Intended for healthcare professionals


Covid-19: Care home deaths in England and Wales rise sharply

BMJ 2020; 369 doi: (Published 29 April 2020) Cite this as: BMJ 2020;369:m1727

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  1. Adrian O’Dowd
  1. London

New figures have shown 4343 deaths from covid-19 in care homes in England and Wales in a fortnight, prompting calls for fresh efforts to stop treating people in care homes as “second class citizens.”

On 10 April, the first day the Care Quality Commission (CQC) was able to distinguish whether a death involved covid-19, the figures show 95 deaths among care home residents that were notified to the CQC. Over the next two weeks (10-24 April) the number of deaths increased to 4343, a rapid escalation in mortality.12

On 28 April, when the figures were released, the government announced that it would start to publish daily deaths occurring in care homes alongside those from covid-19 in UK hospitals. The figures include data from the Office for National Statistics and the CQC, the health regulator, for the first time. Care homes must notify the CQC of any deaths among residents within two or three days, and since 10 April it must be informed of whether covid-19 was suspected or confirmed.

On 27 April the total deaths from covid-19 in UK hospitals reached 21 678. The total daily mortality is falling: 586 deaths were recorded in hospitals on 27 April, down from 980 on 10 April.

The Office for National Statistics’ data show that deaths from all causes in care homes rose by 48.5% in a week, from 4927 in the week ending 10 April to 7316 in the week ending 17 April. This compares with a 10% increase (from 8578 to 9434) in deaths occurring in hospitals over the same period and an 11% increase (from 4117 to 4570) in deaths occurring in private homes.

Funding and testing

Sarah Deeny, assistant director of data analytics at the Health Foundation think tank, said, “Today’s [28 April] data highlights the extent of the challenge for the social care sector in caring for the elderly and vulnerable and protecting them against covid-19. The system is clearly in acute need of support and, while the government has proposed a plan of action, more needs to be done in the short and long term.”

Niall Dickson, chief executive of the NHS Confederation, which represents healthcare organisations, said, “The sharp rise in care home deaths is tragic but not a surprise. We need to stop thinking they are part of a different system, a different world.

“That means doing everything locally and nationally to support this critical part of our health and care sector with the right PPE [personal protective equipment], training, and support in infection control, as well as adequate funding. Radical reform is needed so care homes are not second class citizens but working hand in hand with the NHS.”

Vic Rayner, executive director of the National Care Forum, commented, “This data clearly shows us the importance of tracking the impact of covid-19 beyond hospitals. It is essential we know what is happening in care homes and wider communities.

“The numbers revealed today make it more important than ever that we build a ‘ring of steel’ around care homes. They need the right PPE, medical monitoring devices, rapid and comprehensive testing, proper funding, and intensive research to safeguard the people they care for.”

The need for more support in social care during the covid-19 pandemic was underlined in an editorial published in The BMJ earlier this month,3 which said, “The current emergency has exposed once again the need for a universal integrated health and social care service.”

Correction: On 30 April we removed a duplicated word in the headline.