Author: inlogov

Voter ID gets Code Red

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Picture credit: https://www.electoral-reform.org.uk/why-the-governments-mandatory-voter-id-plans-are-a-terrible-idea/

Jason Lowther & Chris Game

‘Code Red’, for anyone even approaching the generation of this blog’s more senescent author, has to cue the memorable final Tom Cruise/Jack Nicholson courtroom scene in Aaron Sorkin’s film, A Few Good Men. Indeed, said author has actually adapted and used it previously in these very columns:

Lieut. Kaffee (Cruise): “Did you order the Code Red?”  Col. Jessup (Nicholson): “YOU’RE GODDAMNED RIGHT I DID!!!”

In the film, ‘Code Red’ is a term used for any extra-judicial punishment or action taken against US marines for the purposes of humiliation or worse. Its function is, essentially, to deal with issues that can’t be solved using the normal legal framework.

In substantial contrast, the UK Government’s Code Red, though hardly a regular feature of our media’s political reporting, is at the very core of our modern-day governmental system. It is a (arguably the) key instrument of the Infrastructure and Projects Authority (IPA), the Government’s centre of expertise for infrastructure and major projects, reporting to the Cabinet Office and HM Treasury.

Formed in 2016, the IPA’s intended function is to increase government efficiency and save public money by monitoring and ‘scoring’ the viability of its literally hundreds of infrastructure and major projects … and does so with an effectiveness that has some Ministers in the present Government viewing it as more of a PI(the)A.  

This already substantial introduction does have a local government-relevant point – promise!  And it is no blog’s function to deliver lecturettes, which in this instance are both available and well illustrated, from the Institute for Government and the IPA itself in its very recent 2022 Annual Report.

What follow, therefore, are a few shortish paragraphs outlining the IPA’s work, and two graphics from that 2022 Report worth, if not the proverbial thousand words, certainly a good many. We then focus on the issue of voter ID in England, reporting the government’s own assessment on the risks involved, and conclude that Government has still not yet shown how voter ID will operate in England without adversely affecting certain minority and disadvantaged groups.

The focus of the IPA’s work is the Government Major Projects Portfolio (GMPP), comprising this year 235 projects with a total Whole Life Cost of £678bn and estimated “monetised benefits” of £726bn, delivered by 18 departments and their arm’s-length bodies.

The projects are divided functionally into four categories, biggest-spending being Infrastructure & Construction (70 projects: £339 bill. whole life cost; £356 bill. “monetised benefits”) – high investment projects, including improving the UK’s energy, environment, transport, telecoms, sewage and water systems, and constructing new public buildings. Dominated financially, and in the IPA’s ‘unfeasible’ delivery confidence rankings, by the Dept for Transport’s HS2 (£72 – 98 billion) and Crossrail (£19 billion+) projects.

Transformation and service delivery covers projects changing ways of working to improve the relationship between government and the UK people, and harnessing new technology. Example: Vaccines Task Force.

Military Capability ispretty self-explanatory. Example: the Future Combat Air System – clever, mid-2030s stuff like uncrewed aircraft and advanced data systems.

ICT projects enable the “transition from old legacy systems to new digital solutions” to equip government departments for the future. Example: Emergency Services Mobile Communications.

Now to the interesting bit: the actual ‘confidence rankings’, or in the above cases of HS2 and Crossrail ‘no confidence rankings’. The official term is Delivery Confidence Assessments (DCAs): judgements of the likelihood of a project delivering its objectives to time and cost.

In essence, it’s a basic traffic light system. Green represents high likelihood of successful delivery of the project on time, budget and quality; amber: successful delivery feasible, but significant issues already exist, requiring management attention; and ‘Code Red’: unachievable, not a cat in hell’s chance; major issues everywhere, with project definition, schedule, budget, benefits – all at this stage apparently irresolvable.

Given the variables involved, it sounds more than a touch crude, and two additional ratings were added: amber/green – successful delivery probable, if given constant attention; and amber/red – successful delivery doubtful, major risks apparent in numerous key areas, urgent action needed.

Usefully added, it seemed, as unqualified amber regularly took between 40% and 50% of ratings (see Fig.7 below). But no, looked at another way, the “average project rating worsened from Amber/Green in 2013 to Amber in 2020” (p.16). It obviously couldn’t possibly be the quality of the proposed projects, so it had to be the assessment system, which accordingly for the 2022 assessments was changed.

