Nurs­ing homes asked to take in pa­tients with­out neg­a­tive swab

Op­er­a­tors tell of con­cern with some say­ing they won’t ac­cept move as it stands

Irish Independent - - News - Cather­ine Fe­gan and Cor­mac McQuinn

NURS­ING homes are be­ing asked to ac­cept pa­tients from acute hos­pi­tals with­out a neg­a­tive swab for coro­n­avirus.

In the ab­sence of a swab to show the hos­pi­tal trans­fers have tested neg­a­tive, the homes are be­ing ad­vised “wher­ever pos­si­ble” to iso­late the pa­tients in a sin­gle room for two weeks.

In cor­re­spon­dence seen by the Irish In­de­pen­dent ,a con­sul­tant in one Dublin Hos­pi­tal told a col­league to in­form nurs­ing home op­er­a­tors that neg­a­tive swabs are only re­quired for “post-Covid pa­tients”.

The con­sul­tant added: “For non-Covid pa­tients there’s no re­quire­ment for swabs from hos­pi­tal or com­mu­nity but both groups should be iso­lated with droplet pre­cau­tions for two weeks.”

The con­sul­tant made ref­er­ence to HSPC guide­lines for res­i­den­tial Care Fa­cil­i­ties (RCFs), up­dated on May 4, which state that in re­la­tion to asymp­to­matic pa­tients: “Wher­ever pos­si­ble, ev­ery res­i­dent trans­ferred from an acute hos­pi­tal to a RCF should be ac­com­mo­dated in a sin­gle room.”

The HSPC guide­lines in re­la­tion to trans­fers also state:

“Although ac­cept­ing ad­mis­sion or trans­fer of res­i­dents poses a risk of in­tro­duc­ing Covid-19 to a RCF, this may be a nec­es­sary risk in the context of main­tain­ing ac­cess to a crit­i­cal ser­vice.”

Op­er­a­tors have raised con­cerns over the risk to vul­ner­a­ble res­i­dents by tak­ing acute hos­pi­tal trans­fers with­out the as­sur­ance of a test for the virus. One, who spoke on con­di­tion on anonymity, said he would not ac­cept any trans­fers with­out ev­i­dence of at least two neg­a­tive swabs.

Mean­while, Tadhg Daly, CEO of Nurs­ing Homes Ire­land, said nurs­ing homes could not be forced to take hos­pi­tal trans­fers.

“We would share the con­cerns ex­pressed in re­la­tion to ac­cept­ing hos­pi­tal trans­fers that have not been tested.

“There is no way of know­ing who pa­tients have come in con­tact with. In the past we were very con­cerned that there was fairly sig­nif­i­cant num­bers of dis­charges from the acute hos­pi­tals to nurs­ing homes and there was ques­tion marks around that. Each nurs­ing home has the right to de­cide them­selves whether or not they ac­cept trans­fers.”

In April, it was claimed that pa­tient trans­fers from hos­pi­tals hit by Covid-19 into nurs­ing homes had con­trib­uted to the cri­sis that un­folded in many of the care set­tings.

Nurs­ing home op­er­a­tors claimed the trans­fers sparked fa­tal out­breaks among vul­ner­a­ble res­i­dents and Mr Daly de­scribed the prac­tice as a “big con­trib­u­tory fac­tor” in the spread of the virus.

But ear­lier this week, HSE boss Paul Reid said there was “no ev­i­dence what­so­ever” that Covid-19 in­fec­tion spread into Ire­land’s nurs­ing homes by the dis­charge of el­derly peo­ple into nurs­ing homes in March.

Speak­ing at the Spe­cial Dáil Covid-19 Com­mit­tee, Mr Reid said how the virus got into res­i­den­tial and nurs­ing homes was still some­thing the Na­tional Pub­lic Health Emer­gency Team (Nphet) was

“try­ing to get a bet­ter un­der­stand­ing of ”.

Taoiseach Leo Varad­kar yes­ter­day told the Dáil the Depart­ment of Health had set up an in­de­pen­dent ex­pert panel to make rec­om­men­da­tions to en­sure a proac­tive Covid-19 ap­proach in nurs­ing homes as “we may be liv­ing along­side the virus for quite some time”.

He said: “We need to know how we can bet­ter shield nurs­ing homes in the sec­ond wave, if that is at all pos­si­ble.”

Health Min­is­ter Si­mon Har­ris said the panel would con­sist of four mem­bers in­clud­ing a pub­lic health ex­pert as chair­per­son, a geri­a­tri­cian, a se­nior nurse and a pub­lic in­ter­est rep­re­sen­ta­tive.

Mean­while, a so­lic­i­tor rep­re­sent­ing a HSE whistle­blower who works at St Mary’s nurs­ing home in Dublin’s Phoenix Park has called for greater trans­parency in re­la­tion to a HSE in­ves­ti­ga­tion into the mat­ter. Twenty-four res­i­dents have died from Covid-19 in the fa­cil­ity. Caoimhe Haughey’s client made a pro­tected dis­clo­sure al­leg­ing se­ri­ous fail­ings at the home. Ms Haughey claimed there was a “veil of se­crecy” about the re­view.

The HSE has ap­pointed a re­view team with an in­de­pen­dent chair to ex­am­ine the al­le­ga­tions made in the 35-page dossier.


Re­jec­tion: Paul Reid, HSE CEO, said there was no ev­i­dence that in­fec­tion spread into homes by hos­pi­tal dis­charges.

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