Care homes in London and the North worse hit by COVID-19 than other areas of England New Health Foundation analysis of regional variations in care home deaths

New analysis from the Health Foundation reveals significant regional variation in the impact of COVID-19 on care homes across England, with London and the North of England the hardest hit in terms of the proportion of deaths among residents.

While the South East has seen 2,109 deaths among care home residents related to COVID-19 (more than any other area in England), after adjusting for the number of care home beds within each region, a very different picture emerges. London and the North have had the highest number of deaths per care home bed – 4.68 and 3.16 deaths per 100 beds. Whereas the South East, South West, East Midlands and East of England have had least – 2.47, 1.83, 2.03 and 2.06 deaths per 100 beds, respectively.

A lack of detailed up-to-date data from care homes prevents us from fully understanding which homes are most vulnerable and why. However, the Health Foundation’s analysis identifies several factors that are likely to be playing a role. These include:

• Differences in how the outbreak has spread through different parts of the country and whether care homes had enough time and support to put in place measures to reduce likely routes of transmission from the community and from hospitals.
• Factors related to the staff and residents in individual care homes, including their own health and vulnerability to COVID-19.
• Individual care providers' financial and organisational resources, and their ability to procure PPE and access to testing for staff and residents.
• Regional variation in terms of deprivation. Recent data has shown that those in the most deprived areas are more than twice as likely to die from COVID-19 – nationally, care homes are relatively evenly distributed across poorer and wealthier areas, but within regions the proportions vary widely. Compared to the South, more care homes in the North of England are in underprivileged areas, which might be reflected in increased vulnerability to COVID-19 among care home residents and staff.

Fiona Grimm, Senior Data Analyst at the Health Foundation, said:

'To better understand the effect of COVID-19 on care home residents, just as in the general population, 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. The sector also needs urgent investment to improve the collection of data, so local and national decision makers have the information they need to effectively tackle the virus.

'The government’s strategy for care homes stands in contrast to its approach to the NHS which has seen a more comprehensive and timely response to the pandemic. 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. While no action plan could undo decades of political neglect, questions should be asked as to how many deaths could have been prevented had action been taken earlier.’

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Simon Perry

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