Leaked Whatsapp messages expose how elderly were failed on Covid
Slow decision-making over testing and concerns about PPE and ‘inhumane’ rules revealed in social media exchanges
CARE homes bore the brunt of the coronavirus pandemic, with 46,000 residents dying from Covid across England and Wales in the first two years while staff felt continually “forgotten”.
More than a quarter of all Covid deaths in England and Wales during the pandemic occurred in care homes, a tragedy many families believe could have been avoided if ministers had made the right decisions at the start of the health crisis.
Much of the blame has been attributed to guidance issued in spring 2020 which ordered NHS hospitals to “urgently discharge” all patients “who are medically fit to leave”. It also told care homes that “negative tests are not required before transfers”.
Matt Hancock has since claimed that early mistakes were down to a lack of understanding that the virus could be transmitted by people without symptoms.
But Whatsapp messages between Mr Hancock and ministers and officials show that the then health secretary was expressly warned about the issue on April 8, 2020 – months before testing was mandated for everyone admitted into care homes in England. He was also warned to test staff, the very people he would later blame for carrying the virus from one care home to another.
It was not the only time the Government was slow to act, according to these disclosures.
They also reveal that in Oct 2020 Helen Whately, the social care minister, expressed the view to Mr Hancock that rules preventing visits to care homes were “inhumane” and that residents were at risk of just “giving up” and dying as a result of the impact on their mental health.
One of the most fateful decisions for care homes came on March 17, 2020, the day after Boris Johnson, the then prime minister, urged the public to stop nonessential contact and travel.
It was on that day that NHS hospitals were instructed to discharge thousands of patients in order to free up beds. Just over two weeks later, on April 2, government guidance to care home providers was that “negative tests are not required” for those arriving from hospital, and that patients without Covid symptoms or a positive test could be safely cared for “as normal”.
On April 8, two weeks after the first lockdown came into force, Ms Whately warned Mr Hancock that “lessons learned internationally” showed the need to begin testing all care home staff and residents who had been exposed to the virus – regardless of who had symptoms:
By April 14, the advice to the government to test all residents and staff who had “had Covid contact” was widened by Prof Sir Chris Whitty, England’s Chief Medical Officer:
Later that day, Mr Hancock made it clear he had decided to ignore the advice – a decision that Allan Nixon, one of Mr Hancock’s special advisers, queried.
Care homes were not able to start testing residents or staff without symptoms until the end of April – and the Government did not implement regular testing until early July. By the end of that month, four in every 10 care homes had experienced an outbreak.
On April 15, the day after Mr Hancock declined to order blanket testing for care home admissions, the Government published its social care action plan, which restated the policy of discharging hospital patients into care homes “to free up NHS capacity”. It caused divisions between Mr Hancock and Ms Whately.
Before the document was published, Ms Whately told Mr Hancock: “The discharge policy [is] my biggest concern.”
When she was asked by Mr Hancock if she had agreed a discharge policy with NHS England, she replied:
Later that night, after considering the matter further, Ms Whately shifted her position.
As well as being let down by the testing policy, care homes also struggled to get hold of personal protective equipment (PPE). Some were reduced to begging local nail bars for face masks and other items.
Ms Whately knew PPE supplies to social care were “all over the place” in early April and that there was no one in the supplies team dedicated to overseeing the task full-time. Ministers still failed to get a grip on the situation. A month later, Ms Whately asked Mr Hancock whether he “minded” if she pushed harder on PPE, because she did not “want to take up too much of your time”.
Early in May, Ms Whately again raised concerns around PPE pior to a call with the governent’s procurement tsar.
As Britain entered its second wave in late 2020 and the Government drew up plans for its new “tiers” system of local lockdowns, Ms Whately told Mr Hancock that keeping spouses apart was “inhumane”. Under the new system in England, care home residents who lived in Tier 1 – the level with the most relaxed restrictions – were told that they could only have up to two consistent visitors. Those unlucky enough to live in tiers with tighter restrictions were banned from having visitors at all, unless there were “exceptional circumstances” like “end of life”.
By January 2021, Ms Whately was warning Mr Hancock again that the impact on residents’ mental health could itself be fatal – and that they had to balance the Covid risk of opening up care homes against the death toll from people “just giving up”.
By late spring 2021, Covid cases were finally coming down again. On the morning of May 10, Ms Whately and Mr Hancock discussed how restrictions on visiting in care homes could be loosened.
Ms Whately pushed back against him and asked him to explain the rationale for his caution. The rules for care homes were significantly relaxed one week later, with residents allowed to name five regular visitors. Mr Hancock appeared to turn on a dime and told Ms Whately: “Ok you win.”
A few months into the pandemic, testing capacity was increasing. But not every care home was willing to use the tests available. Ministers discussed how nearly 100 care homes had refused to test for Covid – including 10 in the north of England – amid fears that Covid-positive staff would have to stop working. Seven months later, it emerged that care homes had been allowing Covid positive staff to work regardless.