Government official says discharging 25,000 untested patients into care homes was right decision

Discharging 25,000 hospital patients to care homes without testing for COVID-19 was not “high risk and wrong”, the Department of Health and Social Care’s (DHSC) most senior civil servant has said.

Top civil servant Sir Chris Wormald told MPs during the Commons Public Accounts Committee meeting on 22 June: “We believe that we took the right decision based on the right clinical evidence at the time.”

The permanent secretary at the DHSC, was responding to a question from Labour MP Nick Smith, who highlighted government guidance from 2 April which advised care homes that they ‘could admit patients with COVID-19’.

“Given what we knew at the time about what was happening in places like Italy, in care homes, do you now accept that was high risk and wrong guidance?”, asked Nick Smith.

Chris Wormald replied: “We believe that we took the right decision based on the right clinical evidence at the time.

“We are both undefensive and reflective on what we have done both in the NHS and in social care.”

‘Balance of risk judgements’

But Nick Smith pressed on with his questioning by asking Chris Wormald: ”Given that there were 400,000 vulnerable residents in care homes, do you think that the guidance that care homes ‘could admit patients with COVID-19’ was high risk?”

The health official said: “There were clearly risks in whatever you do in these circumstances. I’m not going to deny there were risks.

"All our guidance is very carefully considered based on the best clinical advise at the time. There are considerable risks to people staying in hospital. When we are setting our guidance on all these issues, we’re having to take balance of risk judgements, where there is no no-risk option.”

'Pretty reckless'

Conservative MP Geoffrey Clifton-Brown asked: “Wasn’t this a pretty reckless policy by the government?”

Permanent secretary Chris Wormald replied: “We don’t believe that. At this point COVID was not considered to be widespread in the community.”

Mr Clifton-Brown then reminded the health official that there were already 1,000 care homes with coronavirus cases at the beginning of April - the peak of the pandemic - when this guidance was in place.

The Conservative MP suggested the government’s actions was “to stop the NHS being overwhelmed and there wasn’t the same degree of care … for the care homes, who had to deal with these patients”.

Chris Wormald was answering questions put to him during the Commons Public Accounts Committee in light of a National Audit Office (NAO) report which found that 25,000 people were discharged from hospitals to care homes in England between 17 March and 15 April.

In Wales alone, 1,097 patients were sent from hospital to Welsh care homes without being tested for COVID-19 during March and April, the Welsh Government has confirmed.

The government's hospital discharge policy is in the spotlight and has been widely criticised for its failure to meet health secretary Matt Hancock's promise to create "a protective ring" around care homes.

Formal legal action over the government's guidance is being taken by the daughter of an 88-year-old man who died in a care home.

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