Coronavirus: 25,000 people discharged from hospitals to care homes without tests at height of pandemic, NAO confirms

Former health secretary Jeremy Hunt says report reveals 'no one appeared to consider the clinical risk to care homes'


Care homes screen visitors for coronavirus to protect residents – but until 15 April people were being discharged from hospital without tests. Photo: Owen Humphreys/PA Wire/PA Images

Twenty-five thousand people were discharged from hospital into care homes without being tested for the coronavirus before the government changed its policy.

A new report by the National Audit Office confirms that 25,000 people went untested from hospitals into care homes between mid-March and mid-April.

Jeremy Hunt, the Conservative former health secretary who now chairs the Commons Health Committee, said the findings were “extraordinary” and came “despite widespread knowledge that the virus could be carried asymptomatically”.


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The latest figures show that more than 13,000 people have died in care homes from causes involving Covid-19 since the start of the pandemic.

The NAO’s report, which looks at the wider response of the NHS and the care sector to the pandemic, says the health service moved to ensure there “were enough beds and respiratory support nationally at the peak of the outbreak in April”.

It upped the numbers of available beds by more than 40,000 by “discharging patients and postponing elective, or planned, procedures”, a move that the NAO says helped it to “respond at speed to the unprecedented challenge of the Covid-19 pandemic”.

But, in a finding branded “scandalous” by one care staff union, the spending watchdog said: “Patients discharged quickly from hospitals between mid-March and mid-April were sometimes placed in care homes without being tested for Covid-19.”

Hospitals were, on March 17, told to “discharge urgently all in-patients medically fit to leave in order to increase capacity to support those with acute healthcare needs”.

“Between 17 March and 15 April, around 25,000 people were discharged from hospitals into care homes, compared with around 35,000 people in the same period in 2019,” the NAO said.

And it added: “Due to government policy at the time, not all patients were tested for Covid-19 before discharge, with priority given to patients with symptoms. 

“On 15 April, the policy was changed to test all those being discharged into care homes. It is not known how many patients discharged to care homes had Covid-19 at the point they left hospital.”

'Afterthought'

Hunt said: “The figures released by the NAO today confirm that 25,000 patients were discharged into care homes without being tested at the height of the epidemic. 

“Whilst the impact of such discharges meant the NHS was never short of beds or ventilators it seems extraordinary that no one appeared to consider the clinical risk to care homes despite widespread knowledge that the virus could be carried asymptomatically. 

“Places like Germany and Hong Kong took measures to protect their care homes that we did not over a critical four week period.” 

And Christina McAnea, assistant general secretary of Unison, whose members include care workers, claimed the “catalogue of errors” showed “a complete absence of planning or thought for social care”

“Discharging patients to care homes without testing was simply scandalous and accelerated the spread of the virus among an obviously high-risk group,” she said.

Labour’s Meg Hillier, who chairs the Commons Public Accounts Committee said of care homes: "Residents and staff were an afterthought yet again: out of sight and out of mind, with devastating consequences."

The NAO’s report also found that the government’s bid to get health and social care workers tested for covid-19 ran into “challenges”, with “limits on testing” capacity meaning tests could only be rolled out to symptomatic staff from late March.

“From 28 April, all care home staff were eligible for tests but the DHSC capped the daily amount of care home tests at 30,000, to be shared between staff and residents,” the report said.

And it added: “The government does not know how many NHS or care workers have been tested in total during the pandemic.”

The spending watchdog meanwhile said the only central stockpile of personal protective equipment (PPE) available to the health and social care sector at the start of the outbreak “was designed for a flu pandemic” — with calls to step up the supply unheeded.

“Although an independent committee advising on stockpile contents had recommended in 2019 that items such as gowns and visors should be included, these had not been stockpiled,” the NAO said.

Labour’s shadow health secretary Jon Ashworth said the NHS had “entered the Covid-19 crisis exposed after years of underfunding, bed cuts and with huge staff shortages”.

And he added: “We now need a resourced plan to help the NHS meet the growing burden of unmet clinical needs, such as growing waiting lists and delayed treatment.”

But a Department of Health and Social Care spokesperson said: “This is an unprecedented global pandemic and we have taken the right decisions at the right time based on the latest scientific and medical advice.

They added: “We have been working tirelessly with the care sector throughout to reduce transmission and save lives and a result 60% of care homes have had no outbreak at all, according to the latest PHE statistics.

“Since the launch of whole care home testing, the government has provided over 1 million test kits to almost 9,000 care homes and on Monday we announced that every care home in England will now be offered a coronavirus test for all residents and staff, even if they have no symptoms.

“We have delivered over 1.7 billion pieces of PPE and we continue to ensure supplies reach the frontline. The modelled PPE requirements presented in this report are theoretical worst case estimates - it is misleading to compare them to figures on centrally procured PPE which do not account for equipment supplied through other routes or existing local stocks.”

Gareth Davies, the head of the NAO, said the report showed “the enormous efforts of staff across health and social care to respond at speed to the unprecedented challenge of the Covid-19 pandemic”.

But the watchdog said: “Government’s ability to increase beds, ventilators, PPE and testing has varied in part because of the number of other bodies, both national and international, with which it has had to engage. All of these issues need to be taken into account as government plans for the later phases of the pandemic and future emergencies.”

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