But oops! The number of red assessments nearly quadrupled, almost equalling the previous four years’ red totals between them – but that’s OK, because the average project rating, we are assured, “has improved over the past two years”, though it’s not entirely transparent in the second flow chart.

Which brings us back to Code Reds.  Unlock Democracy, the democratic reform campaign group – and also the Daily Mirror – reported last week that “the Government’s own rating system has given the Elections Bill implementation a code red, which is defined as successful delivery of the project appear[ing] to be unachievable.”  Followed by the Association of Electoral Administrators announcing that it “no longer believes it is possible to successfully introduce Voter ID in May 2023.”

The Government’s “Electoral Integrity Programme (EIP)” has been red rated in the IPA’s annual report (see page 58).  The report summarises the Programme as ‘implementing changes arising from the Elections Bill. The Elections Bill makes provision about the administration and conduct of elections, including provision to strengthen the integrity of the electoral process. Reforms will cover: overseas electors; voting and candidacy rights of EU citizens; the designation of a strategy and policy statement for the Electoral Commission; the membership of the Speaker’s Committee; the Electoral Commission’s functions in relation to criminal proceedings; financial information to be provided by a political party on applying for registration; preventing a person being registered as a political party and being a recognised non-party campaigner at the same time; regulation of expenditure for political purposes; disqualification of offenders for holding elective offices; information to be included in electronic campaigning material’.

DLUHC’s commentary on this result noted the deteriorating assessment and added: ‘The IPA Gate 0 Review of February 2022 concluded that the programme Delivery Confidence Assessment is rated Red and that the programme needs to address key risks related to the suitability of the structure, approach and governance given its complexity and delivery focus, suitability of its minimum viable and digital products, and its lack of contingency to deliver against immovable deadlines’.

Reassuringly, the department felt that ‘the programme is addressing these points’.   Meanwhile, the estimated ‘whole life costs’ of the programme jumped from just under £120m to over £145m.

Unlock Democracy’s Tom Brake has reportedly written to Levelling Up SoS Greg Clark saying ‘It would be highly risky to attempt the first roll out of photo voter ID for the largest election in the UK, without having tested it on lower turnout elections beforehand’.  This echoes Jason Lowther’s comment on this blog almost a year ago that ‘The Government has not yet shown how voter ID will operate in England without adversely affecting certain minority and disadvantaged groups.  Until issues such as costs and access are fully addressed, it needs to proceed with caution’.

Chris Game is an INLOGOV Associate, and Visiting Professor at Kwansei Gakuin University, Osaka, Japan.  He is joint-author (with Professor David Wilson) of the successive editions of Local Government in the United Kingdom, and a regular columnist for The Birmingham Post.

Jason Lowther is the Director of INLOGOV. His research focuses on public service reform and the use of “evidence” by public agencies.  Previously he worked with West Midlands Combined Authority, led Birmingham City Council’s corporate strategy function, worked for the Audit Commission as national value for money lead, for HSBC in credit and risk management, and for the Metropolitan Police as an internal management consultant. He tweets as @jasonlowther

Why and how do municipalities merge? A view from the cognitive perspective

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[Photo: https://www.linkedin.com/pulse/mental-virus-flipside-covid-pandemic-dr-abha-bhartia/%5D

Dr. Veronika Vakulenko

Among all public sector reforms initiatives, those appearing on the municipal level are the most tangible. This is because in modern democracies citizens can observe and (if willing to) trace changes in, for example, city planning, local infrastructure, education and many other spheres. Let’s be honest, everyone likes to visit a clean park, modern library, drive perfect roads or celebrate an opening of a new school. Meaning that local governments need to use financial recourses on creating a comfortable place for all to live in. However, it becomes rather common that local governments are not able to balance their budgets, due to a higher per capita spending, lower public service provision, or limited infrastructural capacity, which is the case particularly for smaller rural areas.

Seeking to improve local financial condition, many countries worldwide launched local government reforms, which still remain on the top of agenda among academia and practitioners. Pursuing mainly the objective to enhance local financial efficiency and quality of local public services, the reforms can vary from contractual inter-municipal cooperation to mergers or amalgamations. Mergers are the most drastic reforms as they require alterations of territorial boundaries, changes in administrative responsibilities and routines, and adjustment of financial management practices, all of which affects significantly the lives of citizens.

Several European countries, e.g., Finland, Switzerland, Ukraine, selected to implement voluntary mergers, allowing local governments to celebrate the freedom in deciding whether to initiate the territorial reform. While some municipalities recognized merger’s benefits (i.e., improvement local governments’ economic condition and quality of local public service delivery), others resisted merger. In this situation, it becomes interesting to approach municipal amalgamations from a dynamic perspective to understand behaviour and interactions between different actors, which can result in diverging reform outcomes.

