Background Medical emergencies in residential or nursing care homes are common and costly, resulting in ambulance attendance and hospitalisation, with extra pressure on an emergency system severely impacted by the Covid-19 pandemic. The aim of this study was to explore how the number of ambulance attendances to care homes varied before and during Covid-19 pandemic whilst considering the UK national lockdowns.

Methods We used a cross-sectional study design analysing routine data from electronic clinical records from East Midlands Ambulance Service NHS Trust (EMAS) from 2018 to 2021. An interrupted-time series analysis (ITSA) was used to compare the total number of ambulance attendances to care homes per week before and during the pandemic whilst considering the three UK national lockdown periods. Seasonality (i.e., month of the year), call category, deprivation, and rurality were included as covariates in the model.

Results The interrupted time series analysis indicated a significant decrease of 9.9 ambulance attendances to 1956 East Midlands care homes per week during the first lockdown relative to the pre-pandemic period (CI: -19.1, -0.8, p=0.034). This was followed by a significant increase of 13.7 attendances per week in the period between the first two lockdowns (CI: 4.0, 23.5, p=0.006) relative to the first lockdown period. There was no significant change during the second lockdown but there was a significant decrease of 19.7 attendances per week in the third lockdown (CI: -30.5, -9.0, p<0.001) compared to the non-lockdown period preceding it.

Conclusion Ambulance attendances to care homes decreased during the Covid-19 pandemic, were significantly reduced in the first and third lockdowns, and remained lower during the pandemic compared to pre-pandemic levels. Further research is needed to investigate the factors that might have influenced this trend including changes in ambulance service policies, ambulance and care home personnel, and increased death rates in care homes.