Thursday, 22 Oct 2020

Coronavirus ticking time bomb: Memo suggests key care home flaws risk being repeated

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A leading clinician has warned it could become “commonplace” for coronavirus patients in hospital to be discharged into care homes in England this winter. This would come just months after the Government came under fire for the care home crisis which is feared to have killed thousands. As new cases of the virus are sharply increasing and several regions have been sent into local lockdowns, fears of a care home shutdown are ratcheting up ahead of the winter months.

Experts have predicted the NHS could be hit by a double whammy if a second wave of coronavirus arrives during the annual flu season.

A leaked contract from Trafford Council in Greater Manchester lays out plans to have COVID-19 hospital patients landed at the doors of care homes within two hours of them being given the green light for discharge.

The document seen by Channel 4 News came to light after the Government issued guidance on how care homes should prepare for the winter.

It outlines the “Rapid Discharge” of patients from hospital, and said “some of these patients may have COVID-19, whether symptomatic or asymptomatic.”

The Government has said care homes in England should be prepared to accept patients who “may have COVID-19”.

The latest guidance was updated on September 16.

The guidance also states care homes will not be forced to admit COVID-19 positive patients.

Professor Adam Gordon said the practice of moving coronavirus patients from hospitals to care homes could be repeated over the coming months despite the uproar over the situation during the height of the epidemic.

He said the Government should not treat care homes as hospitals for the elderly.

He told Channel 4 News: “It can be very difficult to isolate people with COVID safely.

“And it’s a really quite significant burden to place on care homes to take that responsibility when they perhaps haven’t been able to see the patient and aren’t quite sure what their care needs will be at the point of discharge.

“Care homes are not hospitals.

“They are designed to be homes, and, in many instances, care home staff are not healthcare professionals who in the past have had really in-depth training in infection control.

“If you were to be absolutely belt and braces about this, you might choose to isolate patients in an NHS setting until such time as they were confirmed to be COVID negative.”

His warning comes after a member of the Government’s Scientific Advisory Group for Emergencies (Sage) attacked ministers over their “failure” to act upon “early” advice to shield care home residents from COVID-19.

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John Edmunds claimed Boris Johnson’s Government had been warned about care homes being “particularly high risk” as early as February – a month before the lockdown was rolled out.

The epidemiologist was also critical of Sage, saying the group should have issued bolder guidance to ministers as they made critical decisions on how to handle the country’s biggest public health crisis in a generation.

Despite Sage’s warning to the Government, ministers waited until April 15 to advise hospitals against discharging coronavirus patients into care homes.

This meant a month passed between the warning and when action was taken, resulting in thousands of coronavirus patients being sent to care homes where the virus spread rapidly.

Mr Edmund told ITV News: “Sage just gave scientific advice, scientific advice being care homes are particularly high risk; you should stop infection getting into care homes and do everything you can to stop infection once it’s in care homes.

“It’s up to others to action that and do it, and that clearly failed.”

A spokesperson for the Department for Health and Social Care told Express.co.uk: “Our priority is to ensure that people are discharged safely from hospital to the most appropriate place, and that they continue to receive the care and support they need.

“No care home will be forced to admit an existing or new resident to the care home if they do not feel they can provide the appropriate care.

“Today we announced over half a billion pounds extra funding for care providers to reduce COVID-19 transmission and help protect residents and staff throughout winter.”

 

A spokesperson for Trafford Council said discharging patients from hospital is a “carefully co-ordinated process in line with national government guidance” and the health and wellbeing of the person is treated as a priority.

They defended the timescale which could see patients sent to care home hours after doctors deemed them ready for discharge.

The spokesperson said: “The alternative to doing this would be to leave the person in hospital. This would mean that the person’s recovery may take longer in an inappropriate setting, leaving them at higher risk of infection while also preventing seriously ill people being admitted to hospital to receive critical care when they need it.”

They pointed out that care homes had the right to refuse patients.

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