Owen Donovan, Senedd Home
Care home testing and shielding failures during coronavirus pandemic highlighted by committee
Health & Social Care Committee
The Impact of Covid-19 on Health and Social Care: Part I (pdf)
Published: 8th July 2020
“The shock of Covid-19 has been so severe, it has shaken our very foundations. Yet, it gives us the chance to reset our course for the future. We can rethink how we support our vital yet fragile social care sector, and re-assess our approach to mental health, bringing services in line with those for physical health. This is the time to be radical, and significant changes for the better can be achieved if we grasp this opportunity.”
– Committee Chair, Dr Dai Lloyd MS (Plaid, South Wales West)
This is the first in what will be a series of reports from the Committee looking at different ways the coronavirus pandemic impacted health and social care.
It’s a long one, but these things always are and it has to be to get the full picture.
- There were grave concerns over lack of PPE during March and April 2020
The distribution of Personal Protective Equipment (PPE) in Wales was organised by the NHS Shared Services Partnership and local government joint equipment stores.
Updated guidelines on the use of PPE in the care home sector in April 2020 led to confusion as some local authorities had already implemented the guidelines while others delayed by a week or more.
Towards the end of April 2020, a survey of doctors in Wales found that 67% felt they weren’t adequately protected and 60% had to buy PPE directly. During March, 74% of nurses raised concerns about PPE and more than half felt they were pressured into caring for patients without adequate protection. There were also worries that PPE wasn’t properly fitted.
In the care sector, the GMB union told the Committee the sector was completely unprepared for a pandemic, with many care workers using only gloves and plastic aprons. Care Forum Wales said PPE supplies were unpredictable, while other witnesses said suppliers resorted to only dealing with existing clients, which in the end resulted in English suppliers exclusively supplying English care homes.
In the early days of the pandemic, there were only days’ worth of PPE supplies in storage as opposed to weeks; this eventually changed to months’ worth of supply. The Welsh Government actively tried to obtain PPE from multiple sources, including domestic manufacturers, instead of relying on single sources (traditionally China and south-east Asian manufacturers).
Despite this, 90% of Wales’ PPE supplies are imported and the Welsh Government described the situation as “stable, but fragile”.
- Access to tests improved as the pandemic went on, but there were big variations across Wales
While there was initial difficulty in accessing virus tests, the situation improved – albeit with significant regional differences, which were eventually addressed.
One of the biggest regional differences was test turnaround times, with just 36% of people receiving test results within 2 days in the north, compared to 59% in South Wales Central.
When it became clear that the original target of capacity for 5,000 tests a day by the third week of April 2020 couldn’t be met, the Welsh Government dropped it. The reasoning given was that lockdown was reducing the number of new cases overall – a view backed by the Chief Scientific Adviser, Dr Rob Orford.
- Older people’s rights may have been violated during the pandemic due to the care home testing policy
The most controversial issue was the lack of testing in care homes. 28% of all Covid-19-related deaths in Wales happened in care home settings.
The official Welsh Government guidance in the early days was that virus testing was only required where a resident was showing symptoms. The result of this was that people were being discharged from hospital into care homes and neither they – nor the residents or staff in the home they were being discharged to – were testing for Covid-19.
Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), said there was no evidence that releasing asymptomatic patients into care homes contributed to deaths. However, the WLGA called for patients to be tested twice before discharge to avoid “false-negatives” (a test result that says someone doesn’t have Covid-19 when they do have it – one of the arguments made against blanket testing).
The guidance, however, rapidly changed throughout the pandemic and by mid-May, routine testing in care homes (including staff) was authorised – though an initial restriction to care homes with 50+ residents was described as arbitrary.
The Older People’s Commissioner has called for the Welsh Government to be investigated by the Equality & Human Rights Commission for a possible breach of older people’s rights.
£40 million has been made available by the Welsh Government to sustain adult social care services, but the sector was in a fragile state even before the pandemic. There was confusion over what precisely the funding was supposed to cover and concerns that, while welcome, it wasn’t anywhere near enough.
Additionally, there were fears that social care staff who test positive may not be able to afford to take time off work due to the low rates of UK statutory sick pay (£95.85-per-week).
