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UK coronavirus: Government is ‘holding up NHS demands’ to discharge patients into care homes

Care homes say it would be a ‘grave mistake’ to use their empty beds as overflow for packed hospitals as the number of people being admitted with Covid-19 surges.

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. 

But 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, the Health Service Journal reports.

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.

Care homes could be told to accept hospital patients as wards fill up with Covid-19 patients but the Government is reportedly reluctant to foot the bill (Pictured: Joyce Birrell, a 104-year-old resident at a care home in Hertfordshire, gets her coronavirus vaccine)

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. 

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.’

And another ‘well-placed source’ added: ‘There is the sense that, because the Government’s fingers got so burnt in March and April, it is running scared to have a discussion about what role they should play now, or even to be seen to have a discussion.’

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. 

Vic Rayner, chief executive of the National Care Forum, which represents not-for-profit care homes, said today: ‘It would be a grave mistake to discharge large numbers of Covid-19 positive people to care and nursing homes, particularly with the new variant of the vaccine being so virulent. 

LONDON HOSPITALS COULD BE ‘OVERWHELMED’ WITH COVID-19 IN TWO WEEKS 

London’s hospitals could be overwhelmed by Covid-19 in less than two weeks even in a ‘best’ case scenario, an NHS briefing has reportedly warned.

Medical director at NHS London, Vin Diwakar, provided the worrying analysis to medical directors of the capital’s hospital trusts over a Zoom call yesterday.

Even if coronavirus patient numbers grow at the lowest likely rate and capacity is increased – including opening the Nightingale – the NHS would still be short 2,000 general, acute and ICU beds by January 19, the HSJ reports.

Three scenarios are laid out for both general beds and intensive care – ‘best’, ‘average’ and ‘worse’. These account for the impact of four per cent daily growth, five per cent growth and six per cent growth respectively.

Growth for G&A beds on January 5 was 3.5 per cent, with the rate at 4.8 per cent for ICU beds, the report claimed.

Mr Diwakar found the ‘best’ case forecast would mean the number of Covid patients in G&A beds rising to 9,500 by January 19, with non-Covid patients remaining the same at 7,460 – a number which remains constant throughout all the scenarios. 

After small demand control measures, the total demand is predicted to be at 17,100.

Possible ways of increasing capacity includes the NHS securing an additional 400 beds, with the independent sector finding 50.

In addition to this, 1,000 ‘step down beds’, some supplied by the Nightingale hospital’s opening, and 150 made available by specialist trusts, would give a total capacity of 15,600 – still 1,500 short of the forecast demand.

‘Hospital patients must not be discharged to care homes without a cleared test result and there must not be pressure for care homes to take patients who are Covid-19 positive if they are not either established as a designated scheme, or have suitable arrangements in place. 

‘The crisis and pressure in the hospital sector is mirrored in the care and nursing home sector where we are already seeing testing and widespread community transmission causing rapid and unpredictable staffing shortfalls, adding phenomenal pressure to an exhausted and stretched workforce. 

‘Calls to protect the NHS must not ignore the massive potential impact on those living and working within care.’ 

The boss of healthcare union NHS Providers, Chris Hopson, confirmed this morning that hospitals are looking around for extra capacity.  

Many are seeing wards fill up at pace and the UK’s chief medical officers have warned there is a ‘material risk’ of the NHS being overwhelmed within weeks.

The national lockdown should bring down infection rates but hospital admissions will continue to soar as people who caught the virus over Christmas get sick.

Mr Hopson said on BBC Radio 4 today: ‘They [hospitals] know there is some spare capacity in the care and nursing sector.

‘They’re in the middle of conversations with care and nursing home colleagues to see if they can access that capacity.

‘It’s literally leaving no stone unturned to maximise every single piece of capacity that we’ve got, in those areas under pressure.’ 

A Department of Health and Social Care spokesperson said today: ‘No care home should be forced to admit an existing or new resident if they do not feel they can provide the appropriate care.

‘The NHS and social care systems are working closely together to ensure that patients are discharged as quickly and safely as possible. All patients will be tested on discharge from hospital and must have their result prior to admission to a care home.

‘We have put in place designated care home or NHS community settings that can provide Covid-positive residents with the care and support they need, while protecting other vulnerable residents from the risk of infection. 

‘This is in addition to £3billion to maintain independent sector support and Nightingale hospital surge capacity over winter, while supporting safe discharge from hospitals.’

If care homes are turned into overflow wards for hospitals it is likely only non-Covid patients would be sent to them, following uproar over a Government policy in the first wave which saw people recovering from coronavirus sent into care homes where they were feared to have triggered killer outbreaks.      

Mr Hopson explained that a big issue with the Nightingale hospitals, which were set up to provide overflow beds, is that they have to be staffed by the NHS.

But the NHS is already short of qualified medics, in some cases struggling to staff even hospitals’ own wards, let alone lend workers to others.

There are already more than 95,000 frontline medics off sick in England, with around half of those isolating because of coronavirus. 

Mr Hopson added: ‘It’s better if we can access any spare capacity in the nursing home sector because it’s got staff there.

‘We all recognise that if we’re going to do that then we really need to help care and nursing homes.

‘So, for example, if we’re going to discharge patients who need consistent access to high quality therapy we’re going to need to ensure that our community services can provide that support.

‘We also know if we’re going to discharge patients that are perhaps slightly more higher levels of acuity than normal we’re going to have to provide extra nursing support.

‘The issue is we’re now at a point where unless we can access this capacity, we’re not going to be able to treat the patients that we need to treat in the NHS.’ 

NHS England did not respond to a request for comment. 


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