Covid-19: Concern about social care’s ability to cope with pandemics was raised two years ago

Mounting criticism of UK ministers’ failure to prevent the spread of covid-19 through care homes has been fanned by the leak of a government report from two years ago warning that the country was ill prepared for the next pandemic.

Based on the findings of a government simulation of a flu pandemic, codenamed Exercise Cygnus, the 57 page Public Health England document, passed to the Guardian, concluded that the UK would be unable to cope with the “extreme demands” of a flu-like pandemic.

In particular it raised concerns about the social care system’s ability to provide the level of support people needed, raising questions over whether ministers ever implemented any of the document’s 26 recommendations, including boosting the capacity of care homes and staff numbers. It also warned of the challenge facing homes asked to take in patients from hospitals.

Asked recently about the report on Exercise Cygnus, England’s health and social care secretary, Matt Hancock, said he had been assured by officials at his department that “everything that was recommended was done.”

But Martin Green, chief executive of Care England, the largest representative body for independent providers of adult social care, said, “From what we understand, this document set out a range of questions and actions that if they had been followed may have left us in a much better position to navigate the current health emergency.

“It would be really helpful if this document was put into the public domain, as many of the key messages may still be helpful in today’s pandemic.”

Covid-19 has swept through the UK’s care sector. The deaths of at least 6686 care home residents in England and Wales between 10 April and 1 May involved the coronavirus. In some homes covid-19 has claimed dozens of lives.

Staff have struggled with shortages of personal protective equipment needed to limit the spread of the virus among residents, many of whom are highly vulnerable to covid-19.

Liz Kendall, Labour’s shadow social care minister, said, “The report on Exercise Cygnus provided clear warnings that we were not properly prepared for a pandemic. In particular it highlights that local plans for social care were inadequate and that social care services wouldn’t be able to cope with the number of people discharged from hospitals to ensure the NHS had enough beds to meet demand.

“These warnings have now proved all too sadly true as the unfolding tragedy in our care homes shows. Care providers confirm they were not involved in subsequent discussions on how to put these problems right.”

With a third of all covid-19 deaths so far being recorded in care homes, Boris Johnson told parliament on Wednesday: “There is an epidemic going on in care homes, which is something I bitterly regret.”

But this week several care home managers have appeared on television news complaining that their staff were still unable to get antigen tests for covid-19, despite ministers pledging to make 100 000 tests a day available to workers who need them.

The NHS doctor Moosa Qureshi, who with lawyers was campaigning for the release of the full report on Exercise Cygnus,1 said he was considering his next steps.

“I’m not satisfied with a leaked document. I’d like to see complete transparency regarding the raw data behind the Cygnus report, so that the scientific and healthcare communities can analyse it and prepare for any second wave of the pandemic,” he told The BMJ.

“We need complete transparency so that the entire scientific and healthcare community can analyse and challenge data and come up with the informed innovation required to tackle this unprecedented challenge. We also need transparency so that the general public can participate democratically and feel invested in the government’s strategy.”