Thread by @LucindaRAllen

1/ Part 2 of our assessment of the government's pandemic response in #adultsocialcare out today. @pheebsdunn @hughalderwick @fiona_grimm @AlarillaAnne @RichardnotatKF and I looked at policies between June 2020 & March 2021: health.org.uk/publications/r…
Here's a 🧵on some key points…

2/ COVID-19 has had a sustained & grim impact in social care. 27,200 excess deaths in care homes in England, 9,600 in domiciliary care, staff more likely to die of covid than other adults, people going without much needed care, more people (many women) carrying out unpaid care…

3/ There have been some important changes since last spring:
- Govt boosted national oversight, with a new social care 'taskforce' and a plan for the sector in place ahead of winter
- Access to testing & PPE improved over time
- Many people with care needs were vaccinated quickly

4/ But improvements since June 2020 were from a low base.
Our previous report on the 1st wave concluded that govt support for people who use & provide social care was too little, too late. Claims of 'a protective ring’ around care homes do not hold up ⬇️ health.org.uk/publications/r…

5/ Policy action was still slow after the 1st wave, including to protect staff at higher risk from covid. And there were delays to implementing regular testing in social care settings.
➡️See Roselló et al on the importance of frequent testing of staff: medrxiv.org/content/10.110…

6/ It appears that political priority given to older people in care homes increased after the 1st wave but others were overlooked.
People with learning disabilities initially weren't prioritised for vaccines and CQC raised concerns about their care quality & access to testing...

7/ There was more infection control funding + new 💰 for testing, staffing & discharges.
But there were strings attached, and funding cliff edges (sometimes extended at the last min) created extra uncertainty for providers and are emblematic of govt's short-termism in social care

8/ A lack of quality data in social care constrained the policy response. Data for policymakers improved during the pandemic 📈 but providers & the public often haven't had access. So we only know so much about the impacts on social care, particularly outside care homes

9/ Existing problems in social care & longstanding political neglect continued to shape the response and impact of COVID-19 on social care users and staff (it'd be hard for them not to, eg @DHSCgovuk can't magic policy officials with social care expertise from thin air)

10/ Short term, there's still more national support needed to help people and services cope with COVID-19.
➡️ Restoring social care services affected by the pandemic should be a political priority like addressing the backlog of unmet need for the NHS

11/ There are also signs that more funding is needed to cover pandemic costs for local authorities and social care providers, including new @DHSCgovuk data showing that still not all self-isolating care home staff are being paid full wages: gov.uk/government/sta…

12/ And if the best time to reform social care was twenty years ago, the second best time is now. Govt must stick to its promise on this, and it must not only protect against catastrophic costs but also improve access, staff pay & conditions, quality.. see bit.ly/3379mSQ

With thanks to @SarahDeeny @ADMBriggs @NatashaCurry123 @BecksFisher @berni_hk @25DavidPearson @CharlesTTHF @JenniferTHF and others for reviews and to comms colleagues including @SeanAgass @JonnyCoverdale @pstilwell 🙏