A lack of clarity over the allocation of funding during the pandemic has left many care providers facing an uncertain future.
At the end of April, central government had allocated £6.6bn to support health and social care and £3.2bn to local government to respond to Covid-19 pressures across services.
However, an overview of the response by the Department of Health and Social Care (DHSC) and other bodies during March and April to prepare the NHS and adult social care in England for the pandemic has found allocation of funding to local councils and its spend ‘remains unclear’.
Citing Care Quality Commission (CQC) analysis, the overview by the National Audit Office (NAO) said rising personal protective equipment (PPE) and workforce costs as well as falling occupancy represented a ‘real threat to the financial stability’ of many care providers.
Operators would seek to rebuild occupancy, but it could be 18 months ‘at best to return’ to former levels.
The report said: ‘The CQC has warned of a reduced resilience to future shocks and an increased risk of provider failure in the care sector.’
Between 17 March and 15 April, around 25,000 people were discharged from hospitals into care homes and due to government policy at the time not all patients were tested for Covid-19 before discharge, with priority given to those with symptoms. This changed after 15 April.
On testing of workers, it said: ‘The government does not know how many NHS or care workers have been tested in total during the pandemic.’
The report also highlighted issues relating to PPE, data collection in adult social care, and a lack of ‘meaningful integration’ between health and social care, which made ‘responding to the crisis more difficult in a number of ways’.
Gareth Davies, the head of the NAO, said: ‘The speed and nature of the response in health and social care has been shaped by longstanding differences between the sectors and ongoing financial pressures. Government’s ability to increase beds, ventilators, PPE and testing has varied in part because of the number of other bodies, both national and international, with which it has had to engage. All of these issues need to be taken into account as government plans for the later phases of the pandemic and future emergencies.’
Professor Martin Green, Care England chief executive, said: ‘Let’s be clear about this; the dice were loaded against care homes. The government has attempted to alleviate certain pressures on the sector, but whilst the intention is there the Covid-19 relief funds have not made it to the front line. Instead they have been tied up in a tangle of bureaucratic spaghetti.’
The Local Government Association said it has been ‘calling for a long-term, sustainable funding solution for adult social care since long before the current crisis’ and that the sector ‘now needs certainty about how it will continue to operate and be paid for in future.’
A DHSC spokesperson said the government remained committed to bringing forward a plan for social care.
The spokesperson said: ‘We have been working tirelessly with the care sector throughout to reduce transmission and save lives and a result 60% of care homes have had no outbreak at all, according to the latest Public Health England statistics.
‘Since the launch of whole care home testing, the government has provided over 1 million test kits to almost 9,000 care homes and on Monday we announced that every care home in England will now be offered a coronavirus test for all residents and staff, even if they have no symptoms.’