Health officials accused of ‘reckless and negligent’ approach to care homes during Covid-19 crisis

Health officials have been accused of a “reckless” and “negligent” approach to care homes during the coronavirus crisis.

The senior civil servant at the Department of Health and Social Care (DHSC) acknowledged there had been “huge challenges” but defended actions which saw around 25,000 people discharged from hospitals to care homes without a routine coronavirus testing policy.

DHSC mandarin Sir Chris Wormald said the policy in place in March and April was a “rational” one based on the need to free up hospital beds for coronavirus patients.

But Tory MP Sir Geoffrey Clifton-Brown (pictured) claimed England’s care homes were “very much a forgotten cousin” compared to the NHS.

Sir Geoffrey suggested the Government was “negligent” in its handling of care homes.

He said vulnerable people were being discharged to care homes when they were already in “dire trouble” without the proper training, testing or personal protective equipment (PPE).

He added: “Wasn’t this a pretty reckless policy by the Government?”

The Commons Public Accounts Committee (PAC) was questioning health officials following a National Audit Office (NAO) report which found that 25,000 people were discharged from hospitals to care homes between March 17 and April 15.

Between March 9 and May 17, around 5,900 care homes across England reported an outbreak – this peaked at just over 1,000 homes in the first week of April.

Official guidance from April 2 stated that care homes needed to make their full capacity available and that they could admit patients with Covid-19.

Sir Geoffrey told Sir Chris: “You were sending people from hospitals in quite large numbers into the care home sector which you knew was already facing a substantial and increasing number of Covid patients of their own.

“They didn’t have sufficient PPE, they didn’t have sufficient testing and they were the most vulnerable group in society.

“How could that have made any sense whatsoever?”

Sir Chris said hospitals were expecting “large numbers of Covid patients” and people who were clinically able to discharged should have been.

He acknowledged there had been “huge challenges” in care homes but “considerable progress” had been made.

“The decisions that we took around discharge, which were all based on the clinical advice at the time… were rational given the evidence that we had on the table at that time,” he said.

He later added: “We are in a process of learning as we go along about these issues. I am confident that based on the information that we had at the time our guidance was correct. That is not the same as saying we would do the same again.”

NHS England’s national medical director Steve Powis told the PAC that modelling predicted that an unmitigated epidemic would have overwhelmed the health service.

He said patients who were “clinically fit” were discharged – but Sir Geoffrey questioned how this could have been known without a coronavirus testing regime in place.

Prof Powis said the NHS was following the testing advice provided by Public Health England (PHE).

Professor Paul Johnstone of PHE told the committee that 3,500 tests a day were available at the time.

The NAO report said that until mid-April, there was a policy to test no more than five symptomatic residents in any one care home.

Sir Chris told the committee that – particularly during March – the number of available tests was “quite limited and much smaller than we would have wanted”.

NHS England chief executive Sir Simon Stevens said it was currently in discussions about extending the contract with the independent sector to supply 8,000 hospital beds to the NHS on an “at-cost” basis.

He said that while the original contract agreed in March was to provide a reserve capacity if the NHS was overwhelmed with coronavirus cases, in future it was likely to be to provide back-up for other services.

“We do expect that we will want to continue to make use of independent sector capacity for the balance of the year in order to give more buffer for routine surgery, cancer care and other conditions,” he said.

“We are in discussion with Government about that but my hunch is that we will want to sustain a relationship with the independent hospitals.”

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