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Serious concern that care home placements are being considered for Covid positive patients 

Statement & Letter to Secretary of State for Health Matt Hancock on Care homes housing coronavirus positive patients direct from hospital.
Serious concern that care home placements are being considered for Covid positive patients. In the first wave of the coronavirus pandemic, the impact of this virus on care homes was nothing short of catastrophic.Once again however, care homes are being considered by the Government as a way of creating extra hospital bed capacity by accepting residents who are Covid positive, or who have tested negative and then come into contact with someone who has tested positive.

Today we have written to Secretary of State Matt Hancock to say that while we are fully aware of the bed capacity pressures facing our local NHS services, we simply cannot accept our care homes being used in this way.

There are currently a significant number of Covid positive patients within our local NHS Hospital Trusts - North Middlesex and the Royal Free Chase Farm. This unsustainable amount of pressure creates the risk that means our hospitals may either be unable to accept new urgent cases, or there will be a rise in the number of requests for care homes to admit Coronavirus positive people to free up hospital bed capacity.

North Middlesex University hospital has already announced all non-emergency activity has stopped, with the exception of cancer and radiology treatments. The hospital is rapidly approaching a point where it may have to begin diverting blue light services to other areas.

Given that local hospitals in Enfield find themselves limited in bed capacity because of the coronavirus crisis, it is critical the Government and the NHS now consider the need for additional and alternative hospital stepdown facilities for patients who in normal circumstances would remain in hospital until they were Covid free.

No Covid positive patient should be discharged into a care home, whether there is capacity to isolate or not. The risk is simply too great.  Care homes in Enfield should not accept any admissions from hospital settings where people have not received a negative PCR test result immediately prior to their discharge

We have written to the Government to ask what their plans are to urgently address this issue before it is too late. We have offered Enfield’s Council’s assistance in identifying land for temporary structures to house additional hospital beds for elderly and vulnerable residents who are Covid positive.

Enfield Council simply cannot and will not support plans to discharge patients with coronavirus into care homes where the risk of the virus spreading amongst our most vulnerable residents is simply too great. 

Letter Text - from Cllr Caliskan
Dear Secretary of State for Health,

I am writing to you to express my grave concerns about the ongoing and significant impact of this pandemic on our local NHS services in Enfield. I am particularly concerned that the increasing pressure on our local NHS Hospital Trusts, North Middlesex and Royal Free Chase Farm, will result in significant Covid positive in-patients  with the hospitals either unable to accept new urgent cases or an increase in requests to admit Covid positive people into care home beds in order to free up hospital bed capacity.

In the first wave of this pandemic, the impact of this virus on care homes was nothing short of catastrophic. In Enfield we have one of the largest care home markets in London and the impact has been disproportionately felt here with 60% of our 83 care homes suffering outbreaks.

Many dedicated care staff and vulnerable residents lost their lives as this virus entered our care homes. A significant contributing factor in that was lack of testing before people were discharged back to these care homes from hospital. It is for that reason that Enfield Council has taken a very clear position that care homes in our borough should not accept any admissions from hospital settings where people have not received a negative PCR test result immediately prior to their discharge. We simply cannot have a repeat of what happened in the first wave of this pandemic.

Locally we are currently in a position where North Middlesex NHS Trust, our local A&E hospital and one of the busiest in London, is operating at in excess of 97% capacity, with, as at today, 166 of its 382 general and acute beds occupied by patients who are Covid positive. All cases are being actively tracked and the number of Covid positive patients occupying hospital beds within this trust is expected to increase to 250 over the next two weeks.

This is generating significant pressure within our Health and Social Care system. With effect from Tuesday 22nd December, North Middlesex University hospital announced all non-emergency activity has been ceased, with the exception of cancer and radiology treatments. The hospital is rapidly approaching a point where it will have to begin diverting blue light services to other areas. This in itself creates an enormous amount of risk and with it comes pressure to discharge in order to free up beds for people who really need them.

The designated bed capacity established across the North Central London sub-region to support our hospitals with Covid positive discharges is also approaching capacity and we are now being asked to explore the option of creating additional designated bed capacity within our care homes. To be clear, that is a request to receive admissions into care homes for people who are either Covid positive or who have tested negative and then subsequently come into contact with someone who has tested positive.

Whilst I am fully aware of the pressures facing our local NHS services, I simply cannot accept our care homes being used in this way. No Covid positive patient should be discharged into a care home, whether there is capacity to isolate or not. The risk is simply too great. Over 10% of our most vulnerable people living in care homes died as a result of this pandemic in the first wave. These deaths accounted for half of our total deaths in wave one in Enfield. Behind that shocking statistic are hundreds if not thousands of lives impacted in the cruellest possible way with loved ones being lost in homes where they believed they were being helped to stay safe.

Given that local hospitals in Enfield find themselves limited in bed capacity because of the Covid-crisis, it is critical the government and the NHS consider now the need for additional and alternative hospital stepdown facilities for patients who in normal circumstances would remain in hospital until Covid free. Therefore, I am formally asking you, what the government’s plans are to achieve this.

We understand that this is an unprecedented and very fast-moving situation. However, time and again this Council has stepped up and shown itself ready and willing to work with government and other agencies to deliver what is needed on the ground to help keep our community safe.

Enfield Council stands ready to continue this work and to deliver in partnership with government, the NHS and our partners, temporary, safe, alternative NHS accommodation for Covid positive people being discharged from hospital where they can be cared for safely and appropriately until they are free of the virus. For instance, as a local authority we can swiftly identify land for additional temporary hospital beds for elderly and vulnerable residents who are Covid positive.

Our local NHS is on its knees. They are doing the very best that they can, but they simply cannot cope and require urgent government assistance. A failure to act urgently and at pace will result in our local hospitals closing their doors to new admissions, including those who are Covid positive. Government must, therefore, act now for the sake of our most vulnerable residents. 

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