Far from a ‘protective ring’, messages show that care homes were cast adrift
Carers are likely to react with horror at discussions over not testing patients admitted from community
‘We will keep working to strengthen the protective ring that we have cast around all our care homes’
‘For individuals coming from the community, we will move to them being tested prior to admission’
It was during a Downing Street press conference on May 15 2020 when Matt Hancock first claimed to have thrown “a protective ring” around care homes.
Although the former health secretary appeared on the Andrew Marr show in June 2021 insisting he had not uttered the phrase until “much later”, he in fact used that form of words on at least three occasions to describe the action taken during the first wave of the pandemic.
On May 15 2020, Mr Hancock said: “Right from the start, it’s been clear that this horrible virus affects older people most. So right from the start, we’ve tried to throw a protective ring around our care homes.”
Three days later, when questioned on this wording, Mr Hancock told the Commons: “We absolutely did throw a protective ring around social care, not least with the £3.2billion worth of funding we put in right at the start, topped up with £600million worth of funding on Friday.”
He used the phrase again, a day later, telling MPS: “I am glad that we have been able to protect the majority of homes, and we will keep working to strengthen the protective ring that we have cast around all our care homes.”
Yet the Whatsapp messages exchanged between Mr Hancock and his aides in response to the advice of Prof Sir Chris Whitty, England’s Chief
Medical Officer, on care home testing in April 2020 appear to tell a rather different story. On April 14 2020, Sir Chris’s position was clear. He believed there should be “testing of all going into care homes” – and segregation while awaiting the result.
Initially, Mr Hancock welcomed this advice as a “good positive step” and recommended it be included in the Government’s eagerly awaited “Covid-19: Adult Social Care Plan” to be published the next day.
But at the last minute, he appeared to change his mind. In a Whatsapp message to Allan Nixon, one of his aides, Mr Hancock said: “I do not think the community commitment adds anything and it muddies the waters.” Appearing unsure about the decision, he caveated this with: “Tell me if I’m wrong.” No one replied to say he was.
Yet when the government guidance was published the next day, it said it would “move to institute a policy of testing all residents prior to admission to care homes”. However, it said this would “begin with all those being discharged from hospital” – with the NHS taking “responsibility for testing these specific patients, in advance of timely discharge”. “For individuals coming from the community,” it added, “we will move to these residents being tested prior to admission.”
Placing the onus on care providers – rather than making testing of such patients mandatory – the guidance added: “The majority will have come from isolation in their own homes given social distancing and shielding policies. After discussion with the new resident and family, the care home may wish to isolate the new resident for a 14-day period following admission.”
Sir Chris’s advice to “segregate” all those going into care homes – rather than just those coming from hospital – was not made mandatory either. Of course, there is no way of knowing what other conversations were taking place behind the scenes at the time.
But care providers are likely to react with horror at Mr Hancock dismissing mandatory tests for patients admitted into homes from the community on the basis that it “muddies the waters”.
The health secretary insisted he was following the science, but this appeared to be a political decision. He would, more than a year later, concede to the health and social care committee on June 10 2021: “The strongest route of the virus into care homes, unfortunately, is community transmission.”
The last-minute change of mind is all the more puzzling since the April 15 guidance was released to replace a disastrous diktat from April 2, which stated that infected patients could be discharged into care homes without a test. The widely criticised policy was blamed for care homes accounting for roughly half of all excess deaths (25,374) between March 7 and Sept 18 last year, according to the Office for National Statistics, as coronavirus
ripped through facilities caring for 400,000 residents in England.
Far from feeling a “protective ring” had been thrown around them, private care providers found themselves having to deal with infected residents without sufficient personal protective equipment, which at that point was largely being stockpiled for the NHS.
Despite caring for those at most risk of catching and dying from Covid, the Government guidance came far too late for many homes – which were desperately trying to barrier-nurse critically ill elderly residents while operating with staff absence rates of up to 50 per cent, according to a survey by the National Care Forum.
Even when the vaccinations were finally rolled out in Jan 2021, only one in 10 residents and 14 per cent of staff were initially injected – despite Boris Johnson’s insistence that they would be “first in line” for a jab.
My father Dr Damian Tominey, a former GP and care home owner, wrote in The Telegraph in Sept 2020: “The Government should have been better prepared for the Covid-19 crisis, and its shambolic response to the pandemic has compromised one of the most vulnerable groups in our society – the elderly.”
Six months into the pandemic, he described the testing of staff and residents as an “unresolved fiasco” – pointing out that they had never received results back within 24 hours as Mr Johnson and Mr Hancock had promised, with the delays resulting in asymptomatic staff and residents unwittingly infecting others.
The Whatsapp messages now cast new light on the decision-making that formed the backdrop of a 79 per cent rise in mortality rates in English care homes in the first 16 weeks of the pandemic. Sadly, the water on care homes is not muddy but crystal clear – those who most needed a ring of protection largely found themselves cast adrift.