Covid-19: Deteriorating Long-Term Health Conditions

Elliot Colburn Excerpts

Thursday 10th March 2022 Westminster Hall

[Elliot Colburn (Carshalton and Wallington) (Con)]

It is a pleasure to serve with you in the Chair, Mrs Cummins. I congratulate my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill) on securing the debate and thank the Backbench Business Committee for granting it. I join colleagues in thanking a coalition of charities and organisations that have come forward to support us with research and briefings in advance of the debate, particularly the “Moving forward stronger” policy paper.

Prior to being elected in 2019, I also had a background working in the national health service. Never in my wildest nightmares could I have imagined so early on in the job, after leaving the NHS, that we would be dealing with a global health pandemic on the scale of covid-19. It has permanently changed the way we look at and plan health and care services in the UK. In the London Borough of Sutton, where my constituency of Carshalton and Wallington is situated, 600 lives were tragically cut short due to covid-19. I am sure that that number would have been higher had it not been for the dedication, bravery and care of our local health and social care services.

I know that hon. Members across the House have the deepest gratitude and thanks for the unsung heroes. They were not just our doctors and nurses, but associated health professionals, pharmacists, volunteers and all those who stepped up to do their part. Part of the reason why I launched the Carshalton and Wallington unsung heroes scheme was to recognise their dedication. Unsurprisingly, our local health and care volunteers and staff featured heavily among the hundreds of nominations that I received. I cannot possibly name them all, but I would like to thank the St Helier Hospital eye treatment team; Reena, Sanja, Ravi and other local pharmacists; the head of occupational health at Epsom and St Helier University Hospitals NHS Trust; and of course the staff at vaccination centres across Carshalton and Wallington.

At the time of the outbreak of the pandemic, there was very little public discourse—understandably, as we were grappling with something that was unprecedented—about the long-term indirect impacts of the pandemic on our health and social care system. I know that I am not alone in receiving thousands and thousands of cases from constituents during the opening weeks of the pandemic and at its peak, when there were way too many incidences of people with long-term and pre-existing conditions experiencing disruption to their care. Many of them experienced much faster deterioration than would be usual or expected, and I hasten to add that it was through no fault of health and social care staff; it was simply because of the situation that we faced.

Some of the constituency cases that I heard of involved people with long-term cardiovascular problems who were unable to get treatment, spinal cord patients who were not able to be housed appropriately, and people with dementia and Alzheimer’s who were cut off from the social interactions that were crucial to keeping their cognitive and communication skills alive. As an officer of the all-party parliamentary group on dementia and someone who has had personal experience of dementia in my family, I would like to focus on this area.

In the London Borough of Sutton there are over 2,400 people living with dementia. Based on recent trends, it is estimated that well over 3,000 residents over the age of 65 will be living with dementia by 2030—an increase of approximately 25% in a very short space of time. There are almost 1 million cases of dementia nationwide. People with dementia were badly hit by the pandemic, as indeed were many people with long-term conditions. Dementia was the most common pre-existing condition for people who died from covid-19: people with dementia accounted for more than a quarter of all covid-19 deaths in England and Wales during the first wave of the pandemic.

However, the effect of the pandemic on people living with dementia goes far beyond the statistics. Tragically, they have also seen accelerated progression of their conditions, for a number of reasons. We know that social contact is very important for people living with dementia, but it was of course restricted—again, for a very understandable reason. That has exacerbated the issues for people living with dementia. For people living in care homes, where more than 70% of residents have a form of dementia, the restrictions were particularly serious, given that the Office for National Statistics estimates that 97% of care homes were closed to visitors at one point.

People with many long-term conditions, including dementia, rely on rehabilitation services to maintain their skills and abilities. When provided with the right support, rehabilitation services can help people living with dementia to maintain their cognitive, social and emotional skills, as well as meeting their physical needs and any other related conditions. As mentioned by my hon. Friend the Member for Bromley and Chislehurst and the hon. Member for York Central (Rachael Maskell), those services were not able to meet everyone’s needs at the height of the pandemic. That was particularly true for people living with dementia, whose condition often makes it difficult for them to engage digitally, even if the service could be provided that way, which means that many people living with dementia have not been able to preserve their skills in the way that they could have done. That is exactly what happened to my constituent’s mother who is living with dementia and saw a dramatic deterioration during the first wave of the pandemic, suffering severe memory loss by the time she could meet her family again.

For those living with dementia, interaction with family is not just a nicety. It actually forms an integral and formal part of their care and treatment plan, as there is a causal link between lack of social interaction and the worsening of the condition. As we now emerge from restrictions and come out the other end of the pandemic, the long-term impact on the NHS, the care sector and people living with dementia will continue. I welcome the determination shown by the Department of Health and Social Care in dealing with the elective backlog. It is a mammoth task.

I also want to congratulate my own local NHS trust—Epsom and St Helier University Hospitals NHS Trust— for the work it has done. Previously, I welcomed the announcement of £500 million both to upgrade Epsom and St Helier hospitals and build another hospital in the London Borough of Sutton. I particularly want to applaud the trust’s ingenuity. As soon as it realised the scale of the pandemic, it had the foresight to amend its plans for the development of the new hospital to ensure that it can future-proof itself against future pandemics.

I believe we need to see determination from the Department to deal with the backlog of deterioration that we have seen among those with long-term conditions. I join colleagues and the coalition of charities and organisations in support of that national rehabilitation strategy for everyone who has seen their long-term condition progress throughout the pandemic. If planned properly, the rehabilitation strategy is an opportunity to reduce pressure on other services in our health and social care system.

Colleagues will have heard plenty of examples of people in their constituencies ending up in hospital needing round-the-clock care for entirely avoidable reasons, such as a fall. If we help people maintain the skills they have, they will be less likely to require support from acute care. The Alzheimer’s Society estimates that up to 65% of emergency admissions for people living with dementia could be avoided. Both rehabilitative and memory services are under significant pressure, and the waiting lists are still getting longer. That means that we need strategies to deal with the backlogs. With the right planning, we can not only overcome these issues but deliver better, more personalised support, because people living with dementia deserve nothing less.