In our recent study published in open access at Local Government Studies, we use an interdisciplinary concept of cognitive style, to explore the psychological aspect of mergers. By mobilizing cognitive literature, we could take a closer look at local actors’ behaviour, to argue that a merger is not a simple ‘marriage of convenience’ of local actors to increase their economic efficiency. Rather, it is a complex cognitive process, which requires local actors’ mental work in taking decisions and creating (or not) a new merged municipality. Thus, a final decision “to merge or not to merge” depends not only on financial benefits, but also on the way local actors perceive and process information about financial incentives and how they operationalize their decisions.

In a story of two neighbouring local governments in Ukraine studied during 2015-2019, we approached two local political leaders, who were drivers of changes on the local level. By studying very carefully their behaviour and actions, we found that their initial perceptions of merging were completely the opposite. While the first one was viewing this as an opportunity and was able to convincingly explain the need and future benefits of this change, as well as introducing new practices to engage local citizens. Despite several other local actors were supporting this initiative, the second leader was acting in a discouraging way and always emphasized risks for their community, which in the end resulted in collective inaction.  To summarize, new interdisciplinary approaches can be used to better understand the success stories or failures of municipal mergers. Cognitive theory in public administration has a significant potential in this field as well as implications for practice. As our case showed, better mapping the sceptics and addressing perceptions of local leaders before initiating voluntary mergers could facilitate better results from territorial reforms.

Dr. Veronika Vakulenko is an Associate Professor at Nord University Business School, Norway. Their research interests include interdisciplinary public sector accounting research; budgeting and financial management in local governments; national and supra-national public sector audit; reforms particularly in the context of developing countries.

The Winding Stair: half a century of local government

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Sir Rodney Brooke

Image: https://talesoftimesforgotten.com/2019/12/18/no-medieval-staircases-werent-designed-to-give-right-handed-defenders-an-advantage/

My memoir, The Winding Stair, chronicles over half a century of my service in local government, a period which coincided with the decline in the importance and independence of local government as well as the biggest social changes since the industrial revolution. As a local authority chief executive, I experienced these changes at first hand.

Post-war local government attempted to tackle the problems of deprivation. Increasingly the emphasis shifted to the problems of affluence. The three post-war decades saw rising living standards, falling inequality, greater freedom and expanding welfare provision. The following decades saw the opposite. The belief that problems would be solved by spending more money evaporated.

Public expectations rose with the decline of faith in post-war remedies, such as urban motorways, multi-storey flats and town centre redevelopments. Communal services were privatised. Ministers introduced innovations before any assessment could be made about the effectiveness of their precursors. Rather than tackle a problem, governments changed the structure of the agency dealing with it. Responsibilities of the state were transferred to the private sector. An underclass of casual workers was created. My local government career placed me in the middle of these changes and my memoir chronicles them.

In my youth local authority chief executives were great men. Among them knighthoods were ten-a-penny. [Not one serving local government officer now has a knighthood]. The London train would be held for the county chief executives, who traced their authority to the Courts of Quarter Sessions for which they were responsible until 1972. They would expect the Permanent Secretary of the Ministry to call on them when they went to London.

The Councils they ran were fundamental in the life of their residents. During my service I was central to some of the most newsworthy issues of the day. I

  • prosecuted for riot;
  • was the last person ever to be responsible for reading the Riot Act;
  • was responsible for the construction of the last municipal reservoir before water supply was stripped from local government in 1974;
  • warned Bradford City football club of the danger before 56 fans burnt to death in front of the TV cameras;
  • enabled the inquest into the notorious death of Helen Smith in Jeddah;
  • challenged the police belief in Wearside Jack’s claim to be the Yorkshire Ripper;
  • refused Willie Whitelaw’s secret request to sack the West Yorkshire Chief Constable over his failure to catch the Yorkshire Ripper;
  • as emergency controller for Yorkshire in the event of nuclear war, was to shelter in an underground bunker in the Pennines before emerging when Geiger counters showed that it was safe;
  • discovered that three Westminster cemeteries had been sold for 15p;
  • found the press camped on the lawn of our house when I resigned before Dame Shirley Porter began her Homes for Votes gerrymandering – which resulted in her being surcharged £42.5m.
  • acquired a knighthood, a CBE and decorations from France, Germany and three other countries.

