As the rate of transmission of Covid-19 continues to give grave concern, with the admissions to hospitals at an all-time high and the pressure that the NHS finds itself in. The question arises ‘are we about to see the emptying of beds from hospitals to care homes again’.
Care homes say it would be a 'grave mistake'.
The NHS is making plans to commandeer spare care beds across the country to help release pressure on hospitals as their wards fill up with coronavirus patients. More than 30,000 people are currently in hospital with Covid across the UK, and the number is expected to soar after more than 300,000 people tested positive in the last week of December.
The Health Service Journal reports that the Government is blocking the move to send patients to care homes because it doesn't want to pay, and fears patients could spread Covid to the homes' extremely vulnerable residents.
Potential impact on care homes
The National Care Forum warned that care homes are facing their own 'phenomenal' pressures and cannot cope with NHS patients too. It argued calls to protect the NHS must not ignore the 'massive potential impact' on care homes.
The caution is a worrying throwback to the first wave when hospitals were permitted to discharge patients into care homes without testing them for Covid.
These patients, bosses warned, seeded deadly coronavirus outbreaks in the homes which contributed to the sector's devastating death toll of 19,157 in 2020.
Designated areas for Covid patients
The Department of Health in October wrote to care homes asking them to try and make space to accept non-resident patients being discharged from hospitals.
It wanted to set up 500 of these designated areas, sectioned off from the main home and staffed by different workers, in case hospitals became overloaded in a second wave of coronavirus.
Ministers wanted to make sure every local authority in England had at least one of these overflow units at its disposal.
But now that hospitals face fast-rising patient admissions and coronavirus runs rampant around the UK again, the Government is reportedly reluctant to put the plans into action.
Footing the bill
The Health Service Journal reported that the Treasury is holding back on the idea because it doesn't want to foot the bill – most care homes are run by private firms. One council boss told the specialist health news site: 'The ask is an additional financial burden on providers, and someone needs to pick up the tab.
'The obvious department to do so is the Treasury and that is where the barrier is.'
As well as the financial difficulty of commandeering the private homes, companies that run them are also reluctant to run the risk of bringing Covid back in.
Care homes have spent months this year making homes Covid-safe, banning visitors or strictly limiting where they can go, regularly testing staff and residents and bringing in extra PPE.
Protection of residents and staff
Given how much care homes have endured through Covid in the past, it is of paramount importance that steps are taken to protect residents and staff. Prior to any movement from hospital to care home we must follow a criterion for admission:
There must be evidence of a negative test;
There must be capacity for isolation of patients from other residents;
There must be sufficient numbers of experienced staff;
All residents in the home must have been vaccinated;
The manager should have the final say on admission.
We are all concerned about the pressure faced by staff in the NHS, but the last thing we should want to do is to transfer the infection and the burden to staff in care homes. Care homes believe it would be a grave mistake to transfer Covid patients to care homes.
According to the Health Service Journal social care could be in a position to offer some help to alleviate the problem by setting up designated areas, sectioned off from the main home that could provide care for Covid patients. But in its wisdom, the Government is not inclined to pursue this solution. We must learn from the catastrophe of the past and protect residents and staff at all costs, and follow the suggested criterion for admission.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy