Covid-19: Government under fire over its handling of care home crisis

Professor Martin Green, chief executive of Care England, said pandemic planning had been completely inadequate and the Government had focused on the NHS while discharging infected patients into care homes.

He told MPs on the Health and Social Care Committee that despite promises from ministers, there were still huge issues with testing, with results lost and staff waiting eight to 10 days to find out if they have coronavirus.

MPs also heard evidence of how Hong Kong has not had a single care home death after adopting a policy of quarantining patients leaving hospital for three months.

Meanwhile, Germany has recorded 3,000 deaths in care homes.

Prof Green told MPs there would need to be a “forensic examination” in the future to prevent a crisis in care homes from happening again.

He said: “We should have been focusing on care homes from the start of this pandemic.

“What we saw at the start was a focus on the NHS which meant care homes often had their medical support from the NHS withdrawn.

“We also had the disruption of our supply chains for PPE (personal protective equipment).

“We also saw people being discharged from hospital when we didn’t have the testing regime up and running.

“So despite what’s been said, there were cases of people who either didn’t have a Covid-19 status, or who were symptomatic, who were discharged into care homes.

“Now given that care homes are full of people with underlying health conditions, I think we should’ve looked at focusing on where the people at most risk were, rather than thinking about a particular organisation.”

Prof Green said a lot of care homes had not had the right set-up for isolating patients coming from hospitals, while other countries used separate quarantine facilities for infected patients.

“We had a policy of emptying hospitals and filling care homes, but in some (other) countries when people were symptomatic they were taken out of care homes into isolation facilities,” he said.

Prof Green said some test results for staff or residents in care homes had been lost, while others waited so long for test results that it was unclear if they were still valid.

He added: “People are often finding that their tests aren’t arriving on time or indeed being taken away on time.

“There have also been some significant time delays before people have got results.

“So we’re looking at sometimes eight to 10 days before people get results.”

Prof Green said PPE across care homes was still inadequate and called for testing “two or three times a week” to get on top of the virus.

However, he said there were indications of a downward trend in care home cases, telling MPs: “I think we are probably at the top of the curve and hopefully heading downwards.”

Environment Secretary George Eustice rejected the assertion that the Government had made mistakes over its handling of care homes during the crisis, but acknowledged some residents with asymptomatic coronavirus may have been discharged from hospital.

He told the Downing Street press conference: “We don’t accept the caricature that we took an approach that was wrong.

“Very early on in this epidemic we had protocols in place for care homes, there was guidance as to how they should approach things.

“As the situation developed, then more stringent policies were introduced by way of policy around discharge, and we got to the point where everybody was tested before discharge.

“But in those early weeks there will have been some instances where people may have been discharged who were asymptomatic, there may have been some, a small number of instances, where they may have been showing symptoms but would have been isolating.

“That was the guidance at the time that was in place, but we have strengthened that very much ever since then, we now have testing and a rigorous discharge policy that’s in place and that is getting stronger all the time.”

MPs also heard from international experts from Hong Kong and Germany who told how German care home staff had to wear full PPE suits from the end of March.

Professor Terry Lum, head of social work and social administration at Hong Kong University, also said any person infected in Hong Kong was isolated in hospital for three months.

James Bullion, president at the Association of Directors of Social Services, said he was struck by how the UK did not quickly enough take into account the risk of symptomatic or asymptomatic transmission both from people coming out of health settings into care settings, but also amongst the staff that work the care sector.

He said current testing was “nowhere near” adequate enough, adding that agency staff sometimes moved between three or four different establishments.

Elsewhere:

– Downing Street stressed that taking the anti-malarial drug hydroxychloroquine to ward off coronavirus – as Donald Trump said he was doing – was “not something we recommend”

– John Edmunds, a member of the Government’s Scientific Advisory Group for Emergencies (Sage), told MPs the study of other coronaviruses suggested “potentially bad news” for hopes that humans could develop a long-term immunity to Covid-19

– Prime Minister Boris Johnson tweeted: “We are past the peak, and I’m confident that if we continue to follow the rules and work together, we will beat this virus and be reunited with our friends and family soon”

– Of 174 new deaths in England announced on Tuesday, the youngest was a child of seven with underlying health conditions

It comes as the Office for National Statistics (ONS) released new data suggesting that coronavirus-related deaths in England and Wales have fallen by more than a third in the space of a week.
Nick Stripe, head of health analysis at the ONS, said the current tallies suggest that around 15,000 care home residents have now died with coronavirus.

Answering an urgent question in the Commons, Health Secretary Matt Hancock again insisted that hospital patients were discharged to care homes at a time when community transmission of Covid-19 was low.

He said the guidance to care homes that was in place until March 13 “was in place whilst community transmission was low and said it would be updated as soon as transmission went broader and that’s exactly what we did”.

In early March, England’s chief medical officer Professor Chris Whitty warned MPs it was “highly likely” community transmission of coronavirus in the UK was already happening.

On discharging hospital patients to care homes, Mr Hancock said it was “important to remember that hospital can be a dangerous place for people” and can carry risks.

He stood by the principle of discharging patients to care homes, saying: “It is appropriate in many cases for people to be discharged from hospital and safer for them to go to a care home.

“What’s important is that infection control procedures are in place in that care home, and those infection control procedures were put in place at the start of this crisis and have been strengthened…as we’ve learned more and more about the virus, all the way along.

“And as the clinical understanding of coronavirus has strengthened, so too, we’ve updated and strengthened our guidance.”