Source · Select Committees · Public Accounts Committee
Recommendation 2
2
Discharging patients from hospital into social care without first testing them for COVID-19 was an...
Recommendation
Discharging patients from hospital into social care without first testing them for COVID-19 was an appalling error. Shockingly, Government policy up to and including 15 April was to not test all patients discharged from hospital for COVID-19. In the period up to 15 April, up to a maximum of five symptomatic residents would be tested in a care home in order to confirm an outbreak. Belatedly, after discharging 25,000 people from hospitals to care homes between 17 March and 15 April, the Department confirmed a new policy of testing everyone prior to admission to care homes. Public Health England confirmed that it was already becoming clear in late March, and certainly from the beginning of April, that the COVID-19 infection had an asymptomatic phase, when people could be infectious without being aware they were sick. The Department does not know how many of the 25,000 discharged patients had COVID-19. The number of reported first- time outbreaks in individual care homes peaked at 1,009 in early April. Between 9 March and 17 May, around 5,900 care homes, equivalent to 38% of care homes across England, reported at least one outbreak. The Department says that it took rational decisions based on the information it had at the time, but acknowledges that it would not necessarily do the same thing again. Readying the NHS and social care for the COVID-19 peak 7 Recommendation: The Department and NHSE&I should review which care homes received discharged patients and how many subsequently had outbreaks, and report back to us in writing by September 2020. The Department along with NHSE&I should develop procedures so that all patients deemed fit to leave hospital are safely discharged into settings in a way which limits the spread of COVID-19.
Government Response
Not Addressed
HM Government
Not Addressed
2. 1 The government agrees with the Committee’s recommendation. Ta rget implementation date: Spring 2021 2.2 Although the department agrees with the Committee’s recommendation, it disagrees with the Committee’s conclusion. 2.3 The department provided an update to the Chair on 7 October. NHS England and NHS Improvement wrote to the Committee on 30 October 2020. 2.4 The department will ask the SAGE Care Homes Working Group to keep the emerging evidence on discharge under review and will update the Committee as further evidence becomes available. 2.5 As set out in the Adult Social Care Action Plan on 15 April, and the Adult Social Care Winter Plan on 18 September 2020, all individuals are required to be tested prior to discharge from hospital to a care home and no provider should be forced to admit an existing or new resident if they are unable to cope with the impact of the person’s COVID-19 illness safely. Local authorities remain responsible for providing alternative accommodation as appropriate in local systems and the costs of providing alternative accommodation are covered by the discharge funding provided via the NHS. 2.6 The response to recommendation 2b outlines additional measures the department has implemented to ensure discharges are as safe as possible.