Sir Rodney Brooke worked for Morley Council (1955-62); Rochdale Council (1962-63); Stockport Council 1963-73; West Yorkshire County Council 1973-1984 (Chief Executive 1980-84); Chief Executive of Westminster City Council (1984-89); Secretary of the London Boroughs’ Association 1984-90; and Secretary of the Association of Metropolitan Authorities (1990-1997). He remains involved with local government on a non-executive basis.

The Winding Stair is available online or from booksellers at £13.99. ISBN 9781838489977

Theresa Stewart: Leader, Lord Mayor, Councillor and Mother

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Chris Game

A few months ago, in blogging about ‘Women in West Midlands Governance’, I noted that in 1975 – not special, simply the year that had prompted the blog – 21 or 17% of Birmingham City Councillors had been women. They included “Theresa Stewart … a future Leader of the Council, Birmingham Lord Mayor, and wife of a Professor John Stewart”, who himself was, of course, for nearly 30 years an INLOGOV Professor, and builder, shaper and almost embodiment of the institution it would become.

There was no cause to mention in that blog that Theresa Stewart had in fact died, aged 90, during the first year of Covid, in November 2020. It did, however, mean that the City Council’s formal Thanksgiving Service for the Life of Honorary Alderman Theresa Stewart – Birmingham (Labour) City Councillor (1970-2002), its so far only female Leader (1993-99), and Lord Mayor (2000-01) – was indefinitely postponed.      

From a purely personal viewpoint, but also arguably more generally, it was one of the more fortuitous Covid postponements. As a work colleague of her husband, Professor John Stewart, I knew Theresa for nearly four decades, including as one of their countless serendipitous chauffeurs.

However, had the Council’s commemoration event not been Covid-prevented from being held relatively soon after her death, I’m not sure it would necessarily have taken the informal, inclusive, family-led and, yes, appropriately celebratory form that it eventually did. Or indeed that I – and possibly even the Clarion Singers’ delightful ‘socialist choir’ – would necessarily have made the invitation list.  

As it was, though, the Thanksgiving took place over an early June lunchtime in the so-called Banqueting Suite in the Council House home of the City Council in Victoria Square. And yes, there were socialist anthems, food, and much non-alcoholic and cross-party mingling after the ‘Service’ itself.

Moreover, the enforced delay allowed the celebration to be highlighted by the formal unveiling – by the Stewarts’ daughter, Selina, and grandchildren – of the portrait commissioned to celebrate their mother/grandmother’s unique contribution to Birmingham’s civic life.  I say ‘portrait’, but the Council seem commendably to prefer ‘artwork’, as I’d guess does Michelle Turton, the Birmingham-based illustrator who created it.  

It should by now be viewable in the Council House’s (Dame) Ellen Pinsent Room – thus renamed in 2018 after the city’s first female (Liberal Unionist) councillor, who, like so many of Birmingham’s subsequent women councillors and MPs, was elected by Edgbaston voters, as a Liberal Unionist in 1911.

The formal rededication of the former committee room had been undertaken by then Honorary Alderman Theresa Stewart in 2018, and both, pleasingly, are now among the 30+ exceptional ‘Pinsent Room women’ – from Olympic heptathlete Denise Lewis to Nobel Prize winner Malala Yousafzai – whose achievements are celebrated in Louise Palfreyman’s fascinating 2018 book, Once Upon a Time in Birmingham: Women Who Dared to Dream.

As already indicated, the commissioned portrait was a kind of double bonus of the Covid postponement – in its own right, but also in its directly involving younger generations of the Stewart family, always at the heart, in every sense, of Theresa’s exceptional life of public and political service.

Not primarily, on this occasion, her lifelong work for, obviously, the Labour Party; or even the almost countless other causes for which she influentially campaigned – hospital standards, the Birmingham Pregnancy Advisory Service (which she founded), family allowances (going to mothers), CND, the miners’ strike, and indeed, just about every aspect of social services and education.

No – for arguably the most striking feature of Theresa Stewart’s ceaselessly active, seven-days-a-week, public life is that already alluded to: that it was totally interwoven with her family life – her immediate and extended family of 17 grand- and great-grandchildren and counting.   

The other obvious feature is that it was very largely focused on ‘local’ government. Exceptionally large-scale local, given it was Birmingham, but, while turning the initially marginal Billesley ward into pretty safe Labour, she resisted most of what must have been regular opportunities to at least consider Westminster – at a time, pre-1997, when under 5% of MPs were women.

