New report: The COVID-19 Long-Term Care situation in England

Adelina Comas-Herrera, Alan Glanz, Natasha Curry, Sarah Deeny, Chris Hatton, Nina Hemmings, Richard Humphries, Klara Lorenz-Dant, Camille Oung, Selina Rajan, Aida Suarez-Gonzalez

The full report is available here:

Key points:

  • The impact of the COVID-19 pandemic has been severe in England and has affected disproportionally people who use and provide long-term care.
  • Since the beginning of the pandemic and until the 6th November, 15,659 people had died in the care home and their deaths were linked to COVID-19 in the death register. An estimate of the deaths of care home residents (including those who died in hospital) suggests that, until the 13th November, 20.799 care home residents died whose deaths were attributed to COVID-19. An estimate of excess deaths in care homes suggests that 22,948 more people died until the 30th October, compared to the previous 5 years. This would represent around 5% all care home residents.
  • There have also been increased deaths among people receiving care at home, people who work in social care provision, and the people with learning disabilities and dementia.
  • The initial COVID-19 policy responses did not adequately consider the social care sector. A social care action plan was not introduced until mid-April, almost a full month after the Prime Minister announced the country would go into lockdown.
  • With the response almost entirely focused on the NHS, too little consideration was given to the fragmented social care system, which was already in a fragile state prior to the pandemic, and into which many people were being discharged from hospital. Delays in access to personal protective equipment and staff and service user testing are likely to have contributed to the high death toll in the sector.
  • Since the first wave, there has been improvement in terms of availability of guidance, access to Personal Protection Equipment and testing.
  • In the second wave, care providers continue to face challenges with testing capacity (and speed), visiting policies and the financial implications of the additional costs of the pandemic and decreases in revenue.
  • In the absence of standardised and robust national data on the sector, finding data about the impact of the pandemic on people who use and provide long-term care remains a challenge.
  • The pandemic has laid bare long-standing problems in the long-term care system in England, such as the fragmentation of responsibilities, funding and workforce pressures, as well as the unequal relationship between the health and social care systems and the invisibility of groups such as working age adults with disabilities and unpaid carers in social care planning.


Adelina Comas-Herrera, Klara Lorenz-Dant and Alan Glanz: Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science
Natasha Curry, Nina Hemmings and Camille Oung: The Nuffield Trust
Sarah Deeny: The Health Foundation
Chris Hatton:  Manchester Metropolitan University
Richard Humphries: The King’s Fund
Selina Rajan: The London School of Hygiene and Tropical Medicine
Aida Suarez-Gonzalez: University College London

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