Exclusive: Almost a fifth of Bedford coronavirus deaths have been in care homes

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Deaths among care home residents have made up almost a fifth of the Borough's statistics

The Bedford Independent can reveal there have been at least 183 COVID-19 (coronavirus) connected deaths in Bedford Borough, with almost a fifth of the deaths occurring in care homes.

This figure accounts for 37 more deaths than those recorded on the NHS England website.

Analysing a range of data sources from the Office for National Statistics (ONS), NHS England and the Care Quality Commission (CQC), the Bedford Independent can reveal that while hospital deaths form the vast majority of the figures, deaths in care homes make up almost a fifth of the cases in the Borough.

The Bedford Independent’s analysis of the most recent publicly available data also found:

●      The first COVID-19 involved death in the borough was in Week 13 / 23-29 March

●      As of 17 May, according to NHS England provisional data on the deaths of patients in hospitals who tested positive for COVID-19 up to 16 May, 146 people had died with COVID-19 in Bedford Hospital.

●      During the period 17 April to 8th May 2020, the CQC were notified of 30 deaths in care homes in Bedford Borough involving COVID-19. Current ONS data on COVID-19 involved deaths in Bedford by place of occurrence up to 1st May, but registered up to 9th May, indicates at least one COVID-19 linked death in a borough care home prior to 17 April, making the overall indicative total of COVID-19 linked deaths in care homes within the borough 31.

●      The same ONS data by the local authority area separately confirms five COVID-19 linked deaths at homes and one in a hospice.

Currently, the Bedford Independent uses NHS England figures to record confirmed cases of coronavirus and only deaths recorded at Bedford Hosptial are included in the figures.

ONS figures on COVID-19 related deaths by Middle Layer Super Output Area (MSOA) from 1 March to 17 April 2020 provide a possible indication as to intra-Borough level COVID-19 death data.

During that time period according to the latest ONS data, there were 231 deaths from all causes in the Borough and 51 involving COVID-19, indicating that more than one fifth (22.08% rounded to 2dp) of all deaths in the Borough during the time period involved the virus.

On a more detailed level, subject to the limitation that a small number of deaths are moved to different MSOAs to protect privacy, the areas of Bedford roughly corresponding to De Parys, Harper, Castle and Kingsway, Brickhill and Putnoe, had the highest COVID-19 death toll during the 1 March to 17 April 2020 period. The ONS map of this data can be found here.

To understand the extent of the overall COVID-19 linked death toll in Bedford Borough and deaths outside of hospital, it was necessary to look at a range of data sources.

Differences in how a death is counted as COVID-19 involved and how and when data was compiled mean that the statistics compiled do need to be treated with caution.

NHS England figures for individual hospital deaths only show figures for patients who died and tested positive for coronavirus.

Both ONS and CQC compiled figures for COVID-19 linked deaths do not require a positive test result.

Instead, ONS statistics count a death as COVID-19 related when COVID-19 is mentioned on the death certificate upon registration. Similarly, the CQC compiles their figures by the mentioning of COVID-19 on death notifications to the CQC from care homes.

Additionally, NHS England release hospital deaths involving COVID-19 data daily with the four immediately preceding days’ figures being provisional.

Meanwhile, the ONS release their statistics weekly and the time lag between a death in the community occurring and being registered may vary considerably.

The CQC supplied data only began to become available at the beginning of this month and also has a time lag.

Notwithstanding these caveats, the figures compiled do provide an initial picture of both the spread of COVID-19 deaths by place of occurrence and a more complete picture than PHE England hospital confirmed deaths alone of the true death toll of COVID-19 in Bedford Borough.

Bedford Independent contacted Cllr Louise Jackson (Lab), Bedford Borough Council portfolio holder for Public Health and Wellbeing, Cllr Christine McHugh (Lib) as the member of the council executive responsible for social care resilience and Cllr Graeme Coombes as leader of the opposition Conservative group on the council.

They were asked for any comments they wished to provide about the data highlighted to them, any further data within the borough they may be able to provide, and whether they thought central government support for local authorities in fulfilling their social statutory requirement during the pandemic has been adequate, especially in light of the recent £600m care home infection control fund announcement.

All three councillors treated the publicly available figures with caution, particularly in view of time lags, though Cllr McHugh stated that ONS data “is the best available but only time will tell how complete it is”.

Cllr Jackson commented that “general testing data is very difficult to provide because people are going to a variety of different places to be tested’ including outside of the borough.

However, there had been ‘a significant increase in testing over the last few weeks as sites have opened up locally and care home testing has commenced.”

On what the local authority was doing to support care homes in the borough during the COVID-19 outbreak, she added, “I am confident that the Adult Services team at Bedford Borough Council have a robust system for checking in with care providers, which includes monitoring outbreaks where they have occurred and working with ELFT to support homes with testing.