Things have progressed, somewhat. Paulette Hamilton’s recent Erdington by-election win increased Labour’s women MPs to 52%, but the Commons total is still barely one-third and the proportion of mothers significantly lower still.

Which is why ‘Dirty Mother Pukka’ – aka Walthamstow Labour MP – Stella Creasy recently launched her VoteMama UK campaign, modelled on the US VoteMama movement. Its MotheRED grants of up to £2,000 are as timely as ever, at least helping – in the absence of maternity rights for MPs – to cover campaign childcare costs and encourage more mothers to stand for Parliament.

Early indications are that even these modest subsidies are attracting particularly single mothers and BAME (Black, Asian and minority ethnic) women. Yet one more worthy cause which Honorary Alderman Theresa Stewart would undoubtedly have backed with enthusiasm.

Pictured: Emeritus Professor John Stewart; Selina Stewart; C’llr Brigid Jones,
Deputy Leader, Birmingham City Council

If anyone would like to see a copy of the Service ‘programme’ – with summaries of Theresa’s life and Council record, and the tributes by Baroness Estelle Morris, Steve McCabe MP, Deputy Council Leader Brigid Jones, and Sir Michael Lyons – a small number are available via [email protected]

__________________________

A version of this blog appeared in the Birmingham Post on 30th June – https://www.pressreader.com/uk/birmingham-post/20220630/textview

The role of scrutiny in navigating our new health and care economy

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Picture credit: https://www.gponline.com/deadline-extended-gp-access-cover-england-brought-forward/article/1456385

Cllr Ketan Sheth

Mortality rates during the pandemic laid bare the health inequalities that exist across the country. Behind these figures lie human stories and grieving families that should remind us of the urgency and importance of understanding and addressing these inequalities.

In Brent, an ethnically diverse North West London borough, we recently set out to do just that.

Systems thinking

We know that Brent residents, who are from ethnic minority communities, disabled, or who are in poverty, experience significant health inequalities; but what does that look like in practice? How are our healthcare systems contributing to and/or compounding inequality? And what can be done to resolve this challenge?

Usually, GPs are the first point of call when someone is not feeling quite right. They ought to help everyone to access timely and safe healthcare. Therefore, reviewing access to GP services is critical and we decided to focus a dedicated scrutiny task group for eight months to report.

By giving ourselves time to understand this complex area in detail, we developed a deep comprehension of the landscape we were going to scrutinise. Patient voices are at the heart of our work, and we worked closely with Brent Healthwatch to ensure those from communities that have been under-represented in these conversations in the past, as well as those experiencing the worst health outcomes, were able to articulate and share their experiences.

Also, the task group held a number of evidence sessions over the course of six months, which were attended by stakeholders across Brent’s health economy. This included council officers, local commissioners and service providers.

All of this enabled the team to make a number of practical recommendations to  Brent Council and NHS partners.

Our work focused on three pivotal areas: Demand, Access and Barriers

With the dynamics of our healthcare and well-being landscape changing locally as well as nationally, it is more vital than ever to ensure all our residents have equality of access and consumption of healthcare services.

We found repeatedly that some groups of patients experience significant, and unnecessary, barriers, specifically:

• Patients of low-income

• Patients with a disability

• Older patients

• Patients whose first language is not English

• Children and young people

• Refugees and asylum seekers

• Patients who cannot access digital technology

Knowing this, GP services must seek to reduce and resolve the barriers experienced by patients, with a focus on deprivation, ethnicity, disability, and other protected characteristics as described in the Equalities Act 2010, if we are to execute our duties under the Act.

We recognise that rising demand, changing patient expectations and workforce retention issues continue to place pressures on primary care. Therefore, it is essential that the NHS continues to plan for this and uses the expertise of healthcare professionals across the system.

The digital transformation to healthcare, brought about by the pandemic, although helpful to some, introduced additional barriers for other people and communities.

In acknowledging the varying levels of ease in which patients access GP service, we strongly believe an access and treatment standard ought to be developed. This will ensure that Brent residents experience consistent and high levels of service: whether their requests are routine or urgent, focused on physical or mental wellness; or made via the telephone, online or in-person.

Our work has been conducted in the spirit of cooperation and partnership, and particularly, we look forward to continuing our dialogue and work with our partners across Brent’s health economy to evolve our shared vision of GP access across Brent.

Cllr Ketan Sheth is Chair of Brent Council’s Community and Wellbeing Scrutiny Committee

Can drama “Help” social care?

