Tabled by
To ask Her Majesty’s Government which department or
non-departmental public body is responsible for the programme of
COVID-19 testing in care homes in England; and when they expect
all care homes to be offered COVID-19 tests.
The Question was considered in a Virtual Proceeding via video
call.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care ()
(Con)
My Lords, I assure the House that the provision of tests for care
home staff and patients is a number one priority for the
Department of Health and Social Care. We are currently making
available 30,000 tests a day through satellite, mobile and
at-home channels. By early June we aim to have offered tests to
all care home residents and staff specialising in the care of
older people and those living with dementia.
(Lab)
My Lords, the Minister will be aware that there have been stark
warnings from across the sector that, unless testing of staff and
residents in care homes is urgently and significantly improved,
there could be a second peak in deaths, potentially coinciding
with the autumn flu season. Lives are being put at risk and
conditions for dementia sufferers have worsened because of the
continued failure to test hundreds of thousands of staff and
residents. While the DHSC, the CQC and Public Health England will
squabble over who is responsible and what each has or has not
done, the Government’s own recovery strategy document now admits
that they cannot even guarantee that every care home will be
offered testing until 6 June, so we have yet another false and
misleading promise. The Government themselves admit that only
tens of thousands of tests have so far been done in care homes,
and over 1.5 million are needed to cover staff and residents.
Will the Minister explain to the House how he plans to get to
grips with the total and tragic chaos that currently prevails?
My Lords, I completely acknowledge the threat of a second peak.
It focuses the mind and is very much a priority for the
Government, but there is no squabble of the kind the noble
Baroness describes. I pay tribute to colleagues at the CQC,
Public Health England, the NHS and the private care providers
with which we work. Care home testing is offered to all care home
staff and patients who need it. We are prioritising those who ask
for it first and working through the list for any who need it by
early June.
(Con)
My Lords, given the press briefing by Dr Jenny Harries on
Wednesday 13 May, when can we expect testing of all residents and
staff in care homes? Covid-19 infects older people in care homes
at different times. Therefore, a test is valid only on a specific
day. Do the Government understand that one test per resident is
not enough? Repeat tests are often required. Can my noble friend
the Minister say what steps have been taken to increase the
number of tests in care homes to save lives?
The noble Lord is correct: it is one test per resident for each
infection. I pay tribute to the many care homes which have no
infection at all, which have applied the correct disciplines and
systems and for which no demand for the tests is currently
present. We are prioritising homes that have infection and
working through all their residents and staff, offering second
and regular testing until the infection is eradicated. That
logical prioritisation is exactly the right way to use the
resources of both time and supplies, which are necessarily
limited.
(Lab)
My Lords, I welcome the Minister’s reassurances, but is it not
the case that this Question had to be asked because it was not
clear whether the issue in care homes was a priority at the
beginning of this crisis? That is shown by both the release of
hospital patients into care homes and the failure to provide
testing and PPE for their staff and residents. Was it true that
the list of priority sectors at the beginning of this crisis did
not include care homes?
My Lords, it is not true that the list of priorities did not
include care homes. In every epidemic, care homes are always a
priority. History has taught us that and we knew it from the
beginning. We have focused on them enormously; that is why care
homes are a number one priority at the moment. We are determined
to reduce the rate of infection so that infection does not leak
into the community.
(LD)
In a reply during Oral Questions earlier today to my noble friend
Lady Barker, the Minister said that test results for the care
sector are turned around within 48 hours. Yesterday, care home
organisations told the APPG for Adult Social Care that many are
not getting any results back—a big black hole—that those which do
say that 10 days is not unusual, and that local resilience forums
are not being allowed to get the results either. They cannot plan
support. While 6 June is three weeks away, the crisis in our
homes is now. Given his previous Answer, can the Minister give a
date by which all care sector results will be returned within two
to three days?
I think the noble Baroness casts the situation unfairly. There
are undoubtedly cases where test results have taken longer. Last
weekend, a laboratory let us down and we had some delays, but I
pay tribute to the team who turned around a very difficult
situation. By far the vast majority of tests are turned around
within our target time, and we are currently trying to reduce
that time by using mobile and satellite units to take the tests
to residents. That work is showing great and encouraging signs of
improvement.
(CB)
My Lords, will the Minister assure us that the department accepts
that residential care homes exist for those who suffer from
multiple and serious health problems? That being so, can he help
us understand better why, when we have known for months that
Covid-19 was a severe threat to residents and staff, it is still
not possible to guarantee either testing or essential equipment?
I completely acknowledge that one of the most horrible aspects of
this disease is that it targets those who are most vulnerable and
live closely to each other. Care homes are therefore a priority.
I also acknowledge that we started with a very low base of
diagnostic testing and have had to work extremely hard to build
that up. But now that that capacity is there, we are focusing it
on care homes and using innovative methods to get those tests
directly to people. We could not be working harder to get the
right people tested in the care home sector.
(GP)
NHS England recommends to staff that if they have symptoms after
a negative coronavirus swab test they do not return to work,
given the estimates of false negatives of up to 30%. But the
Government’s official advice to someone with a negative test, in
Our Plan to Rebuild, says:
“If a negative test is returned, then isolation is no longer
required.”
What is the Minister’s advice to care home workers after a
negative coronavirus swab test?
No one working in the NHS should go to work if they feel ill or
have a temperature. That is true for anyone working on the front
line, but it is not necessarily true for people who work in
normal workplaces.
(Con)
Is my noble friend aware of the guidance released to the NHS on
24 April announcing that all residents of care homes must be
tested before admission? In paragraph 1.30, the guidance
specifically states that:
“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”.
Even now, this has resulted in care homes being required to take
people out of hospital without knowing whether they have the
virus and without necessarily having the appropriate PPE.
I am aware of that guidance. It is sensible guidance. It is
necessary to free beds in our NHS hospitals to make them
available to those who need them more. It is also necessary to
isolate people when we are not sure whether they have Covid.
These are uncomfortable truths and I do not deny that this will
result in uncomfortable outcomes for some patients. One aspect of
the disease is that it targets care homes and I make no apology
for those arrangements.
(Lab)
Following the question asked by the noble Baroness, Lady Altmann,
why in an English care home where a close relative of mine lives
do staff and patients—including, astonishingly, patients
discharged from hospital—still have to wait up to 21 days for the
results of their Covid-19 tests?
The noble Lord gives powerful personal testimony. I cannot
possibly argue with the details of his story, but I reassure him
that the data I have is that the turnaround time for tests is, in
the vast majority of cases, radically less than what he
described. We are on course for hitting the target of 48 hours
for a very large number of tests and 24 hours for a lot of tests.