Longer-term, the Committee called for reform of the social care sector and its funding model.
- Shielding was poorly handled
One of the biggest cock-ups during the pandemic was the distribution of 13,000 shielding letters – advising people with serious pre-existing medical conditions to remain at home and avoid face-to-face contact with anyone – to the wrong addresses. This happened because a previous address of the targeted person was used and they subsequently moved.
Parkinson’s Cymru said there was confusion amongst clients over the support that would be available, while other witnesses criticised a lack of shielding instructions for people with learning disabilities and carers.
Additionally, some medical conditions were left off the list of those which would trigger shielding advice as an extremely vulnerable person – including motor neurone disease.
Local government was also only given three days’ notice that shielding exercises would take place, but on a more positive note, the WLGA said the response to the call for volunteers was “fantastic” – the only downside being a lack of co-ordination.
The Committee recommended the Welsh Government re-examines arrangements with supermarkets to ensure there’s sufficient capacity for online shopping and home delivery to meet demand during the winter.
- “Track and trace” may be needed for a year or until a working Covid-19 vaccine is found
Tracking people with coronavirus system and tracing people they will have been in direct contact with is a key measure to suppress new cases of the virus and prevent a second wave.
In what’s probably the most positive part of the report, there was confidence that the system was operating effectively. Pilot programmes had enabled officials to fine-tune the contract tracing scripts and administration of test samples.
While there were few concerns about the number of tests that can be carried out, turnaround times – as mentioned earlier – have been a problem, with 85.6% of tests completed end-to-end within 48 hours (as of 21st June). Turnaround time is important because the sooner people know they have the virus, the sooner they/their household can self-isolate. The Committee recommended all tests to be turned around within 24 hours as soon as possible.
So far, 600 staff have been recruited (mainly from councils and health boards) for the track and trace programme. Though this may need to eventually increase to 1,000 people, due to the fall in new cases it may not be required. Additionally, a single digital platform for contact tracing is yet to be completely rolled-out though it is operational as of 8th June 2020.
Two deaths of people with coronavirus have been confirmed by Public Health Wales, taking the official total to 1,540.
Thirteen new cases were reported over the last 24 hours, taking the total number of cases in Wales to 15,929. There were 2,301 tests carried out on Wednesday.
No fines for keeping children at home when schools reopen in Wales
Education Minister Kirsty Williams says parents will not be fined for keeping their children off school when they reopen in September.
Her comments followed the announcement that all students in Wales will return in September with schools at “full capacity” and only limited social distancing measures in place.
There will however be a fortnight of flexibility at the start of term in recognition that schools may want to focus on priority year groups, such as those new to secondary schools, those sitting exams next summer or those in reception classes.
Speaking at Thursdays press briefing said: “We want all children to be back in September, but I recognise that there may still be lingering concerns.”
“So initially we will not to be imposing fines on parents who choose not to send their children back.
“But we will be expecting schools to reach out to those parents, to do that now… to discuss with parents now any concerns that they may have.
“Of course, we will keep this policy under review, and at some stage we may indeed return to the situation as it was pre-Covid, where fines will be issued to parents.”
Last week the UK government announced that schools and local authorities in England will be able to issue fines of up to £120 to parents whose children do not attend school “without good reason” from the start of the autumn term.
Local councils can issue each parent a fine of £60, which rises to £120 each if it is not paid within 21 days.
If parents do not pay the fine after 28 days, they may be prosecuted for their child’s absence from school.
Tories release wish list ahead of coronavirus review decision
The Welsh Conservative have released a list of changes they want the government to put in place when they announce the result of the review of coronavirus restrictions in Wales tomorrow.
They are urging the government to:
- Relax the 2m social distancing rule (with mitigating measures)
- Require face coverings on public transport and in shops
- Re-open indoor dining
- Re-open campsites
- Re-start services in places of worship (socially distanced)
- Re-open playgrounds and outdoor gyms
- Re-open beauty salons and wellness clinics
- Re-start driving lessons and tests
- Re-open toilets in pubs and restaurants
- Re-start house viewings
Shadow Minister for Covid-19 Recovery, Darren Millar MS, said: “This pandemic is about lives and livelihoods. It has never just been a public health emergency, it’s an economic one too, but the Welsh Labour-led Government is dragging its feet on the reopening of our economy and society.