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Jason Lowther

Photo credit: https://www.youtube.com/watch?v=5Z2ufAl2lko

Fresh from winning the Grand Jury Prize at the Banff Rockie Awards on Monday, Channel Four’s drama Help was yesterday nominated for Best Drama in the Edinburgh TV awards, with its lead actor Jodie Cromer also nominated for Best Actor.  The drama was one of the most watched on the channel, bringing to millions of viewers the plight of care homes and their residents during the pandemic.  Whilst the Help storyline is fictional, it is based on hard and devastating facts.

In my view, Help could be criticised for its farfetched ending and sometimes unsympathetic rendering of the care home manager, however its characterisation of care home staff and residents is both caring and revealing.  Clearly emotionally affected researching the programme, writer Jack Thorn said: “hearing the stories of those at the frontline, having people break down in tears on zoom in front of us has been incredibly moving and galling”.   

My two favourite parts of the programme (no spoilers) are the endless recorded message of a hopelessly over-run “NHS 111” call centre in the background for several minutes, and Jodie Cromer’s wrenching speech to camera (1:34 on the video) demanding “…underlying health conditions, eh?  When did all lives stop being worth the same?”  The programme ends highlighting some stunning research findings: 40% of Covid deaths in the early pandemic (from March to June 2020) were in care homes; the average wage of a care home worker is £8.50 per hour; whilst government provided 80% of PPE needs for the NHS, it only met 10% of adult social care’s needs. 

This last claim is based on the National Audit Office analysis published in November 2020, which found that the adult social care sector received approximately 331 million items of PPE from central government between March and July (10% of their estimated need) whereas NHS trusts received 1,900 million items sent to NHS trusts (80% of estimated need).  Whilst both fell significantly short of what was required, there is an apparent imbalance here.  Data collected by the Care Quality Commission (CQC) showed that, throughout April and May 2020, more than a fifth of domiciliary care providers had no more than a week’s supply of PPE. 

This situation was well known to the Secretary of State, not least because the LGA and the Association of Directors of Adult Social Services wrote stating “we continue to receive daily reports from colleagues that essential supplies are not getting through to the social care front-line. Furthermore, national reporting that equipment has been delivered to providers on the CQC-registered list does not tally with colleagues’ experience on the ground”.  Nevertheless, in a scene included in Help, during a Downing Street press conference on 15 May, 2020, Mr Hancock said: “right from the start, it’s been clear that this horrible virus affects older people most. So right from the start, we’ve tried to throw a protective ring around our care homes”, repeating in the House of Commons on 18 May that “we absolutely did throw a protective ring around social care”. 

Understanding the human costs of these central government failures is difficult, with the effects on staff, residents and their family impossible to measure objectively.  Help does a good job in illustrating some of the pressures on care staff and the pain of relatives unable to visit dying residents, made all the more poignant now that we know some of the behaviour during the pandemic of senior central government actors such as Hancock’s affair and Johnson’s multiple parties forensically examined in Sue Gray’s recent report. 

Perhaps the most basic measure is in human lives.  Last year researchers used the national death registry of all adult (aged ≥18 years) deaths in England and Wales between January 1, 2014, and June 30, 2020 to compare daily deaths during the COVID-19 pandemic against the expected daily deaths.  They estimated that during the early pandemic, about 26,000 excess deaths (almost half of the total excess deaths) occurred in care homes and hospices.  This is likely to be an underestimate since early in the pandemic, testing of suspected cases was available only in the hospital, whereas routine testing of staff and residents in care homes was not implemented until May 2020.

The latest ONS statistics, issued in February 2022, suggest that since the beginning of the coronavirus (COVID-19) pandemic, there have been over 274,000 deaths of care home residents (wherever the death occurred) registered in England and Wales; of these, 45,632 involved COVID-19 accounting for 17% of all deaths of care home residents. 

Intriguingly, The Lancet reported in March that “COVID-19 has had a disproportionate impact on the mortality of care home residents in England compared to older residents of private homes, but only in the first wave. This may be explained by a degree of acquired immunity, improved protective measures or changes in the underlying frailty of the populations.” Meanwhile, last month the Care Quality Commission finally published data on deaths in each care home during the first year of the pandemic (April 2020 to March 2021).

Whatever the precise figures, it’s clear that adult social care residents and staff were badly let down by central government, far from the Secretary of State’s “protective ring” narrative. This despite the best efforts of care managers, local commissioners and councils discussed in Luke Bradbury’s blog here last week.  Help does a fantastic job of showing the impact of these critical central failures – and recognising the incredible work care staff did in such difficult circumstances with so little financial reward.