2/16 Usual basis – we are not Government, we are not @NHSEngland, we are the voice of trusts. Full basis of comment here: nhsproviders.org/news-blogs/pre…. We recognise there is a different perspective from the social care sector. We are communicating what trusts have told us.
3/16 We strongly agree with the key @NAOorguk report sentence (Summary point 16) “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”.
4/16 We strongly agree with this statement for four reasons. 1. Trusts were acting within Government policy. 2. “Not all patients were tested” is a good description. No-one has the full actual data but the implication is that most patients were tested, though some weren’t.
5/16 3. There is a clear implication that there was pressure on testing capacity and that this was a difficult problem that NHS trusts were trying to solve. 4. In prioritising the limited testing capacity NHS trusts were giving priority to covid and suspected covid patients.
6/16 NHS trusts tell us (see nhsproviders.org/resource-libra…) that they did discharge a small number of covid and suspected covid patients to care homes without a test. But only where the care home had agreed to take those patients. This was fully in line with the guidance.
7/16 NHS Trusts also acknowledge that they may have unwittingly discharged asymptomatic patients without tests in the first few days after 19 March. But they tell us that they rapidly amended their procedures to manage this risk as soon as it became apparent to them.
8/16 Trusts tell us that the vast majority of care home discharges were tested. But nobody has the full data so we can’t be sure exactly how many were tested. We agree with @NAOorguk words - not all patients were tested - because it says we can’t be precise but implies most were.
10/16 It would be helpful if all those commenting and reporting on this issue were precise in their language. “All were tested” and “All were not tested” are both not true. “Up to 25,000” is in danger of implying that most weren’t tested, which is also not true.
11/16 Those who argue that there was clinical risk because there was insufficient testing capacity and the Government policy allowed discharges without testing are right. And we agree that it is right to hold the Government to account for the existence of this risk….
12/16 ….This could have been done differently, as it was in many other countries. But trusts feel very strongly that they identified this risk as soon as reasonably possible and then sought to manage it as well as they possibly could in the circumstances.
13/16 So whilst it is right to point to potentially serious policy failures here, this can be done without accusing the NHS of doing something it didn’t do. NHS trusts did not knowingly and systematically discharge many thousands of patients to care homes without a test.
14/16 NHS trust leaders particularly resent suggestions that they “seeded the virus in the care sector”; or “looked after their own interests” because they felt they did the opposite. They recognised how fragile the care sector is and sought to support it as much as possible.
15/16 We can hopefully all agree on the following. Care home deaths have been far too high and could have been lower. There are a number of potential reasons for this but we can’t be sure about balance of responsibility between them at this point.
16/16 We can also hopefully agree on the following further points. The social care sector has been massively under-prioritised and under-funded. We need to create a sustainable social care system and workforce. We need to integrate health and care as quickly as possible.
