(C) OpenDemocracy This story was originally published by OpenDemocracy and is unaltered. . . . . . . . . . . Covid inquiry: Scotland ‘waited too long’ to test patients discharged to care homes [1] [] Date: 2024-01 The Scottish government waited two months after concerns were raised to introduce Covid tests for hospital patients being discharged into care homes, the UK’s Covid inquiry has heard. Donald Macaskill, the chief executive of Scottish Care, which represents the country’s independent social care sector, said he warned the then-secretary for health and sport, Jeane Freeman, about the need to test outgoing hospital patients for Covid in late February 2020. At the time, guidance from Health Protection Scotland, part of Public Health Scotland, said patients set to be discharged to care homes should be subject to a clinical assessment. It was not updated to state that patients admitted to care homes should be tested until 21 April 2020. There were 4,193 deaths registered in Scotland where Covid was mentioned on the death certificate between 16 March and 19 July 2020. Almost half of these deaths (47%) related to care homes, according to the National Records of Scotland. Help us uncover the truth about Covid-19 The Covid-19 public inquiry is a historic chance to find out what really happened. Make a donation During the two months without proper testing, Macaskill said Scottish Care advised its members not to admit new patients unless they were assured of “the robustness of the clinical assessment”. Guidance from Public Health Scotland to care homes issued on 13 March 2020 said operators should accept admissions to the home only “if safe”. “We challenged that that should include the testing of those being admitted, both from the community and from discharge from any setting but particularly in acute and secondary care settings,” Macaskill told the inquiry’s module 2A, which looks at decision-making in Scotland during the pandemic. “There were reasons given to us as to why that was not possible and the argument that was made by clinicians was that a robust clinical assessment should be sufficient to enable somebody to be admitted.” Care homes and care providers felt under pressure to admit discharged patients in order to keep NHS beds free and protect hospitals’ capacity, Macaskill added. “We were cautious about being the sector which stopped that flow, but on the other hand, we were also extremely well aware that the population most at risk (...) tended to be a population that lived in Scotland's care homes.” On 18 March 2020, Scotland’s then-first minister, Nicola Sturgeon, and Freeman received a briefing document from Derek Grieve, the Scottish government’s head of social care response, advising that laboratories did not have the capacity to deal with testing both patients being discharged to care settings and existing care home residents. Macaskill confirmed when questioned that Scottish Care’s position of testing only hospital patients being discharged to care settings could have helped to reduce demand for tests while still protecting those most at risk. He acknowledged that in February and March 2020, the UK and Scotland’s testing capacity had been limited, but said that also prioritising social care residents and staff – as well as NHS staff – would have helped prevent outbreaks of the virus in these settings. Better testing would also have reduced periods of isolation for residents and better protected care staff, he added. “The palpable fear that individuals felt in working for care was extremely high,” he said. “It's to their credit that those individuals continued to get up in the morning, leave their families and go out to care homes and to other people's homes.” Macaskill described the care sector in April 2020 as facing “a very real risk of collapse of our workforce” owing to the spread of the virus. Extending testing to staff sooner would have made an immense difference at a critical time, he said. ‘A lack of engagement’ Macaskill described a “minimum level of engagement” from Public Health Scotland in the development of Covid-19 guidance for care homes and care services in community settings in March 2020. Scottish Care was given only hours to comment on the first guidance issued to care homes before it was published on 13 March, Macaskill confirmed. As well as challenging the lack of testing, Scottish Care also raised concerns that the guidance developed for a hospital setting was being transposed to care settings without necessary adaptions. Advising people to social distance in a care home, for example, ignores the reality of working and living in such an environment and could harm residents living with dementia, he said. Macaskill said there was a “lack of engagement and professional respect” from Public Health Scotland (PHS) to the social care sector throughout the pandemic. He added that PHS’s understanding of issues such as infection control and prevention in care settings was “wholly regrettable”. “I think we failed to balance the rights, the individuality of individual care home residents in guidance which was developed by people who had no contextual understanding and, to be blunt, showed no interest in gaining that interest in understanding from people like myself and other practitioners,” said Macaskill. “That guidance treated people as a group, as a blanket entity, instead of the individuals who have rights and autonomy, which they deserve to be treated as.” Prioritising the NHS Mackaskill said there was an “almost myopic political, media and public attention and focus on the NHS at all costs” during the pandemic, which at times had a detrimental effect on social care workers. He recalled an instance of frontline care staff not being given the same priority as other key workers to use supermarkets and mentioned that the first two weekly ‘Thursday night clap for the NHS’ had excluded care workers. “The emphasis on ‘protect the NHS’ everywhere made social care staff feel – and certainly providers of care home and home care feel – we’re of less significance and of less value,” he said. openDemocracy is fundraising to pay reporters to cover every day of the public hearings. Please support us by donating here. [END] --- [1] Url: https://www.opendemocracy.net/en/covid-care-homes-scotland-inquiry-test-hospital-patients-discharge-deaths/ Published and (C) by OpenDemocracy Content appears here under this condition or license: Creative Commons CC BY-ND 4.0. via Magical.Fish Gopher News Feeds: gopher://magical.fish/1/feeds/news/opendemocracy/