“There appears to be little rationale behind decisions to re-open some businesses while keeping others closed, if caravan parks can open, why can’t campsites? And if a hairdresser can go back to work, a beauty therapist should too.”
Support for face coverings on public transport, but Welsh Government hits back at claims they haven’t supported bus services during lockdown
- Welcomes the recent relaxation of coronavirus restrictions on travel and acknowledges the adverse impact previous travel restrictions had on personal relationships, mental health and wellbeing and retailers.
- Regrets the failure of the Welsh Government to provide adequate support for Welsh bus operators during the coronavirus pandemic.
- Expresses disappointment that the Welsh Government has discouraged airlines from flying from Cardiff Airport.
- Calls on the Welsh Government to: rule out quarantine requirements for residents travelling to Wales from within the Common Travel Area (Owen: presumably after they’ve been abroad based on the debate); urgently review and increase the support available to bus operators; promote new routes from Cardiff Airport to safe destinations to help it bounce back from the coronavirus pandemic.
Decade of cuts have left bus services in peril
Slamming the Welsh Government’s pandemic movement restrictions as “more draconian and longer-lasting” than any other part of the UK, Darren Millar MS (Con, Clwyd West) said it was important government rules are fair and proportionate.
With lockdown easing, many people will opt to travel by bus, but a decade of cuts and the implementation of social distancing restrictions (i.e. limiting the number of seats in use) should prompt more support for the sector. The Confederation of Passenger Transport said an additional £5.7million a month would restore bus services to pre-pandemic capacity.
While finding a lot to agree with in the Tory motion, Helen Mary Jones MS (Plaid, Mid & West Wales) presented a scenario whereby there was an outbreak in Paris. In those circumstances, wouldn’t it be right for the Welsh Government to be able to require quarantine for someone from the rest of the UK visiting Wales?
“….the (bus) industry welcomes the £29 million that the Government announced on 31 March, but let’s be clear, that was not new money. Also, that money only lasted three months, and those three months have now passed. So, Wales is the only UK nation that has not provided additional funding for support for the industry.”
– Shadow Economy Minister, Russell George MS (Con, Montgomery)
People face a choice between public transport or nothing
Lynne Neagle MS (Lab, Torfaen) said that for many of her constituents, it’s a choice between travelling by public transport or nothing. She supported calls for mandatory face coverings to be used on public transport, both for general public health reasons but also to protect bus drivers – who’ve been disproportionately affected by Covid-19.
Leader of the Opposition, Paul Davies MS (Con, Preseli Pembs.) said the haulage industry has missed out on important grant aid, though Huw Irranca-Davies MS (Lab, Ogmore) praised how quickly Bridgend and Rhondda Cynon Taf Councils, working with First Cymru, managed to bring some bus services back.
“….we’re calling on the Welsh Government to relax the 2-metre rule to 1 metre plus….to ensure buses can run, and other transport bodies can reopen. As UK Covid-secure guidance states….wearing a face covering, thorough cleaning, practising good hygiene, improved ventilation, and using protective screens at 1 metre is broadly equivalent to being 3m apart.”
– Mark Isherwood MS (Con, North Wales)
“Not a serious response to serious times”
Deputy Minister for Economy & Transport, Lee Waters (Lab, Llanelli), thanked transport workers for delivering key services during the pandemic, noting the importance of Cardiff Airport in securing supplies from abroad.
He rejected pretty much every claim made by the Conservatives during the debate and accused them of trying to make public health policy by press conference.
“Our emergency funding will continue to guarantee backing for the (bus) industry. Our support now stands at over £45 million for the first six months of this financial year, and yet today’s motion regrets our failure to provide adequate support. These are serious times – this is not a serious response.”
– Deputy Minister for Economy & Transport, Lee Waters
Guidance on the use of face coverings on public transport in order to allow more people to travel is being considered, but he warned the Senedd that there are trade-offs – such as the impact on the disabled (who might not be able to wear face coverings). He also rejected Conservative criticisms of a lack of support for Cardiff Airport, saying the Tories should put more effort into arguing for a UK Government-led regional airport strategy.
