Cambridgeshire care homes took over 100 patients from Addenbrooke’s without Covid-19 tests
More than 100 people were discharged from Addenbrooke’s Hospital into care homes in March and early April without receiving a test for Covid-19.
The period covers a month and a half in which Covid-19 dramatically changed life in the UK, from the first recorded death involving the virus on March 5, to the week leading up to a change in national policy relating to care home discharges on April 16, when on average more than 700 deaths were announced every day in England’s hospitals.
Information provided to the Local Democracy Reporting Service under the Freedom of Information Act shows that 148 people were discharged from hospital by the Cambridge University Hospitals NHS Foundation Trust into care homes between March 1 and April 15.
According to the trust, 116 of those people were discharged from Addenbrooke’s to care homes without being tested for the virus. The trust says the other 32 people discharged to care homes in that time were tested, and all tested negative.
The national guidance then changed so that from April 16 every hospital in the country was instructed to test patients prior to discharging them to a care home.
Cambridge University Hospitals’ medical director, Ashley Shaw, said that prior to April 16, all patients showing symptoms of the virus were tested.
Dr Shaw said: “Since April 16, 2020, every patient being discharged to a care home has been tested for Covid-19 regardless of their symptoms. Before that date, testing capacity was more limited and was protected for those patients who were symptomatic.
“However, our clinical teams were using their best judgement to assess whether any patient was showing any signs of Covid-19 infection. If any symptoms were identified then they were not discharged until we had undertaken a test and received the result.
“On April 16, as testing capacity was increasing, the national requirement was introduced for all patients to be tested prior to discharge to a care home. This has become our routine procedure and we are working hard to support the care homes in our area to help them manage the risks related to coronavirus.”
According to NHS England data on daily death announcements, between April 9 and April 15, Cambridge University Hospitals NHS Foundation Trust recorded 21 deaths involving Covid-19.
Data from the Care Quality Commission, published by the Office for National Statistics, shows there have been 99 deaths involving a confirmed or suspected case of Covid-19 in care homes in the Cambridgeshire County Council area in the period for which there is available data, April 10 to May 29.
The first confirmed case of Covid-19 in the UK was recorded on January 31. The first of the daily Downing Street press conferences was held on March 3, two days before the first recorded death involving the virus in the UK.
The UK went into lockdown on March 23. As of June 3, the government statistics show between April 9 and April 15 the UK was averaging more than 900 deaths involving Covid-19 a day.
Cambridgeshire County Council said it did work with NHS trusts across the county to discharge patients into extra beds procured in care homes to move people out of hospital in March and early April.
The council said there was a “general policy of rapid discharge of patients who no longer required hospital care, in order to increase NHS capacity for treating a surge in Covid-19 patients. This included discharge into care home settings. Local actions were in line with national guidance, which changed on April 16 to require testing of all patients discharged from hospital into care homes.”
All councils were asked to discharge people from hospital in anticipation of the Covid-19 peak, and at the time testing was not widely available in the way it is now.
Charlotte Black, the service director for adults and safeguarding at Cambridgeshire County Council and Peterborough City Council, said: “We have always followed national guidelines, and in addition gone over and above these to support those who require support from adult social care and our care providers. We have also continued to focus our efforts on enabling people to stay well and independent and access support in their local community. In March, national policy was that testing capacity was prioritised for those patients in hospital with coronavirus symptoms. This means many patients would not have received a test before discharge unless they were showing the recognised symptoms at the time.
“All councils were asked to discharge people from hospital in anticipation of the Covid-19 peak, and at the time testing was not widely available in the way it is now.But from the start of the year we were working with all our providers to ensure that they were observing general good infection control regimes and had appropriate PPE – and supporting them with emergency supplies if their usual sources ran short.
“We are now working with the NHS to implement the Government’s Action Plan for Adult Social Care and national guidance that anyone being discharged to a care home is tested beforehand. A Covid-19 care plan is also agreed in advance of discharge with each patient being considered on an individual basis.
“Our support package to residential and nursing homes across Cambridgeshire and Peterborough has included a 10 per cent uplift in funding from April 18, daily and weekly support and advice, access to essential PPE if any home’s own stocks were low, and providing additional staff, including trained volunteers and those redeployed from other roles in the council, to support homes where staffing levels were affected by the epidemic.”
According to the government’s Covid-19 action plan published on April 15: “The UK Government with the NHS set out its plans on March 17, 2020 to free up NHS capacity via rapid discharge into the community and reducing planned care.
“We are mindful that some care providers are concerned about being able to effectively isolate Covid-positive residents, and we are determined to make sure discharges into nursing or social care do not put residents currently in those settings at risk. We can now confirm we will move to institute a policy of testing all residents prior to admission to care homes.
“This will begin with all those being discharged from hospital and the NHS will have a responsibility for testing these specific patients, in advance of timely discharge. Where a test result is still awaited, the patient will be discharged and pending the result.”
More by this authorBen Hatton, Local Democracy Reporter