Hospital discharge link to care home outbreaks 'not ruled out'

Public Health Scotland (PHS) has said it “cannot rule out” a link between hospital discharges and coronavirus outbreaks in care homes.

Its latest report found mortality to be high among people discharged to care homes, with nearly a third of Scotland’s homes experiencing an outbreak.

According to PHS, 675 people died within 30 days of discharge – 14.1% of all of those discharged – and Covid-19 was associated with 21.6% of deaths within 30 days of hospital discharge.

In the 30 days after their hospital discharge to a care home, 154 people tested positive for the virus – 3.5% of all people discharged who had not previously tested positive.

The report, which is available online, states: “Hospital discharge is associated with an increased risk of an outbreak when considered on its own.

“It is important to note that after accounting for care home size and other care home characteristics, the estimated risk of an outbreak due to hospital discharge reduces.

“No statistically significant association was found between hospital discharge and the occurrence of a care home outbreak.

“However, due to the uncertainty observed, we cannot rule out a small effect, particularly for those patients who were discharged untested or discharged positive.”

Using laboratory-confirmed cases, the report says 348 care homes in Scotland (32.1%) experienced an outbreak between March 1 and June 21 last year.

Earlier this month, outgoing health secretary Jeane Freeman told the BBC’s Politically Thinking podcast that the Scottish Government had failed in “understanding the social care sector well enough” and “we didn’t take the right precautions” when older people were leaving hospitals.

Scottish Labour health and social care spokeswoman Jackie Baillie said the PHS report “has shown what we already know – the discharge of Covid-positive patients into Scotland’s care homes fanned the flames of the pandemic and put lives at risk”.

She added: “Despite the claims of the First Minister and the health secretary, it is clear that the discharge of Covid positive patients into care homes led to people’s lives being put in danger.

“The report confirms that Covid-positive patients were discharged into care homes on numerous occasions and illustrates the danger of this practice and how it led to cases in care homes.

“Thousands of care home residents lost their lives to this dreadful virus and many thousands more were put in danger.

“The Scottish Government has catastrophically failed in its duty of care – this wasn’t ‘taking the eye off the ball’, this was a colossal and deadly failure of judgment.

“Those responsible must be held to account.

“Scottish Labour is committed to a public inquiry into the situation in Scotland’s care homes and is dedicated to ensuring that such a travesty never occurs again.”

Scottish Liberal Democrat leader Willie Rennie said he warned at the time of the dangers of admitting untested residents into care homes.

He said: “Families have been treated to a longstanding exercise in spin and duplicity as ministers sought to minimise their role in the most tragic saga of this sorry year.

“Care homes were missed out of pre-pandemic exercise planning and received more than 3,000 untested patients from hospital.

“That was shamefully neglectful. The forthcoming public inquiry must ensure that nothing like this can ever happen again.”

An SNP spokesman said: “Every loss of life is a tragedy no matter how or why it happened, and as the SNP have made clear, we are committed to a full public inquiry, to be established by the end of the year, to learn the lessons of the Covid pandemic, including the impact on care homes and their residents.

“While this report shows that a range of factors, not just hospital discharge, contributed to deaths in care homes from Covid, and that the size and type of the care home, as well as the prevalence of Covid in the community, were strong factors, we express our sympathy for all those who have lost loved ones, and for the distress and grief experienced by individuals and their families.

“Saving people’s lives has been and continues to be the priority of the Scottish Government and by beginning the vaccination programme in care homes as soon as the vaccine became available in Scotland, we have ensured that there have been no excess deaths in Scottish care homes since the start of this year, and that deaths in care homes have fallen by 95%.”