People with deteriorating long-term health conditions during the covid-19 pandemic

Aaron Kulakiewicz; Tom Powell

Background

The Covid-19 pandemic has had a detrimental effect on many people with pre-existing long-term health conditions who have, in many cases, deteriorated faster than usual since the pandemic began. This increased rate of deterioration is due to both the impact of contracting Covid-19, and the measures taken to contain the virus such as lockdowns that reduced social contact. Additionally, an insight published by the Health Foundation in May 2020 outlined reasons why people with long-term health conditions may have had their access to care restricted. These reasons include patients choosing not to access care or treatment, through fears they might contract or transmit Covid-19 or concerns about breaking the lockdown measures, and also patients being unable to get an appointment or the care they needed.

In June 2021 a number of health charities supporting people with long-term health conditions, and organisations representing rehabilitation professionals, contributed to the report Moving forward stronger: Addressing deterioration in people with long-term conditions during the pandemic. This report, coordinated by the Alzheimer’s Society, proposed a strategy to provide support to people living with long-term health conditions in the UK. Organisations, including the Stroke Association, Macmillan Cancer Support and Age UK, contributed short summaries on how Covid-19 has impacted people with long-term health conditions, why a rehabilitation strategy is needed and what an effective strategy needs to include. The joint proposals in the report called on national and local government to:

fully fund a national two-year rehabilitation strategy that ensures people with significantly deteriorated long-term conditions get the therapeutic support they need
appoint a national clinical lead to implement this rehabilitation strategy
ensure local partners – such as local authorities and Integrated Care Systems (ICS) – develop and deliver their own localised rehabilitation strategy, and that each ICS has a regional rehabilitation lead. (Page 3)

Recent government comment on this issue

In response to a Parliamentary Question answered on 15 July 2021 the Government stated they welcomed the ‘Moving forward stronger’ report and “will consider the findings and recommendations carefully.” However, in another PQ answered on 13 July 2021 the government made clear that “There are currently no plans to introduce a specific rehabilitation strategy for people with dementia and long-term conditions.” The Government went on to state:

Guidance is provided to clinical commissioning groups to support them in commissioning rehabilitation services for their local population. The guidance covers the scope and components of good quality rehabilitation and how to compare rehabilitation services locally, regionally and nationally. NHS England and NHS Improvement’s resource ‘Dementia wellbeing in the COVID-19 pandemic’ which includes specific considerations for rehabilitation.

The following PQ response provides future background on Government action to address potential backlogs in care and treatment for people with long term conditions:

Disability: Health Services

29 Jun 2021 | 21290

Asked by: Vicky Foxcroft

To ask the Secretary of State for Work and Pensions, whether the final National Strategy for Disabled People will include a focus on the potential effect of backlogs in care and treatment caused by the covid-19 outbreak on the number of years people with long term conditions have had to live with a disability.

Answering member: Justin Tomlinson | Department: Department for Work and Pensions

The National Disability Strategy will be published in the shortly. The strategy will take into account the impacts of the COVID-19 pandemic on disabled people and will focus on the issues that disabled people say affect them the most in all aspects of life.

Separately, and ahead of the strategy’s publication, the Department for Health and Social Care has already taken comprehensive action to address potential backlogs in care and treatment.

In April 2021, NHS staff completed 1.8m diagnostic tests and began treatment for 1.1m patients, against the backdrop of caring for 400,000 seriously ill COVID-19 patients in hospital since the pandemic began.

The 2020/21 Spending Review provided £1 billion to help tackle the elective backlog and support hospitals to cut long waits for treatment, systems are asked to deliver activity levels above set thresholds in order to access this additional funding as Elective Recovery Funding (ERF).

On 13 May 2021, NHS England launched a £160 million initiative to tackle growing waiting lists. A network of “accelerator” areas has been established to pilot new initiatives, including extra clinics at weekends, virtual assessments at home and new clinics that can complete high numbers of cataract operations.

During the pandemic, £450 million was provided to expand and upgrade A&E departments to reduce overcrowding and improve infection control so we can continue to treat both Covid and non-Covid patients safely.

Library Briefings

In the past two years there have been a number of debates in the House of Commons on various long term health conditions. These debates have included the impact of covid-19 on these conditions. The Library has produced briefing papers for these debates which are included for further background.

House of Commons Library, Access to radiotherapy, 10 January 2022

House of Commons Library, National Stroke Programme and aftercare and rehabilitation services for stroke patients, 19 April 2021

House of Commons Library, Women and Equalities Committee: covid, disability and access to services, 13 April 2021

House of Commons Library, The effect of the covid-19 outbreak on people affected by dementia, 10 November 2020