Minister’s letter reveals pressure on hospitals to send patients into homes
A leaked letter from Health Secretary Jeane Freeman reveals the pressure piled on hospitals to move patients into care homes as the pandemic loomed. The minister wrote to health service managers in April to hail their efforts to meet “challenging” targets, demanding patients were moved out of wards to protect the NHS from collapse under an expected onslaught of Covid cases. However, hundreds of patients were transferred without being tested and dozens were sent into homes, where 2,000 residents would die of the virus, despite testing positive. Yesterday, Labour leader Richard Leonard said: “This letter confirms ministers, not clinicians, drove this policy and they must now explain why lives of residents were risked.”
Progress has been tremendous. We are very pleased – Health Secretary Jeane Freeman hails exodus of patients from wards
A leaked letter from Health Secretary Jeane Freeman has revealed the pressure put on hospitals to send elderly patients into care homes in the weeks before and after lockdown.
In the letter to health boards, dated April 10, Ms Freeman praises them for surpassing “challenging” targets as the NHS prepared for an onslaught of Covid patients. However, hundreds of patients were sent into care homes untested and the Scottish Government has come under sustained pressure since we revealed last week how dozens were transferred into homes despite testing positive. Critics of the policy have described it as “putting a match to tinder” in homes where almost 2,000 residents were to die in the pandemic.
The letter from Ms Freeman to NHS bosses reveals they had been asked to hit a target of clearing 900 delayed discharges out of hospital by the end of April before she goes on to thank them for making “tremendous progress” after they moved 920 patients out by April 8.
The “challenging” target cited in the letter can be revealed today, days after First Minister Nicola Sturgeon denied ministers had been involved in the process and insisted it was the responsibility of hospitals and councils to make individual clinical decisions. She added: “The responsibility of ministers is to put in place guidance.” However, Dr Lewis Morrison, chairman of doctors union BMA Scotland, said: “The responsibility for hospital discharge to the community is a complex mix of multidisciplinary clinical decision-making, NHS and local authority management of delayed discharges and, of course, Scottish Government policy and directives.
“At the beginning of the pandemic, decisions were taken and funding made available to facilitate a more urgent reduction in the numbers of patients delayed in hospital awaiting complex care or care home placement, to free up capacity for an anticipated but unknown major peak of Covid-19 admissions.” Ms Freeman and Cosla’s health spokesman, the SNP councillor Stuart Currie, wrote to Scotland’s health and social care partnerships, involving health boards and local authorities, to thank them for their efforts in clearing beds.
Their letter said: “The requests from Malcolm Wright, Director General, Health and Social Care,
during March to reduce delayed discharges by 900 by the end of April must have seemed very challenging when first made.
“We were very pleased to note that that goal was passed on April 8, when delays had reduced overall by 920 since the beginning of March – a remarkable national reduction overall of 57%. Please pass on our thanks to everyone involved.” Ms Freeman’s letter goes on to urge NHS bosses to continue to clear hospital beds but says the needs of patients must be the priority. It states: “Of course, it remains of paramount importance not only that we free up hospital beds to help manage our Covid-19 response but that now, as always, we are focused on ensuring people have access to the care that is most appropriate to their needs and wellbeing.
“We know that this is also your priority, and with this in mind we ask you to continue to do as much as you can both to sustain and to learn from the progress you have made to date.”
Official statistics show almost 2,000 deaths linked to coronavirus happened in care homes, almost half of Scotland’s toll so far, despite just 1% of the population living there.
Nick Kempe, a former Glasgow
City Council head of services for older people, wrote a report on the coronavirus crisis in care homes for think tank Common Weal. He said: “The average consultant would not have much idea of how good care homes were at infection control in general, let alone whether a specific home was capable of providing care to an infected person while ensuring the virus did not spread to anyone else. Those issues are outwith their remit.
“The Health Secretary’s letter shows the Scottish Government put enormous pressure on hospitals to discharge patients. The letter also said it remains of paramount