Health chiefs defied advice on hospital tests
Recommendations from scientists to test patients for virus before discharge were not enacted by NHS
‘It is the collective view that the infection and infectious status of all individuals should be known at discharge’
HEALTH chiefs failed to act on requests by government scientists to test all hospital patients for coronavirus before they were discharged, amid fears they were “reseeding” the disease in the community, it has emerged.
Minutes from a Scientific Advisory Group for Emergencies meeting on June 18, show that experts had “reiterated concerns” that infectious patients were being released without testing.
The Scientific Pandemic Influenza Group on Modelling (SPI-M) and New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), which feed into Sage, also both recommended that pre-discharge testing was vital in the previous weeks.
But the recommendation was not enacted by NHS England.
Last night, an NHS spokesman said: “The Government is responsible for setting policy on testing, which hospitals continue to carry out.”
On May 28, Nervtag said: “Since there continues to be acquisition of SARS-COV-2 in hospitals, patients admitted for other reasons may be presymptomatic or asymptomatic for Covid on discharge, and might reseed infections into the community. Consideration should be given to screening all patients before discharge.”
On June 17, SPI-M warned: “SPI-M is concerned about the discharge of infected patients from hospital, both into the community and into high-risk environments such as care homes.
“The considerable numbers of likely nosocomial (hospital-acquired) infections detected in hospital implies that comparable numbers of patients may also become infected in hospital, but then be discharged before they become symptomatic. It is the collective view that the infection and infectious status of all individuals should be known at discharge, and consideration given to quarantine outside the home for potentially infectious persons.”
Asked whether allowing untested patients to be discharged may have played a role in keeping cases higher in the community, Prof John Edmunds, a member of both SPI-M and Nervtag, said: “That was our fear at the time.”
Although the matter was put before the UK Senior Clinicians Group, which includes the four chief medical officers, Public Health England and the NHS, no action was taken.
The Department of Health and Social Care initially said that pre-discharge testing was the responsibility of NHS England, adding that the Senior Clinicians Group was not a decision-making body. But NHS England said the decision lay in the hands of the Senior Clinicians Group.
Prof Robert Dingwall, a SPI-M participant, said other factors may have influenced the decision, such as the accuracy of tests, and the harms of keep- ing people in hospital.
“Nervtag was expressing a view on a potential risk, but NHS England and DHSC were entitled to take a broader view of the likely benefits and harms and come to a different conclusion,” he said. “With the subsequent availability of the Office for National Statistics survey and the REACT study of community prevalence, it has become clearer just how much asymptomatic and mild infection is around in the community, and how little difference these discharged patients would have made if they’d acquired the virus in hospital.”
A DHSC spokesman said: “The current clinical advice is that testing of individuals without symptoms should be used where clinically appropriate, predominantly for outbreak investigation and infection control.
“We continue to use the latest science and clinical advice to inform our approach. Anyone who has symptoms can get a test and we continue to ensure that testing is as easy and accessible as possible.”