Doctors and nurses must urgently be deployed to fight coronavirus in care homes, care bosses have said, as the largest operators announced sharp rises in their death tolls.
Care UK, which runs 122 homes in England and Scotland, revealed a 65% increase in deaths in just four days and said the virus had reached 70% of its homes. Four Seasons Health Care, which operates 190 homes, said fatalities had increased by 60% in six days, with nearly two in three of its homes affected.
Ministers have continued to cite a figure of 217 care home deaths across England and Wales, which was published last week by the Office for National Statistics with a three-week time lag. But five of the largest providers contacted by the Guardian have now recorded at least 1,052 deaths between them from confirmed or suspected cases of Covid-19.
By Friday, 412 people had died in homes operated by HC-One, Britain’s largest care home provider, an increase of a third in four days.
“Social care is clearly on the frontline, yet we haven’t drawn up a fully fledged battle plan,” said Vic Rayner, executive director of the National Care Forum, which represents charitable care home networks. The forum wants medical staff and clinical equipment urgently targeted at care homes.
Rayner said homes had been forced to “second guess” how to treat the disease. “We are not focusing enough attention at a medical level on how best to keep people safe in these environments. We always knew these were the most at-risk groups, but we haven’t responded to an unprecedented situation with an unprecedented plan as we did in hospitals.”
UK care homes are not typically staffed by doctors or registered nurses. Residents’ health is overseen by GPs, who have been restricting consultations to phone or video calls to avoid contagion.
Doctors say this is sufficient to draw up a treatment plan in most cases, but it has left some care staff feeling isolated as the virus sweeps through homes. In the largest networks, 50% to 70% of properties are affected – many times higher than the 13.5% estimated by England’s chief medical officer, Chris Whitty, last week.
MHA, the largest charitable provider of care homes, has recorded at least 251 deaths, an increase of 20% in three days. Barchester reported 130 Covid-19 deaths, with a further 66 dying after hospital admission, and cases in half of its 230 homes. Bupa, one of the largest providers, with more than 120 homes, declined to reveal its death toll but said it was updating residents, relatives and the sector’s regulator.
Care England, which represents some of the largest providers, estimated last week that the number of deaths across all care homes could already be as high as 7,500, while a National Care Forum survey suggested more than 4,000 had died from Covid-19 in UK residential and nursing services by 13 April.
Such are the rising tolls that some bereaved relatives have complained of pressure from care home operators to arrange the rapid removal of the dead.
“Where there have been several deaths, care homes are applying pressure to families to remove [bodies] quickly,” said Helen Wildbore, the director of the Relative and Residents Association. “At a time when you are grieving and emotional, it is the last thing you want to think about.” She added that many funeral directors lacked the capacity to help at short notice.
Research by London School of Economics academics suggests that if the UK follows international trends, care homes could ultimately account for around half of all deaths from Covid-19.
Updated figures from the Long Term Care Policy Network show that in Italy, Spain, Portugal, Ireland, France, Belgium, Norway and Canada, the proportion of all Covid-19 deaths that occurred in care homes ranged from 33% to 64%.
Dr Richard Vautrey, chair of the British Medical Association’s GP committee, said: “We do need to identify the patients in our care homes that would benefit from hospital admission. The worry that hospitals would be overwhelmed has not been the case in most parts of the country.”
Some care homes were told by doctors early in the crisis that they should not expect to send any Covid-19 patients to hospitals, which were expected to face extreme pressures on their capacity from the wider population. Ministers have made clear that this should not happen en masse and that each case must be decided on its merits.
Updated figures on deaths in care homes will not be available from the Care Quality Commission until 28 April. It started asking care homes whether people had died from Covid-19 only on 9 April, two and a half weeks after Boris Johnson announced the UK-wide lockdown.
A Department of Health and Social Care spokesperson said: “Every death from this virus is a tragedy and that is why we are working around the clock to give the social care sector the equipment and support they need to tackle this global pandemic.
“Our adult social care action plan sets out how we are protecting workers by ramping up testing across the system for care workers and their families and ensuring millions of additional PPE items reach those on the frontline.
“The government has announced over £3bn to help local authorities deal with the immediate impacts of Covid-19.’’
