Northern Ireland (UK) – Resources to support community and institutional Long-Term Care responses to COVID-19

LTCcovid Country Profile – Printable Version

1.01. Population size and ageing context

In mid-2020 the total population in Northern Ireland was 1,896,000, which represents 2.8% of the total population of the United Kingdom. The median population age was 39.2. The share of the population aged 65 and more was 16.9% and share aged 85 and over was 2.1% (Source: Population estimates for the UK).

Update for: Northern Ireland (UK) Last updated: March 8th, 2022

2.02. Deaths attributed to COVID-19 among people using long-term care

The Northern Ireland Statistics and Research Agency publish data on deaths, including those where COVID-19 (suspected or confirmed) is mentioned on the death certificate.

As of March 5, 2021, there had been 2,839 COVID-19 related deaths, with 762 of these occurring in care homes (27%). Furthermore, there had been 997 COVID-19 related deaths of care home residents. Therefore as of Wave 2 care home residents accounted for 35% of all COVID-19 related deaths in Northern Ireland.

As of April 15, 2022, there have been 4,519 deaths COVID-19 related deaths of which 1,270 (28%) were care home residents. 968 deaths have occurred within care homes. There are 14,935 care home residents in Northern Ireland. Therefore, the number of COVID-19 related deaths of care home residents represents 8.5% of this population.

Update for: Northern Ireland (UK) Last updated: May 3rd, 2022 Contributors: William Byrd | Disha Patel |

2.04. Impacts of the pandemic on access to care for people who use Long-Term Care

Impact on access to health and social care services for adults with intellectual disabilities

UK-wide interviews with approximately 500 adults with intellectual disabilities and surveys with approximately 300 family carers and support workers of adults with intellectual disabilities who could not take part in an interview, at three time points during the pandemic, have reported that access to a wide range of health services (including primary care, more specialist therapists, and annual health checks) significantly reduced from before the pandemic to the lockdown in the winter of 2020. Access has improved since then up to the summer of 2021, but not to pre-pandemic levels, with more consultations being conducted by phone rather than face to face.

The picture is similar concerning access to a wide range of social care services, including day services, community activities and short breaks, with the exception of support at home which has continued at consistent levels through the COVID-19 pandemic. Reduced access to many health and social care services was evident for a greater proportion of adults with intellectual disabilities with greater needs, particularly adults with profound and multiple intellectual disabilities.

Update for: Northern Ireland (UK) Last updated: March 8th, 2022 Contributors: Chris Hatton |

2.05. Impacts of the pandemic on the health and wellbeing of people who use Long-Term Care

Impact on adults with intellectual disabilities

UK-wide interviews with approximately 500 adults with intellectual disabilities across the UK reported that in the four weeks before being interviewed in the summer of 2021: 13% of people said they often/always felt angry or frustrated, 15% often/always felt sad or down, 21% felt often/always worried or anxious, 12% often/always felt lonely with no-one to talk to, and 19% of people said they had a new or worsening health condition. Across all these indicators well-being had improved from previous interviews in winter 2020/21 and spring 2021. In the summer of 2021, 50% of adults with intellectual disabilities interviewed felt at least a little worried to leave the house – this was at a similar level to the winter of 2020/21, reversing an improvement in spring 2021.

The same project included surveys with approximately 300 family carers and support workers of adults with intellectual disabilities who could not take part in an interview. In the summer of 2021, family carers and support workers reported that 14% of people were often/always angry or frustrated in the four weeks before the survey, 12% of people were often/always sad or down, 25% of people were often/always worried or anxious, and 28% were reported to have had a new or worsening health condition in the four weeks before the survey.

Informal carers

In a survey of approximately 300 largely family carers of adults with intellectual disabilities across the UK in July/ August 2021, carers most commonly reported their caring role had affected them in terms of feeling tired (66%), a general feeling of stress (60%), or disturbed sleep (53%), with little change compared to previous surveys in December 2020 – February 2021 and April – May 2021.

Update for: Northern Ireland (UK) Last updated: March 8th, 2022 Contributors: Chris Hatton |

2.06. Other impacts of the pandemic on people who use Long-Term Care

Adults with intellectual disabilities and autistic people

Apart from impacts of the COVID-19 pandemic on access to health and social care services and the health and wellbeing of people with intellectual disabilities, UK-wide interviews with approximately 500 adults with intellectual disabilities and surveys with approximately 300 family carers and support workers have reported a range of others impacts on people’s lives. In July – August 2021, largely after COVID-19 restrictions were lifted in England, 19% of people with intellectual disabilities with greater support needs across the UK (including people with profound and multiple intellectual disabilities) were reported to be still shielding. Over a quarter of adults with intellectual disabilities reported that someone they knew well had died (or any cause) during the COVID-19 pandemic. In terms of paid employment, most but not all people with intellectual disabilities in paid employment before the pandemic were in paid employment in July/ August 2021, often via furlough or people’s jobs being held open.

No systematic information is available concerning the impact of the COVID-19 pandemic on autistic people without intellectual disabilities in England.

Update for: Northern Ireland (UK) Last updated: March 8th, 2022 Contributors: Chris Hatton |

2.08. Impacts of the pandemic on people working in the Long-Term Care sector

Mental Health Impacts

Emerging evidence suggests that, since the pandemic began, health and care workers have been at high risk for significant psychological distress. Greene et al. (2020) surveyed a convenience sample (n = 1194) of health and social care workers from across the UK in the summer of 2020, to identify predictors of clinically significant distress (PTSD, anxiety, and depression) during the early phase of COVID-19. The study found that clinically significant distress was common: just under 60% of participants met the threshold for PTSD, anxiety, or depression. This was less likely in participants with higher incomes. Predictors for a clinically significant mental disorder were concerns about passing COVID-19 onto others, being unable to discuss concerns with managers, being stigmatised, and not having reliable access to PPE.

It is noted that the sample only included 14 participants from Northern Ireland, so it is possible that the results are not fully representative of the experience in this part of the UK.

References:

Greene, T., Harju-Seppänen, J., Adeniji, M., Steel, C., Grey, N., Brewin, C. R., Bloomfield, M. A., & Billings, J. (2020). Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19. MedRxiv, 2020.10.21.20216804. https://doi.org/10.1101/2020.10.21.20216804

Update for: Northern Ireland (UK) Last updated: March 8th, 2022 Contributors: Daisy Pharoah |

3.09. Access to Personal Protection Equipment (PPE) in the Long-Term Care sector

Issues with PPE provision has come through in some recent academic literature. For example, a study by Greene et al. (2020), which found that lack of reliable access to PPE in the first phase of the pandemic (before July 2020) was a robust predictor of clinically significant mental distress in health and care workers across the UK. This highlights that the impacts of unreliable access to PPE go beyond compromising physical health of this workforce.

References:

Update for: Northern Ireland (UK) Last updated: March 24th, 2022 Contributors: Daisy Pharoah |

4.05. Reforms to address Long-Term Care workforce recruitment, training, pay and conditions

The ‘Social Care – Making a Difference’ campaign has been developed by the Northern Ireland Social Care Council (NISCC) on behalf of the Department of Health as part of its ongoing work to reform Adult Social Care. The campaign highlights that social care staff are an integral and valued part of the health and social workforce and their work is critical to the sustainable provision of social care services now and in the future. This campaign went live on May 10, 2021 and is centred on local social care workers, whose stories are told through video and photography while highlighting the diversity, impact and importance of social care and the positive difference it makes in people’s lives (Source: Adult social care recruitment campaign launched).

Update for: Northern Ireland (UK) Last updated: March 28th, 2022