The UK Covid-19 Inquiry on Adult Social Care: Residents, Families, Staff and the Costs of Not Listening

In The Guardian today was an article by Jessica Murray, “UK government failures led to Covid spreading ‘like wildfire’ in care homes, inquiry finds.” It is based on a report  ‘Module 6: Care Sector,’ just released by the Rt Hon the Baroness Hallett DBE, as part of the UK COVID-19 Inquiry.

For those of us who work in and around healthcare workforce resilience, the report on adult social care is very much welcomed. It provides an important and careful account of what happened to people receiving care, their families and staff. Those who conducted the Inquiry and contributed evidence, particularly those revisiting painful experiences, deserve real thanks. 

Its findings matter. The Inquiry concludes that care homes were too often treated as an afterthought, that the drive to protect hospital capacity came at considerable cost to social care, and that failures around testing, PPE, hospital discharge and infection control contributed to devastating consequences for residents and their families. “More than 43,000 people died from Covid-19 in UK care homes between March 2020 and July 2022” (⁠The Guardian).

It is also important that the report recognises what happened to staff. Care workers were trying to hold an already fragile system together amid staff shortages, inadequate PPE, rapidly changing guidance and extraordinary personal risk. The Inquiry evidence describes a workforce that was already understaffed, underpaid and undervalued before the pandemic. (⁠The Guardian)

But there is a difficult question that needs to sit alongside the findings. Who working anywhere near social care at the time did not know that something was going badly wrong?

That is not the same as saying that everyone knew precisely what should have been done, or that the evidence available then was as clear as it is now. It wasn’t. But many of the central problems were being raised, repeatedly, by people working in the sector, families, professional organisations and others trying to get decision makers to listen. The fragility of social care was hardly a secret. Indeed, my reading of the evidence submitted to the UK COVID-19 Inquiry is that it was already well known to those working in and caring for people in the sector.

For many people, then, the report will not simply reveal what went wrong. It will formally recognise things many were desperately trying to say while they were happening.

And that matters because inquiries cannot only be about identifying failures retrospectively.

The harder question is what we change so that the next time people working inside a system are saying, 'Something is seriously wrong here!', it does not require years and a public inquiry before those concerns acquire authority.

What mechanisms will ensure that frontline staff are heard? How will social care have a meaningful voice alongside the NHS in an emergency? How will concerns move quickly enough from workers, residents and families to those making national decisions? And how will we know that anyone is actually listening?

Those seem to me to be among the most important lessons still to learn.