Royal Cornwall Hospitals Trust: Patients discharged without testing

  Posted: 30.06.20 at 07:45 by Richard Whitehouse - Local Democracy Reporter

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New figures show that 136 patients were discharged from Cornwall’s main hospital into care homes without being tested for coronavirus.

The data was provided to the Local Democracy Reporting Service following an Freedom of Information request asking how many people were discharged from Royal Cornwall Hospitals Trust (RCHT) to care homes without a test.

Between March 1 and April 15 it has been revealed that 175 people were discharged from the trust’s hospitals into care homes.

But just 39 of them were tested for coronavirus before they were discharged to the care homes.

Of those that were tested 38 tested negative for covid-19 and one tested positive.

In May it was confirmed that 44 people had died from coronavirus in Cornwall’s care homes.

Royal Cornwall Hospital

There have been a number of outbreaks reported at care homes across Cornwall since the start of the pandemic.

Last week it was confirmed that Pengover House in Liskeard had an outbreak with 11 positive cases reported.

Rob Rotchell, Cornwall Council cabinet member for adult social care, said: “The numbers are quite disconcerting, but they are the side issue really.

“Ideally nobody should have been discharged from hospital without being tested.

“It was such a quickly changing scenario. Almost every day we were getting different guidance or expanded guidance across a range of things, whether it was testing or using PPE.

“RCHT were following the guidelines they were given at the time. In hindsight people should have been tested. If they tested positive they shouldn’t have been discharged.”

Cllr Rotchell said that the fact that patients were discharged to care homes without testing would not fully explain outbreaks of coronavirus in care homes.

“It is really difficult, in the beginning we had visitors going to care homes, staff were moving around freely – there was a lot of movement in the system.

“Whether it is someone discharged from hospital or whether it is staff or visitors we can’t say.

“At the beginning the only guidance we had was washing your hands for 20 seconds. Potentially, yes, people being discharged from hospital could have been the cause for outbreaks in care homes but we can’t say for certain.”

Cllr Colin Martin, who is vice chair of the health and adult social care overview and scrutiny committee, said that the figures we had been provided were different to those he was given.

He said that he had been told that just 36 people had been discharged from hospital into care homes without a test.

Cllr Martin said that the issue was something which was set to be raised at a meeting of the scrutiny committee due to be held at the end of July.

He said: “We have been clear that we want to know how many patients have been discharged in that way and what the consequences were, is there any evidence that was the source of outbreaks in care homes?

“We have been promised that we will get that at the end of July.

“The government has said that it was a clinical decision to send people to care homes, that is a bit of a misrepresentation.

“It is a clinical decision to say this person doesn’t need hospital care but it is a separate decision whether they should go to a care home and if they should be tested.”

Cllr Martin highlighted that Cornwall Council had taken beds at local hotels where people being discharged from hospital could go if they were not ready to return home.

He said that those who had coronavirus symptoms could then be kept isolated and infection could be contained. He said that this had probably prevented outbreaks in care homes being worse than they might otherwise have been.

Cllr Martin said that he had asked RCHT CEO Kate Shields whether there had been pressure from central government to move people out of hospital to free up space for potential covid-19 patients and claims he was told that was “absolutely” the case.

He said: “There was a huge effort to rush people out of hospital to care homes as quickly as possible in order to protect the NHS. While that is understandable when we thought we were going to have this tidal wave that would take over our hospital, but surely it is an obvious thing to make sure that the most vulnerable people in our country, those in care homes, are safe to be discharged. Surely anybody could see that (not testing) was a dangerous thing to do?”

In a statement RCHT said: “We have worked tirelessly to follow and continually update our infection prevention and control practice throughout the coronavirus pandemic.

“In the early weeks of the pandemic the national guidance was clear that where someone did not need to remain in hospital they could be discharged home, or to a care home, without the need for a negative test result, or whilst a result was awaited. The person would have been expected to be isolated and, if in a care home or receiving care at home, those caring for them would take appropriate precautions, including the use of personal protective equipment (PPE).

“It has always been our top priority to keep our patients and staff safe. We implemented the revised national guidance, to test all people returning to a care home, as soon as this was introduced in mid-April.”

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