The chief executive of United Kingdom Homecare Association (UKHCA) has criticised the government over its “lack of interest” in the home care workforce and the people they support during the COVID-19 pandemic.
In an open letter to Stuart Miller, director of Adult Social Care Delivery, Dr Jane Townson highlighted home care providers’ “frustration” over the focus of politicians and civil servants on care homes, at the expense of other parts of the care sector.
The CEO’s comments came in response to Miller’s letter to care providers, which made a request for action on testing and PPE in “all care settings”.
Dr Townson said that while this letter was addressed to all providers, the main focus was on care homes and the “only message” for home care providers was to follow government guidance on PPE.
She stressed that if the government is serious about minimising the spread of COVID-19 among the care workforce and those they support in communities, it needs to fully fund the cost of PPE for care workers and ensure the availability and accessibility of antigen testing, as required for the home care workforce, as well as for those working in care homes.
“As UKHCA has highlighted to Ministers and officials many times, the greatest risk to the correct and consistent use of PPE in homecare is not lack of knowledge of the guidelines, it is lack of money to pay for recommended PPE, in an environment of gross under-funding of home care by central government and local authorities,” she said.
“Whilst there has been some movement downwards in cost of PPE since the start of the pandemic, it remains highly inflated compared with normal times and is unfunded going forward.
“In the first wave of COVID19, additional government funding assisted homecare providers to purchase the correct PPE and remain solvent, for which they are most grateful. Without continuance of suitable emergency funding, there is a substantial risk that many state-funded homecare providers will simply be unable to afford the recommended infection control measures.”
Dr Townson added that most providers in the private-pay part of the home care market have received “little or no support” from the government to date apart from the temporary removal of VAT on PPE, which was welcomed by all providers in the sector, but is “insufficient”.
“People who pay for their own homecare are citizens too and should not have to pay a surcharge for basic public health protection,” she said.
“We call on the government to fund fully the additional cost of PPE for careworkers during the COVID19 pandemic, as well as to ensure adequate PPE supplies and control of price, as a matter of public health and safety.”
On testing, Dr Townson told the director of Adult Social Care Delivery that routine antigen testing for those without symptoms is not available for home care workers, nor is routine testing for home care workers available in areas where there are local lockdowns.
When, on numerous occasions, the UKHCA has raised these examples with officials, Dr Townson said they say “we’ll take that back” and the organisation hears nothing further.
“This adds to the sense that the government is essentially disinterested in the 715,000 people who work in homecare and the 850,000 people per year they support,” she said.
The justification given for not prioritising testing in home care is that a study conducted by Public Health England indicated that prevalence of COVID19 in the domiciliary care workforce was similar to that in the wider population.
But Dr Townson said this “ignores the fact” that people receiving home care are in higher risk categories for COVID19.
“If scientific evidence was really being followed, and a risk-based approach employed, home care workers would be included in routine testing protocols when the R value increases sufficiently to trigger local lockdowns,” she urged.
“Our members have told us, however, that no local systems in lockdown have approached them even to discuss additional precautions, never mind to offer routine testing.”
Reports by officials to meetings the UKHCA has attended recently have made it clear that inadequate laboratory capacity for testing is the underlying reason for the lower prioritisation of testing in home care, as well as for the failure to implement reliable routine testing for care homes.
Dr Townson has suggested creating a similar facility to the Nightingale hospitals that were opened to create more bed space during the start of the pandemic, in order to create additional laboratory capacity for testing.
She concluded: “As a minimum, we ask for the immediate availability of asymptomatic testing for live-in care workers. We also ask for consideration of the need for routine testing of home care workers in areas experiencing transmission rates sufficient to trigger local lockdowns.”