Calls for inquiry after hundreds of patients sent to care homes without coronavirus tests
Hundreds of hospital patients were discharged into Suffolk care homes without Covid-19 tests, we can reveal.
Patients were sent to care homes, untested for coronavirus, from Ipswich Hospital and the community hospitals of Felixstowe, Aldeburgh and Bluebird Lodge more than 300 times between March and mid-April, according to figures obtained by this newspaper.
Health leaders in Suffolk are calling for an inquiry into why the county has consistently recorded a higher number of care home deaths than its neighbours, Norfolk and Cambridgeshire.
A third of the county’s 549 coronavirus deaths have been in care homes, with 176 people dying in total. That’s compared with 137 care home deaths in Norfolk, and 140 in Cambridgeshire.
Adult social care bosses have so far put this down to Suffolk having a higher number of nursing beds than other areas, and more care home residents choosing to die at home.
But David Finch, chairman of the Suffolk association of independent care providers, and Labour’s health spokeswoman Helen Armitage, also vice-chairman of the county’s health and scrutiny committee, said there needs to be an investigation by local leaders ahead of any second wave.
Our investigation has found:
• Patients were discharged from Ipswich Hospital and smaller community units, without Covid-19 tests, into the county’s care homes on 312 occasions between March 1 and April 15. NHS bosses said these numbers are based on admissions, as people may have been discharged and readmitted multiple times in this period
• Of the 182 beds ‘block-booked’ for hospital patients in Suffolk’s care homes at the start of the pandemic, 60 were set aside to house Covid-19 positive patients. These beds were based in separate, isolated areas across two care homes, and another facility run in partnership with the local NHS - the locations of which Suffolk County Council would not disclose
• The death toll from coronavirus has reached 10 at a large care home near Stowmarket, Chilton Meadows, with a further 15 residents testing positive. Bosses confirmed the “very sad” news and said they followed PHE guidelines at every stage
Race to discharge patients as Covid-19 ‘overwhelmed’ NHS
In mid-March the head of the NHS, Sir Simon Stevens, urged all hospitals to discharge patients who were “medically fit to leave”.
This was done from March 17 to free up space for an anticipated surge in coronavirus cases.
It is feared that these patients, who were not tested for Covid-19, brought coronavirus into care homes.
It was not until a month later, on April 16, that national guidance changed requiring patients to be tested for Covid-19 on leaving hospital.
Even after this date, the guidelines allowed patients to go back to care homes while waiting for their test results, with providers required to isolate them.
Across England, 25,000 people were discharged into care homes without tests in the ‘crucial’ 30-day period.
Hospital chiefs said they closely followed national guidance and added: “No patient being actively treated for Covid-19 would be discharged from our hospitals to a nursing or care home.
“They would be discharged when well enough to convalesce at their care or nursing home.”
MORE: How the coronavirus crisis unfolded in care homes
Ipswich Hospital data also shows there were 56 ‘positive’ results recorded after April 16.
NHS bosses have said that due to the way national data is recorded. If a patient tested positive at some point during their visit, they would stay that way on leaving hospital – even if they tested negative before being discharged.
West Suffolk Hospital was also asked to provide information on the number of patients it discharged without Covid-19 tests.
However, the trust said that due to the way its data is recorded, a patient’s ‘usual place of residence’ would not be noted down as a care home, and a street address would be used instead.
It said this meant it would be “unable” to distinguish whether a patient was discharged to a care home or a private home.
‘Impact would have been devastating’
Mr Finch said even if a small proportion of untested patients were sent to care homes, because of PPE levels and infection rates at the time, the impact would have been “quite devastating”.
Central Suffolk and North Ipswich MP Dr Dan Poulter, who is also an NHS doctor, said there was “huge pressure” on hospitals in late March.
“What we weren’t aware of at that stage was the level of asymptomatic transmission,” he said.
“It’s very difficult to pass judgement on hospitals that were under huge pressure at that time.”
But he added: “Looking back on things, we can see that (hospital discharge) itself could have led to some complications and challenges.”
Agency staff, and staff working across a number of care homes, “seem to have emerged as the single biggest vector of transmission between care homes and between patients”, Dr Poulter said.
‘There must be some sort of inquiry’
Mr Finch said that ahead of any second wave, health leaders need to know what went wrong this time around.
“There has to be some sort of inquiry,” he said. “We need to know, if patient A was sent out to care home A, did patient A have Covid, did home A then suddenly have an outbreak?
He added: “SCC has said repeatedly (the higher number of deaths) is down to having more nursing beds. But I haven’t seen any data to support anything yet.
“If someone has lost a loved one, they have a right to ask how that happened.”
MORE: ‘A real kick in the teeth’ – Suffolk carers’ chief on Boris Johnson’s comments
Meanwhile, Labour group health spokeswoman Helen Armitage has called on Suffolk’s health and scrutiny committee, of which she is vice-chairman, to “urgently investigate” the impact of untested patients being discharged into care homes.
Chairman Jessica Fleming, Conservative, said the committee may decide it wants to look into the issue at a later date, but said she would not back an inquiry at this stage.
Ms Hopfensperger said her team is continuing to review information coming in locally and nationally to understand how Covid-19 has affected Suffolk’s care homes, adding that “every death is a tragedy”.
But she added: “There are many areas of the country that have experienced far greater challenges during the pandemic with care home deaths in higher numbers than Suffolk.”
60 isolation beds allocated for Covid-positive patients
In May, it was revealed that Suffolk County Council and the county’s clinical commissioning groups ‘block-booked’ 182 beds in care homes ready for hospital patients at the outset of the pandemic – one of the highest numbers allocated in the country.
So far, not all of these beds have been used, with £1.6million spent on them in April and May.
Now SCC’s adult social care boss Beccy Hopfensperger has confirmed 60 of them were allocated for Covid-19 positive patients.
An SCC spokesman said these beds are based across two care homes, and another facility run in conjunction with the local CCGs.
They are specifically for people who may be Covid-19 positive when discharged from hospital but need further care and rehabilitation before they return to their usual residence.
“These beds are in completely separate, isolated areas away from other people,” the spokesman added.
“The nature of these isolated areas ensures there is no risk of cross infection with any other care home resident.”
National debate rages over alleged care home shortfalls
Speaking to The Times earlier this month, patient safety expert Professor Brian Sharman claimed that across England, health chiefs were aware of rising cases of coronavirus in care homes even as hospitals were urged to discharge patients without tests.
Sir Brian, who helped to expose the Mid Staffordshire hospital deaths scandal, told the newspaper: “They then monitored what was happening – like the spectators in Roman times watching what happened to the gladiators when they were thrown to the lions.”
Boris Johnson has this week sparked backlash after claiming too many care homes didn’t follow procedures to guard against the spread of coronavirus in the way they could have done.
The Care Quality Commission has confirmed inspections at 50 care homes across England happened in lockdown over concerns they were not operating safely.
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