“The team are in constant contact with the Borough’s homes and providers across the area, and there is an established pathway to ensure that Covid 19 positive patients are NOT discharged back to care homes.”

Cllr Jackson also described the £600m care home infection control fund announcement as, “an admission that the level of support provided centrally to local government was inadequate, and that the Government push to discharge patients from hospitals, without testing into care homes was absolutely wrong.”

She said, “Directors of Adult Services and Directors of Public Health working together to deliver testing in homes will help. However, the way in which these changes have been communicated has been chaotic.

“The Government’s insistence on handling all of this centrally up until now has undoubtedly resulted in significant numbers of deaths in care homes up and down the country.”

On PPE supply, Cllr Jackson said, “PPE in any setting is important to keep people safe” and referenced stories nationwide of shortages before adding, “In Bedford Borough we have just about managed as I understand it.”

She said that earlier advice about the level of PPE needed in different scenarios and settings ‘was confusing and has caused understandable anxiety for staff’ and though council officers ‘have worked incredibly hard to get the right PPE in place’, government supplies ‘have been sporadic, incomplete and unreliable’.

On testing, Cllr Jackson welcomed that swabbing could now be done in homes for asymptomatic residents and workers, but that these needed to be carried out repeatedly to “really make a difference” and clarity was lacking about testing capacity.

She added that “a robust test and trace programme” needed to be up and running but viewed the government as ‘very slow to recognise this’.

“Although we are continually told that a track and trace programme is coming, it’s not at all clear that the government have got the resources in place to run such a programme, and we aren’t yet sure exactly what the Local Authority’s role will be in this either.

“I’m not a scientist, but I suspect if you wanted an example of how not to design an effective testing programme in a pandemic, this would be it.”

“Moving forward, the details of what Government are going to ask Local Authorities to do continues to be provided in dribs and drabs, so planning is a challenge.

“In Bedford we’ve been doing an awful lot already and the Council’s community hub has helped us to keep track of the needs of the most vulnerable people in the Borough.

“It is incredibly frustrating that we don’t have much-needed clarity – so I think we’ll just have to try to be as prepared as we can be for whatever responsibilities are handed to us further down the line.”

Likewise, Cllr McHugh said, “Care homes have been the frontline, forgotten by government – but not by those of us who know what a vital role the homes and carers fulfil.

“For years we have been calling on government to address the under-funding of the care sector, for instance by funding it via a national insurance scheme so that care costs are not a lottery.”

She also highlighted Boris Johnson’s first speech as Prime Minister on 24 July 2019 where he stated that the government would “fix the crisis in social care once and for all with a clear plan we have prepared…”, yet as the House of Commons research library on the subject states, ‘the already-prepared plan referred to by the Prime Minister has yet to be published’.

Cllr McHugh commented further regarding care homes and whether central government support to local authorities has been adequate.

She said, “The extra financial strain on the care sector was just one of many calls on the COVID-19 funding councils received. The COVID-19 funding has not funded the additional costs.

“The recently announced £600m will be required to fund ongoing PPE, additional staffing, possibly help with travel and accommodation for carers to live in if required.

“I fail to see how it will be adequate for extra costs that will be incurred over a long period.

“The Council liaises closely with care homes in normal times. For the last two months the Council has worked even more closely with all care homes in the borough, signposting them to testing, supplies of PPE, advice on infection control and keeping informed about the staffing situation.”

Cllr Coombes, leader of the Conservative group, said, “I have told the Mayor that the Conservative Group will put partisan politics aside for the duration, though that is not to say we will be uncritical if we think mistakes are being made and there is a better course of action.

“Bedford’s Conservative councillors continue to question the Mayor on the impact of COVID-19 locally, and his response to it.

“Now that the Government has announced a £600m national fund for care home infection control, we will want to see how the Mayor plans to use this to effectively control the spread of infection across the Borough.

“Adult social care is an area where Bedford Borough Council has real influence and the Mayor needs to act responsibly and effectively, in order to better protect the elderly and vulnerable in our care homes.”

Cllr Coombes echoed his Labour and Liberal Democrat counterparts in treating current statistics on the COVID-19 death toll with circumspection and stated that ‘detecting trends or making comparisons between different areas is virtually impossible because of different circumstances from area to area’.

He added that despite this, “it’s clear that COVID-19 is taking a toll on Bedford’s population and it’s important to remember, that people are not just statistics, these are real lives that have been lost to this awful pandemic.”

However, whichever way the statistics are compiled, however accurate and up-to-date they may be, the stories of those who died with COVID-19 and the impact they had on the lives of others and the friends and families left to grieve and remember those who have died are simply not quantifiable.

This article is part of a two-part series looking into the preliminary data for COVID-19 involved deaths in Bedford Borough.

In the second article, the peak of the number of deaths in Bedford Borough during the current COVID-19 outbreak so far, will be charted with limited comparisons to the regional and national trends and presented with visual aids [and with new figures provided by the latest ONS and NHS England data].

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