A new report by NHS Providers shows how trusts have gone to great
lengths to support care homes through the unprecedented challenges
posed by the coronavirus pandemic.
The report confronts and dispels the damaging and mistaken belief
– deeply resented by trust leaders - that their organisations
systematically and knowingly discharged COVID-19 patients to the
home care sector.
Based on detailed conversations and feedback from trust leaders,
it also highlights the many ways in which trusts have been
working with local authorities and care homes to help them deal
with the pressures posed by the virus.
It sets out in how in the crucial period between the publication
of discharge guidance on 19 March, and the change in testing
strategy on 15 April, the vast majority of patients discharged
from hospitals did not go to care homes. Instead they were
discharged to other settings such as community hospitals, or to
their home with support from carers, as advised in the national
guidance.
Faced in mid-March with the imperative to create additional bed
and staffing capacity to treat patients who were seriously ill
with COVID-19, trusts worked to agreed discharge arrangements
with local health and care partners. Key considerations included:
- overall balance of risk to
individual patients, given that hospitals are not a safe
environment for recovery
- minimising moves for
vulnerable patients
- the pressures on care
providers – in some areas trusts redeployed therapeutic, nursing
and mental health staff to support care.
It is important to remember that testing capacity during this
period was very constrained, and there is still a lot to do to
ensure the health and care sector has access to the volume of
tests and the swift turnaround of results required.
Trusts consistently acted in accordance with the guidance, only
discharging known or suspected COVID-19 patients to a care home
if it had agreed it had the capacity to treat and isolate this
type of patient.
The report says trust leaders responded quickly to the risk of
discharging COVID-19 patients who showed no symptoms of infection
into care homes, long before the government announced that they
would have to test every single patient prior to discharge.
There are many more examples of the close and mutually supportive
relationships between the NHS, local authorities and care homes
in response to the pandemic. These include:
- supporting care homes and
other providers with personal protective equipment (PPE)
- providing advice on care
homes’ processes around infection control, PPE and segregating
COVID and non-COVD residents
- enhanced clinical support
for staff and residents
- opening up lab testing
capacity to care homes as soon as possible
The deputy chief executive of NHS Providers, Saffron Cordery,
said:
“The NHS has done everything it could to respond to the
unprecedented challenge presented by coronanvirus.
“That includes working closely with colleagues in the care
sector, building on longstanding relationships to provide
much-needed support.
“It is a damaging and mistaken belief that trusts knowingly and
systematically discharged COVID-19 patients into care homes.
“Health and care staff are doing their absolute best in
incredibly challenging circumstances with the resources available
at the time, so the blame game must stop.
“It will be for a public inquiry to establish why mortality in
care homes has run so high.
“But we can see that the failures of testing to date and the
supply of PPE have hit the care sector particularly hard and
remain problematic.
“We also note the care sector’s view that the government didn’t
focus on its concerns sufficiently or soon enough, and that
additional funding is taking too long to get to the frontline.
“Beyond that it has long been clear that the sector has suffered
from years of underinvestment despite repeated government
promises to resolve the crisis in social care.
“Trusts have, and will continue to support their colleagues in
the care sector, reflecting our mutual dependence and shared
determination to provide the best possible protection and care
for those who use our services and the frontline staff who
deliver them.”
