The National Care Forum (NCF) – the leading association for not-for-profit social care – has responded to the publication of the Module 3 report of the Covid-19 Inquiry looking at the impact of the pandemic on the healthcare systems of the United Kingdom.
Vic Rayner, CEO of the National Care Forum commented: “The Covid-19 Inquiry’s Module 3 report has found that our health system was brought to the verge of collapse during the pandemic. In many ways the NHS only ‘coped’ by shutting out the vast cohorts of people who were receiving care and support – that is not coping, that is prioritising the care of some over others. The reality for people working in and drawing upon care and support meant that older and disabled people across a range of different types of care and support were simply not able to access the routine and emergency healthcare they needed.
“The results can be seen in what our members told us was happening: people were not admitted when they should have been, ambulances were delayed or never turned up, the pressure to discharge led to mass, unplanned and rushed discharges not in the interests of the individual, providers found it difficult to access clinical expertise and advice, and people shielding were left with very little information about what they should do or the support they could access.
“Two stark areas the report grapples with are the impact visiting restrictions had upon people and their loved ones, particularly in palliative care, and the impact of the inappropriate use of DNACPRs.
“When it comes to visiting, the report highlights the inconsistencies in visiting guidance and calls for guidance to be published for hospitals in the event of a future pandemic. This doesn’t quite get to the nub of the issue: it is fundamental to the provision of good care and support, as well as an individual’s human rights, that relationships and connections with loved ones are actively supported and maintained
“Since the early months of the pandemic, and in our evidence to module 6 of the Inquiry, we have pushed for access to what we called an ‘essential care giver’. Since then, over 100 organisations representing millions of people, have come together to support Care Rights UK’s campaign to introduce a legal right to a ‘Care Supporter’: a trusted loved one to provide support and advocacy in all health and care settings. We’d encourage the government and Inquiry team to look at the proposed ‘Gloria’s Law’.
“In my evidence to module 6, we also outlined the concerns our members raised about NHS colleagues applying blanket DNACPR orders on people with learning disabilities and older people under their care, without involving the individuals or families or taking into account each person’s individual circumstances. There was no excuse for this practice, and the fact it persisted through the pandemic, despite our warnings, is incredibly concerning. The report’s recommendation for a standardised process for advance care planning across the UK while welcome won’t deal with the clear cultural problem that needs to be addressed with how our health system views older and disabled citizens. It is striking that the report fails to make a connection between the use of the Clinical Frailty Scale, the inappropriate use of DNACPRs and other tools, in denying treatment to disabled and older people in receipt of care and support – that is a more fundamental issue than lack of standardisation or inconsistent approaches.”
Vic Rayner concluded: “It is clear then that our health system did not in fact ‘cope’ – the response to the pandemic revealed the inequalities at the heart of our NHS as many people in receipt of care and support were unable to access vital healthcare. As we await the Module 6 report on the care sector, we urge Baroness Hallett to more clearly outline the very real impact of strategic decisions made by key health officials had on disabled and older people – only then can we start to identify and address the inequalities that exist.”
