Matt Hancock stated to the nation at the 15th May 2020 No 10 press briefing, that;
“I want to tell you what we’ve been doing to protect people in care homes throughout the crisis. If we start with the data, in April, 31,203 people died in care homes, of whom 11,560 died with Coronavirus. I’m grateful to the ONS for having responded to the requests to put extra resources into understanding, and measuring all this. Right from the start it’s been clear that this horrible virus affects older people most. Right from the start, we’ve tried to throw a protective ring around our care homes. We set out our first advice in February, and as the virus grew, we strengthened it throughout. We’ve made sure that care homes have the resources they need to control the spread of infection…”
The first document only said this of discharging patients to care homes – “Where applicable to the patient, COVID-19 test results are included in documentation that accompanies the person on discharge.” Note that there was no mandatory requirement to test patients for Covid 19 before discharge.
Paragraph 1.3 sets out the timescale for discharge – “Transfer from the ward should happen within one hour of that decision being made to a designated discharge area. Discharge from hospital should happen as soon after that as possible, normally within 2 hours.”
Essentially this meant that testing before discharge would be impossible – test results could not obtained within 2-3 hours so the stage was set for untested Covid 19 positive patients to be sent into care homes – whose managers at that time had an impossible task of finding sufficient PPE.
The update issued on 2nd April 2020 clearly stated that “Negative tests are not required prior to transfers / admissions into the care home.”
It was then realised that this policy was not working and Covid 19 was spreading rapidly in care homes. Further guidance, published on 15 April, in a Department of Health document headed: “COVID-19: Our Action Plan for Adult Social Care” advised that;
“We are mindful that some care providers are concerned about being able to effectively isolate COVID-positive residents, and we are determined to make sure discharges into nursing or social care do not put residents currently in those settings at risk. We can now confirm we will move to institute a policy of testing all residents prior to admission to care homes. This will begin with all those being discharged from hospital and the NHS will have a responsibility for testing these specific patients, in advance of timely discharge. Where a test result is still awaited, the patient will be discharged and pending the result, isolated in the same way as a COVID-positive patient will be.”
These three official documents clearly show that up until mid April 2020 there were policies in place which demanded that patients be quickly discharged from hospitals to their homes or care homes when testing was not mandatory. Clearly this was not a “protective ring”.
On 25 February 2020 , the official guidance was still that it “remains very unlikely that people receiving care in a care home or the community will become infected”.
This guidance was apparently reproduced on various care home websites and the Public Health England guidance stayed in force until 13 March when it was replaced. This guidance led to a false sense of security and the majority of care homes did not restrict family visits. Likewise, very few families withdrew their relatives from homes. Would they have done so had they been told the full story?
However the new guidance issue on 13th March made no reference at all to testing staff, residents or visitors. Further, the guidance asked that care hones “work with local authorities to establish plans for mutual aid, including sharing of the workforce between supported living and home care providers, and with local primary and community health services providers; and with deployment of volunteers where that is safe to do so.” (my emphasis).
The above documents produced by Public Health England and the Department of Health will be subject to legal scrutiny in the coming weeks.
As the Guardian reported on 29th May 2021 “A woman whose father died of Covid in a care home that admitted an infected hospital patient is demanding that the health secretary release crucial internal documents about his risk assessment before thousands of people were discharged into care homes without tests.
The move is part of a potentially explosive high court case against Hancock, the NHS Commissioning Board and Public Health England scheduled for a three-day trial in October. It is likely to shed new light on this week’s claim and counter-claim between the prime minister’s former chief adviser and Hancock over care homes policy in the first weeks of the pandemic.
Cathy Gardner, who lost her father, Michael Gibson last April, said her lawyer was seeking the key documents before the autumn hearing to decide whether the discharge policy had broken the law. Government research this week concluded that hospital discharges had caused 286 Covid deaths, but the actual toll is likely to be significantly higher when fatalities who were not tested before death are counted.”
It is an insult to the bereaved whose loved ones died in care homes during the pandemic that there is still no prospect of a public inquiry in the near future. It is absolutely shameful that the task of obtaining answers from the Government has been left to individuals with limited resources and a public inquiry, with bereaved families properly represented, needs to commence as soon as possible.