Covid-positive patients were discharged to Scottish care homes in spring – report

The Scottish government has been accused of playing “Russian roulette” over the discharge of patients who had tested positive for coronavirus into care homes last spring, as opposition parties reacted angrily to a delayed report that concluded the risk was “not statistically significant”.

Care industry representatives and unions have called for a more detailed inquiry to reflect the experience of staff, after the Public Health Scotland analysis confirmed that dozens of patients who tested positive for coronavirus, along with thousands who went untested, were discharged from Scottish hospitals into care homes at the beginning of the pandemic.

Although the report concludes that the risk of an outbreak associated with care home size is much larger than that from hospital discharge, it also states that it “cannot exclude a moderate to large excess risk from a care home receiving a discharge where the last test was positive.” It adds that – when considered alone – the risk of an outbreak in the period soon after a hospital discharge was 21% higher than it was in a period without a discharge.

It also presents figures that show new guidance on mandatory testing of discharges, introduced towards the end of April, was not applied consistently.

The report was described as evidence of a “Russian roulette strategy” by Scottish Labour’s health and social care spokesperson, Monica Lennon.

Lennon said: “The combination of knowingly transferring the virus into care homes and not bothering to test hundreds of other patients before moving them, is unfathomable”.

Calling for a public inquiry into what she described as “a scandal”, Scottish Conservatives’ Holyrood leader, Ruth Davidson, said: “The SNP government’s response to this report is wholly inadequate and will give little comfort to those grieving families still trying to find out how and why their loved one died.”

Dr Donald Macaskill, the chief executive of Scottish Care, said that the voices of frontline workers were missing from the report, in particular those who “believe that Covid-19 was introduced into their care home community as a result of discharges”.

Referring to the report at her daily briefing, the first minister, Nicola Sturgeon, admitted that she had expected a different conclusion from the report – which was commissioned by the Scottish government after the Sunday Post revealed in August that at least 37 patients with a positive test had been transferred to a care homes as lockdown came into force and following ongoing concerns about the decision to move untested patients.

The report confirmed that only 650 of the 3,599 discharges from hospital to a care home between 1 March and 21 April were tested – before testing of new admissions became mandatory – and that of those, 78 received a positive result while in hospital.

It also shows that, between 22 April and 31 May, after the health secretary, Jeane Freeman, announced that two negative coronavirus tests would be required before discharge to care homes, this new guidance was not being implemented consistently. For example, 33 patients who had one positive test within 14 days of discharge did not have a second negative test before they were sent to their care home.

Also speaking at Wednesday’s briefing, the acting chief medical officer, Gregor Smith, said that the Scottish government would “take learning” from the report, in particular the findings about care home size: “It does make you wonder about whether contact and footfall is an important feature, but these are aspects we need to understand in a lot greater sense before we respond. These are people’s homes and it’s really important that we don’t cut people off from their communities and their loved ones.”