prioritised by manufacturers.
It is much harder for an independently-run care home ordering much smaller quantities – and local providers like Leonard Cheshire told me their supply of higher level protective equipment dried up completely at the start of the epidemic. We need to find a way to safeguard their supplies, just as we now seem to have found for the NHS.
Finally, coronavirus has put into sharp relief how vital the social care sector is if we want every single older person in our country to be treated with dignity and respect.
The division between the NHS and social care goes back to the founding of the NHS when medical care was made ‘free’ but social care means-tested. We are now realising this is an artificial distinction.
If the social care system is not properly funded, vulnerable older people end up in much more expensive hospital beds and we end up with repeated winter crises.
Far better to help people remain safe and healthy in a care home – or even better, their own home.
When I was health secretary I negotiated the first-ever five-year funding settlement for the NHS alongside a ten-year long term plan. My intention was always to do the same for social care next and I know Matt Hancock shares that aspiration.
Let’s hope finally cracking this issue is part of the broader national lessons we learn from this terrible pandemic.