‘Real concern’ about Covid-19 patients discharged to die in care homes, says Hertfordshire councillor

At the latest meeting of the county council’s special cabinet panel, Cllr Zukowskyj highlighted anecdotal evidence that elderly Covid-19 patients were being discharged from hospital to have palliative care.

But he has since learned that in some cases patients are not being discharged to the care home where they had previously lived – but to an alternative.

And he fears that some of the decisions may be being taken to free up beds in hospitals for those deemed to have a better chance – rather than in their own best interests.

He said: “I think there might be situations where discharge from hospital may be sensible – where it’s the right thing to do for an individual, to allow dignity in their last days.

“But I think it feels to me that at the moment the NHS has the balance wrong; discharging people and getting people out because they need the space for people more likely to survive.”

Cllr Zukowskyj says that he fails to understand why this should currently be the case, when hospitals are not running at capacity.

He says the discharge decisions may be skewing the data on the number of cases of Covid-19 and fatalities in hospitals – which, he says, is vital to determine the next steps to be taken.

And he says the practice may be increasing the risk of transmission to other vulnerable residents in care home.

Now he says Liberal Democrat councillors will push for reassurances – from the county’s health and social care bosses – that these discharge decisions are not having a harmful effect.

And, he says, they will be looking for reassurances focussed on the care of individuals, the transmission of the virus in care homes and the statistical understanding of the outbreak.

In response to the concerns, a spokesperson for Hertfordshire County Council confirmed that in some cases residents were being discharged from hospital to an alternative location that had isolation facilities.

But she stressed the safety and well-being of residents was taken ‘very seriously’- with individuals at the forefront of decisions.

“All patients in hospital will be routinely tested for the virus before being discharged to a care home, and wherever possible we are working to ensure people return to the care home they are resident in directly,” she said.

“However, in some cases this does mean that some people will need to be cared for in a NHS community hospital, or a temporary care home setting with isolation facilities, for 14 days until it is clear they do not have any symptoms.

“While it is not ideal for a person to be moved twice before they get to their home it is important that discharges from hospital are organised in a timely way that ensures people can be cared for safely, and in a way that minimises risk for individuals and other residents.”

Meanwhile East and North Hertfordshire Clinical Commissioning Group and the East and North Hertfordshire NHS Trust say hospital staff and social care staff are working together to ensure the “right plan” is in place.

In a joint statement, they say: “Whenever a person is ready to go home from hospital, either because their treatment is complete or because they won’t gain benefit from a longer stay, a plan is put in place which takes into account their wishes and needs.

“It is normal for older people to need more care when they are discharged from hospital than they required before they became ill. People often need extra support, additional equipment and specialist help for a period after their treatment has finished.

“Hospital staff work with their social care and community-based colleagues to put the right plan in place, which could be a stay in a community hospital, a home with additional nursing expertise, or their own home with extra help.”

And they say that during the Covid-19 pandemic they are working closely with the county council to identify ‘appropriate places’ for people to recover.

“Forty-eight hours before people are due to be discharged from hospital, we ensure that they are screened for COVID-19 to ensure that nobody who tests positive transfers to a community setting, care home or hospice,” says the statement.

“Testing, specialist advice and training and personal protective equipment is helping to keep people safe.“