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Slow Views

There’s so little care about care homes

Monday 8 February 2021

There are plenty of gaps in the statistics, from the number of vaccinations to even just the number of care home residents. It’s a sign of official neglect

The past week has been full of good news on the vaccine roll-out: record days and the additional message of “Care homes done, target met”.

Except there’s a problem: we have seen no proper data at all on the extent of care home vaccination. There were caveats to the announcement, too: “offered” is not “had”; only “eligible” care homes were counted; and some were not visited due to Covid-19 outbreaks.

So the target has been roughly, sort of hit but not totally and certainly not verifiably. Even though most over 80s and many others in the vulnerable cohorts – including most in care homes – have been jabbed, this vagueness and ambiguity matters.

It matters, first of all, to those involved in the care home sector.

The lack of data on care homes is not new. At no point in the last year, despite many promises and claims, have we had data on the extent of testing for Covid-19 in care homes. The same goes for test and trace in care homes. 

And it’s not just Covid. We don’t even know for sure – haven’t ever known for sure – how many care homes or residents there are, so even if we were told the number of vaccinations, we still couldn’t work out the proportion. The statistical system has shared successive governments’ indifference towards the sector. No one has cared enough to collect the data. 

Had care homes been counted and been properly understood they might have been better protected during the pandemic – and at the forefront of policy, rather than an afterthought. There would have been fewer deaths. 

The lack of data about care homes also matters to anyone interested in public policy and democracy. Public sector institutions failing to collect or give access to key information is not a good thing in principle.

Policymakers need the data. So do those who deliver the service. It was kind of the care minister, last week, to ask radio listeners to get in touch with her if they knew that a home had been missed – but hardly a sign of mega-efficiency. 

Those scrutinising the government from parliament need the data. The media should have it, too, if we want accurate reporting. Denying access is not good for society. It’s how conspiracy theories start.

Over the past few months, we have had various statements about the roll out of jabs in care homes. We were told in early January that a quarter had been jabbed. It was three quarters towards the end of January. And now it’s (basically) all – fitting in with the end January target. We’ll never know if the claims were roughly right as no data was published at any time.  

The statistics regulator (the Office for Statistics Regulation) is meant to sort these things out. It has established rules about the release of data in support of policy statements. But the OSR is under-resourced and weak. It is seemingly unable to touch the NHS, which says these figures are management information not statistics. 

We know more can be done because Scotland has done better. It’s England, really, that has had two months with no real data. 

NHS England ought to explain why we have not been told how many care home residents have been vaccinated. It is running the system that calls up people and records the jab. Either NHS England does not want to share the data or it is incapable of collating it. Neither is good.

Among the many thousands of brave staff and heroic acts, some things have gone wrong in the NHS. It will eventually have to answer questions about the move of elderly patients into care homes without testing for Covid-19; about why so many people caught the virus in hospitals; why so many essential services were halted; and deal with the numerous tales of GPs treating care home residents as second-class citizens. 

But we know nothing about such things as no data is released – or, as far as we know, even collected – on these topics. The NHS is hardly alone, as organisations usually fail to collect or publish data that would put them in a bad light. 

Ministers could be stronger, but they can’t micromanage the NHS or other bodies, such as Public Health England, that are responsible for some of the systems, as they are arm’s-length organisations with a large degree of independence in their governance structures. I’d guess that ministers know little more than we do and are also living off soundbites from health professionals.

Ministers and the public cannot afford to leave data selection, collection and publication in the hands of the people who are the subject of the data. Such self-assessment, coupled with a lack of independent audit, nearly always goes wrong – whether it’s banks in the private sector or the police in the public sector. 

By the same token, leaving public health data solely in the hands of those delivering the service must be wrong. Like any other bureaucracies, they have many conflicting demands on them – and might be tempted to prioritise interests, such as those of its leaders or unions, which will not always align with those of the public or the government. 

Whenever the eventual review of policy during the pandemic happens it must ask what health data should be collected, and by whom. It is vital that policy makers, the media and the population can have a more honest and rounded view of what is going on.  

Then at last, for a start, we would know how many care home residents have and have not been vaccinated.

Simon Briscoe is director of the Data Analysis Bureau