Written Evidence Submitted by The Health Foundation




Adult social care and COVID-19 after the first wave


I am writing to share the Health Foundation’s1 latest analysis2 of the national policy response to COVID-19 in adult social care, and the implications for future government policy.

We hope the briefing provides useful evidence for your Committee’s ongoing inquiry

Coronavirus: lessons learnt.

COVID-19 has had a major impact on people who use and provide social care in England. There have been 27,179 excess deaths among care home residents since 14 March 2020 (a 20% increase compared with recent years), and 9,571 excess deaths reported among people receiving domiciliary care since 11 April 2020 (a 62% increase). Social care staff have been at higher risk of dying from COVID-19 than others of the same age and sex.

A key question for the future public inquiry into the handling of the pandemic will be how well government protected people using and providing social care, and what can be learnt for the future. In our new briefing, we analyse central government policies on adult social care in England after the first wave of the pandemic – from 1 June 2020 to 28 February 2021. This follows our previous assessment3 of the national policy response in the early stages of the pandemic – between 31 January and 31 May 2020 – which we published in July last year.

During the first wave, we found that central government support for social care was too slow and limited, leading to inadequate protection for people using and providing care. Since then, we found a mixed picture. Support in some areas improved, such as access to testing and PPE,





1 The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. Our aim is a healthier population, supported by high

quality health care that can be equitably accessed.

2  Adult social care and COVID-19 after the first wave: assessing the policy response in England. Health Foundation. May 2021.

3  Adult social care and COVID-19: Assessing the policy response in England so far. The Health Foundation. July 2020



and the priority given to social care by national policymakers increased. Groups using and providing care were prioritised for COVID-19 vaccines, offering greater protection against the virus. But major challenges remained, policies in several areas continued to be slow, fragmented, and short-term, and gaps in the response risk increasing inequalities.

Long-standing structural issues in social care have continued to shape the policy response and impacts of COVID-19 on the sector. These include chronic underfunding, workforce issues, system fragmentation, and more. COVID-19 also appears to have made some existing problems worse, such as unmet need for care and the burden on unpaid carers.

Government must learn from the COVID-19 response to strengthen the social care system for the future. Short-term actions should include giving the same political priority to restoring social care services affected by the pandemic as to addressing the backlog of unmet need for the NHS, and continuing to strengthen the Department of Health and Social Care’s capacity, expertise, and leadership on social care policy. There also needs to be a robust and clear framework of national policy and financial support to sustain and protect the sector over the rest of 2021 and into 2022. Policy must reflect the diverse needs of people using and providing care

– including services delivered outside care homes and to younger adults.

Fundamental reform of adult social care in England is also needed to address the longstanding policy failures exposed by COVID-19. This reform must be comprehensive and long-term – not narrowly focused on preventing older people selling their homes to pay for care. It should include action to:



If reform continues to be delayed, government will be choosing to prolong major public policy failure and break its promise to provide people with ‘the dignity and security they deserve’.

Continued inaction would also leave the social care system vulnerable to future shocks.


We would be very happy to discuss the findings of our report with you further at any time. I have attached a copy of the full report in my email.


Yours sincerely,



Hugh Alderwick Head of Policy


(27 May 2021)