The government-backed amended version – which replaced the original motion and noted support given during the pandemic and working with other UK nations on lifting travel restrictions – was passed by 29 votes to 22 with 4 abstentions.
Inside the Coal Exchange. Photo by Nation.Cymru
Cardiff Council “unlikely to be repaid” as Coal Exchange owner enters administration
Cardiff Council – which spent more than £1 million redeveloping the historic Coal Exchange before selling it to a developer for £1 – is set to lose out as a creditor after the developer entered administration.
The Coal Exchange was in the process of being redeveloped as a hotel. The developers, Liverpool-based Signature Living, reportedly were £25million in debt and had just £17 in their bank account.
Cardiff Council said: “When Signature Living took over the building in 2016, they agreed to repay the Council’s ’emergency work’ costs on completion of the hotel. With Signature Living going into administration there is now a risk that the £1.1m costs will not be recovered.”
£4 million “lifeline” for community sport
Sport Wales has launched a £4million “Be Active Fund” to support grassroots sport and boost participation levels during the recovery from the coronavirus pandemic.
Chief Executive, Sarah Powell, said: “Our clubs and groups are crucial in keeping the people of Wales active. If they don’t stay afloat or they can’t reopen safely, we can expect another crisis – that of inactivity and ill-health. We must not let that happen. Clearly, clubs will need to adapt many of their activities so that they fully adhere to health guidelines and social distancing requirements. The Be Active Wales Fund will help make that possible.”
The Senedd debated the Culture Committee’s report on the impact of the coronavirus pandemic on sport yesterday afternoon.
New build housing. Picture by David P. Howard (CC-BY-SA 2.0).
Conservatives call for action to boost property market
Welsh Conservative Shadow Finance Minister, Nick Ramsay MS, has called on the government to suspend Land Transaction Tax – formerly known as Stamp Duty, to boost the housing market in Wales.
Yesterday chancellor Rishi Sunak announced a temporary holiday on stamp duty on the first £500,000 of all property sales in England and Northern Ireland until March 2021.
The nine-month stamp duty holiday will cost the Treasury an estimated £3.8bn.
Currently in Wales you pay 0% on the first £180,000 of a property, then 3.5% up to £250,000 and 5% up to £400,000.
Last year LTT raised £265 million in revenue for the Welsh Government.
“Land Transaction Tax in Wales is a tax on aspiration with the charge on properties up to £250,000 higher than other parts of the UK such as in Scotland,” Mr Ramsay said.
“The Chancellor’s announcement today on Stamp Duty will see families across England saving thousands of pounds in tax – giving them a much-needed financial boost and to get the economy firing on all cylinders. We need the Welsh Labour-led Government to take action now to give the same boost to families here.”
Responding to the changes announced at Westminster on Wednesday, Finance Minister Rebecca Evans said: “…our Land Transaction Tax currently has the highest starting threshold in the UK, benefitting home buyers in Wales over the long-term. We are actively considering what the SDLT changes mean for our tax rates aligned with our plans to reopen the housing market. We will continue to deliver tax policy that is made in Wales that is appropriate for the economic recovery.”
Schools to recruit 900 extra teaching staff to help students after coronavirus shutdown
The government has announced a £29m support package to help schools when pupils return after the summer break.
The equivalent of 600 extra teachers and 300 teaching assistants will be recruited throughout the next school year, targeting extra support at Years 11, 12 and 13, as well as disadvantaged and vulnerable learners of all ages.
Professional learning resources will also be provided to support the new and existing teachers, in preparation for September.
Staff will be recruited on a one-year fixed term contract and are expected to move into educational roles in the following school year.
Education Minister Kirsty Williams said: “I now want to ensure schools and pupils have the support they need by recruiting extra staff, to support the recovery phase and continue to raise standards as part of our national mission of education reform.”
“I know that teachers and parents across the country share my determination not to lose that momentum. This extra investment and targeted support will ensure that the impact of time away from school over recent months is minimised.”