Significant regional variation in COVID-19 care home deaths

Care homes in London and the North of England have been hit harder by COVID-19 than those in other parts of the country, new analysis has shown.

(Photo: manonallard/Getty Images)
(Photo: manonallard/Getty Images)

The research by think tank the Health Foundation found significant regional variation in the impact  COVID-19 has had on care homes across England.

Meanwhile, data published by the Office of National Statistics (ONS) on Tuesday showed that, up to the week ending 15 May, there have been 11,650 deaths related to COVID-19 in care homes.

Although the number of deaths is falling, overall death rates in care homes for the week ending 15 May remain more than twice what would be expected based on a five-year average.

Regional variation

The Health Foundation analysed deaths up to the week ending 8 May and found that, with 2,109 deaths, the South East had the more deaths involving COVID-19 among care home residents than other areas. However, London, the North East and the North West had the highest number of deaths per care home beds at 4.68, 3.16 and 3.06 deaths per 100 beds respectively.

The South West had the lowest number of COVID-19-related deaths with 1.83 per 100 beds. Full results are shown in the graph below.

The Health Foundation said that a lack of detailed, up to date data from care homes made it difficult to establish which care homes were most vulnerable and the reasons for this.

However, it said the regional variations in death rates could be explained by differences in how the outbreak had spread through the country, which could have given care homes in some areas more time to put in place infection control measures, and regional variation in terms of deprivation.

Impact of deprivation

Recent analysis by the ONS has shown that people in the most deprived areas of England have died at more than twice the rate of those in the least deprived areas. The Health Foundation pointed out that more care homes in the North of England are in deprived areas, compared with the South, which could mean care home residents and staff in the region were more vulnerable to COVID-19.

Other reasons for the variation could be related to individual providers' finances and their ability to procure PPE and access testing for staff, the foundation said.

The government has announced an additional £600m in funding for care homes as part of its COVID-19 action plan for social care. The Health Foundation said that it was vital that the 'money goes where it's needed', suggesting that some areas of the country may be in 'more need of support than others'. It said that investment in data and technology in social care was also essential in order to help local leaders to understand why some areas are harder hit and effectively tackle the virus.

As part of the second phase of the NHS's response to COVID-19 in England GP practices have been asked to provide enhanced support to care homes, which involves undertaking weekly check-ins with homes in their patch. Practices were given just two weeks to set up the scheme, which in most areas will be delivered at PCN-level. Last week NHS England welcomed a 'record response' from practices, revealing that all care homes now have a named clinical lead in place.

'Avoidable loss of life'

Health Foundation senior data analyst Fiona Grimm said: ‘To better understand the effect of COVID-19 on care home residents it is crucial to go beyond the national picture, recognising that certain groups of people and areas of the country are more at risk of infection and even death from COVID-19.

‘The overall mortality data for care homes suggests that a government ‘action plan’ for social care, published nearly a month after the lockdown was introduced, has come too late to stem avoidable loss of life among both care home residents and staff.

'Whilst there remains a lack of data at the national level to monitor these risks, the information we do have on deaths among residents and staff highlights the urgent need to ensure that care homes across all regions have access to adequate PPE and testing to protect both staff and residents.

‘But the emergency that social care now faces is also related to well-known failings in the sector, including years of inadequate funding that is putting many care providers at risk of collapse, and staff shortages linked to poor pay and conditions.’

A DHSC spokesperson said: 'Every death from this virus is a tragedy and our deepest sympathies go out to the families everyone who has sadly lost relatives or loved ones.

'Supporting the social care sector has been a priority throughout this unprecedented pandemic. Our action plan has ensured delivery of millions of items of PPE to care homes and our increased testing capacity is being used to test care home residents and staff, regardless of symptoms. We are also providing an extra £600m for infection control measures in care homes on top of the £3.2bn we have already given to local authorities to deal with COVID-19 pressures.'

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