Alex Garner and Rachel Stocker (Lancaster Medical School, Lancaster University)
The COVID-19 pandemic has had a major impact on adult social care. The provisional number of care home resident deaths between 28th December 2019 and 12th June 2020 was 93,475 – forty-six percent more deaths than in the same period last year. Twenty-one percent of the total deaths of care home residents in this period (19,394) mentioned “novel coronavirus (COVID-19)” on the death certificate (suspected or confirmed), with other causes accounting for a significant number of excess deaths . Understanding the causes of the excess deaths, as well as understanding how the virus enters and spreads through care homes, is vital to guiding the country’s response to future COVID-19 ‘waves’, or possible future pandemics.
Our work combines quantitative and qualitative research to provide a detailed description of the pandemic in care homes for older people in the North East of England. The quantitative analysis utilises data from the NHS Health Call Digital Care Home app to understand how care homes in the region dealt with the pandemic. Health Call Digital Care Home is an app for smart devices that allows care home workers to refer patient details and observations to clinical teams – the idea is that greater online support enhances care in the homes and reduces hospital admissions and clinician call outs. Data from the app is linked via NHS patient number to hospital data, giving a record of residents’ care across settings over the first lockdown period and beyond, as well as regular patient status updates.
In parallel with the quantitative analysis, interviews are being conducted with staff, residents and families from the same group of care homes, along with community health care staff that support these homes, and key members of the local Health Call implementation team. These interviews will provide in-depth insights into the experience of living and working in and supporting care homes during the pandemic. We will be exploring the challenges and successes in these care homes and the impact on residents, families and staff.
This study is part of a larger programme of work funded by Health Data Research UK; investigating the effectiveness of the Health Call DCH app – which is a collaboration between researchers from four universities and Newcastle upon Tyne Hospitals Trust. This study, led by researchers at Lancaster University in collaboration with the University of Sheffield, Durham University and Newcastle University alongside County Durham and Darlington NHS Foundation Trust, is funded through the NIHR-UKRI COVID-19 rapid response initiative. We will utilise the information from the app and hospitals to gain an understanding of how residents who fell ill (with COVID-19 or non COVID-19 conditions) during this time were managed, and the subsequent outcomes. Combining this with interview findings will provide a detailed account of the pandemic in care homes in one of the worst-hit regions of the UK. Recommendations and guidance for care homes in future ‘waves’ of the pandemic will be provided, alongside strategies to reduce infectious disease spread in these vulnerable environments.
More information about the study is available here:
 – Deaths involving COVID-19 in the care sector, England and Wales: deaths occurring up to 12 June 2020 and registered up to 20 June 2020 (provisional) – ONS