Embargoed until 17:00 Thursday 31 July 2025
As the final day of hearings for Care Sector Module 6 of the UK COVID-19 Public Inquiry concludes today, 31 July 2025, the Homecare Association has called for a revolutionary shift from hospital-centric to community-centric pandemic preparedness, describing the traditional approach as a "fatal flaw" that contributed to over 100,000 excess deaths at home.
Dr Jane Townson OBE, Chief Executive of the Homecare Association, said:
"The pandemic revealed a devastating paradox. Whilst the UK government told people to “Stay at Home, Protect the NHS, Save Lives”, many at home were left without access to healthcare, increasing deaths from non-COVID-19 conditions, such as dementia, cancer and heart disease. The unintended consequence was over 100,000 excess deaths at home by July 2022, only 7% of which were attributed to COVID-19 – a stark displacement that revealed the fatal flaw in hospital-centric emergency planning."
Homecare must be recognised as essential infrastructure
The Association argues that home-based support and care should be treated as essential infrastructure, comparable to water, electricity, or transport networks. With at least nine million people needing or receiving support at home – compared with just over half a million in hospitals and care homes combined – the sector's role is critical to national emergency preparedness.
"Just as we wouldn't plan an emergency response without considering water or electricity networks, we cannot plan a health and care system pandemic response without home-based care and support as critical infrastructure," Dr Townson said.
International models show better way forward
During the pandemic, some successful international approaches prioritised community-based care. In Italy, Dr Luigi Cavanna's revolutionary home-based COVID-19 care achieved hospitalisation rates of fewer than 10%, while regions embracing community-centric models saw death rates six times lower than hospital-focused areas.
South Korea similarly demonstrated that sophisticated medical intervention can be delivered at home whilst maintaining wider healthcare access rather than restricting it, proving that home can be the safest place during a pandemic – if we design our systems properly.
Song tribute honours homecare workers
To mark the conclusion of hearings, the Homecare Association is releasing a song with accompanying video lyrics to honour the extraordinary dedication of the 740,000 professional homecare workers in England who continued to deliver essential care despite significant personal risk, often lacking adequate PPE, testing, or recognition as essential workers.
Three critical themes exposed
The Association's evidence to the Inquiry consistently highlighted three overarching themes:
First, homecare was overlooked in key decisions. Despite supporting nearly one million adults – more than double the number in care homes – ministers and officials focused on protecting the NHS and later care homes, with insufficient awareness of care delivered behind closed doors.
Second, homecare was misunderstood. Decision-makers treated social care as synonymous with residential care for older people, overlooking the diversity and complexity of services delivered at home to people of all ages.
Third, homecare was disadvantaged compared to the NHS and care homes. Access to PPE, testing, vaccines, data, guidance, funding, and professional respect all lagged behind.
Seven pillars for pandemic resilience
Drawing on extensive evidence gathered throughout the pandemic, the Homecare Association has developed seven pillars that must form the foundation of future pandemic resilience:
Pillar One: Embedded Expertise – Social care expertise must be embedded at every level of emergency planning, science advice, and operational command through a standing expert committee.
Pillar Two: Equal Protection – Hospital-grade PPE quality, testing access, vaccines, sick pay, and psychological support must be guaranteed across all care settings.
Pillar Three: Automatic Funding – Emergency support must reach all providers immediately and equitably through pre-established systems, avoiding the bureaucratic delays that characterised COVID-19 funding distribution.
Pillar Four: Valuing the Workforce – Sustainable funding must support professional registration, fair pay, training, and technology adoption. The pandemic accelerated digital care record uptake from 40% to 80%, proving the sector's capacity for innovation when supported.
Pillar Five: Maintaining Healthcare Access – Face-to-face health and care services supported by telemedicine must be protected, not suspended, bringing hospital capabilities to people's homes.
Pillar Six: Modern Data Infrastructure – Systems must capture everyone giving and receiving home-based care, creating the visibility needed for effective pandemic planning and resource allocation.
Pillar Seven: Effective Governance – Continuing oversight with homecare-specific policy development is essential, requiring dedicated governance structures that understand the unique challenges of home-based care.
Looking forward
"The government's 10-Year Health Plan creates an unprecedented opportunity," said Dr Townson. "Its three shifts – from hospital to community, illness to prevention, and analogue to digital – align perfectly with the lessons from this Inquiry."
"We owe it to those we lost and those who served to ensure we learn lessons and implement change that is effective and enduring. The question is not whether we can build better systems, but whether we will choose to do so."
Link to song: Through the Door
ENDS
