Senior MP says care home resident were an 'afterthought' during pandemic

12 June 2020, 00:05

A senior MP said care home resident have been "overlooked"
A senior MP said care home resident have been "overlooked". Picture: PA
Maddie Goodfellow

By Maddie Goodfellow

Care home residents were "an afterthought" during the pandemic, according to a senior MP, after a report found that one in three homes for the elderly suffered coronavirus outbreaks.

The National Audit Office (NAO) said 25,000 hospital patients were discharged to care homes at the height of the pandemic, and not all were tested for Covid-19 so it was not known how many had it.

Meg Hillier, chairwoman of the Commons public accounts committee, said care homes had been left at the "back of the queue" for both personal protective equipment (PPE) and testing.

The Labour MP said: "Residents and staff were an afterthought yet again: out of sight and out of mind, with devastating consequences."

The NAO's report into the readiness of the NHS and social care in England for the pandemic said 25,000 people were discharged from hospitals into care homes between March 17 and April 15. That was 10,000 fewer than the same period last year.

"It is not known how many had Covid-19 at the point of discharge," said the report.

One in three care homes has experienced a Covid-19 outbreak
One in three care homes has experienced a Covid-19 outbreak. Picture: PA

The public spending watchdog said NHS England and NHS Improvement (NHSE&I) advice at the time was to urgently discharge from hospital "all patients medically fit to leave" in order to free up bed space for coronavirus patients.

"Due to Government policy at the time, not all patients were tested for Covid-19 before discharge, with priority given to patients with respiratory illness or flu-like symptoms," the report outlined.

The advice was changed on April 15 but the NAO noted that, as of May 17, one in three care homes had declared a coronavirus outbreak, with more than 1,000 homes dealing with positive cases during the peak of infections in April.

The North East was the worst affected region, with almost half its care homes reporting an outbreak by the middle of May.

The Department of Health and Social Care (DHSC) said it took the "right decisions at the right time", and that 60% of all care homes had avoided outbreaks entirely.

Other aspects of the response highlighted in the report, which covers the period from when the NHS moved to its most severe incident level in January, include:

- Calls from an independent committee, which was advising the DHSC in 2019, for gowns and visors to be added to the PPE stockpile list were not heeded, with the central stockpile in place at the time designed for a flu-style pandemic.

- Only health providers' demands for face masks and clinical waste bags were met in terms of the modelled PPE requirements for the reasonable worst-case scenario during the outbreak, with just 20% of the gowns and 33% of the eye protectors said to be needed in such a situation being supplied.

- Despite testing being available for health staff in some form since the end of March, ministers do not know how many NHS or care workers have been tested in total during the pandemic.

- The NHS managed to increase the number of beds available for Covid-19 patients from 12,600 to 53,700, with the number of coronavirus patients never exceeding the number of available beds during the peak of the virus in April.

- The number of mechanical ventilators rose from 9,600 to 13,200, with national demand for oxygen met during the outbreak's peak.

Ms Hillier said frontline health workers had been "badly let down by the Government's failure to prepare properly".

She added: "Shockingly, the Government squandered the last opportunity to add to the central PPE stockpile, even after the NHS had gone to the highest level of alert."

Jeremy Hunt, chairman of the Commons Health and Social Care Committee and a former health secretary, said "it seems extraordinary that no one appeared to consider the clinical risk to care homes despite widespread knowledge that the virus could be carried asymptomatically".

He added: "Places like Germany and Hong Kong took measures to protect their care homes that we did not over a critical four-week period."

The NAO said the complicated nature of social care provision, including its "lack of" integration with the NHS, "made responding to the crisis more difficult in a number of ways".

Similarly, the number of bodies, both national and international, involved in acquiring PPE made the process more onerous.

Comptroller and auditor general Gareth Davies, head of the NAO, said: "This report demonstrates the enormous efforts of staff across health and social care to respond at speed to the unprecedented challenge of the Covid-19 pandemic.

"While we have not sought to evaluate Government's response in this report, our work raises some important considerations.

"The speed and nature of the response in health and social care has been shaped by longstanding differences between the sectors and ongoing financial pressures.

"Government's ability to increase beds, ventilators, PPE and testing has varied in part because of the number of other bodies, both national and international, with which it has had to engage.

"All of these issues need to be taken into account as Government plans for the later phases of the pandemic and future emergencies."

Susan Masters, a director at the Royal College of Nursing, said: "Without the extraordinary efforts of nursing staff across health and social care, the impact of Covid-19 could have been worse.

"But this report shows nursing staff were let down by a system ill-prepared to tackle this pandemic.

"Years of under-investment means social care was left exposed."

Unison assistant general secretary Christina McAnea said the report highlighted "a catalogue of errors" and added: "Discharging patients to care homes without testing was simply scandalous and accelerated the spread of the virus among an obviously high-risk group."

The Local Government Association said coronavirus had highlighted the need for a "long-term" funding solution to be put in place for social care and called for "certainty about how it will continue to operate and be paid for in future".

Labour's shadow health secretary, Jonathan Ashworth said the NHS had "entered the Covid-19 crisis exposed after years of under funding, bed cuts and with huge staff shortages".

The DHSC defended the Government's record and said it had stepped in to reduce care home transmission.

"We have been working tirelessly with the care sector throughout to reduce transmission and save lives and a result 60% of care homes have had no outbreak at all, according to the latest Public Health England statistics," said a spokesman.

"Since the launch of whole care home testing, the Government has provided over one million test kits to almost 9,000 care homes and on Monday we announced that every care home in England will now be offered a coronavirus test for all residents and staff, even if they have no symptoms."

The spokesman said the numbers used for judging PPE supply in the NAO report were "misleading", stating: "The modelled PPE requirements presented in this report are theoretical worst case estimates - it is misleading to compare them to figures on centrally procured PPE which do not account for equipment supplied through other routes or existing local stocks."

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