MPs told Hancock's 1.6% outbreak figure is among PHE's care home 'inaccuracies'

Health Secretary Matt Hancock's statement that only 1.6 per cent of care home Covid outbreaks originated from hospital discharges of Covid-infected patients is one of “a number of inaccuracies” in a Public Health England (PHE) report which the National Care Forum (NCF) says must be rejected as evidence.

Mr Hancock quoted the statistic in evidence he gave yesterday (10 June) in a joint session of the Health and Social Care Committee and the Science and Technology Committee, but the figure came from a PHE report (published 27 May 2021) that the NCF calls "upsetting" and “unhelpful”.

Vic Rayner, executive director of the NCF, which represents care home providers, has urged the joint committee, looking into lessons learned from the pandemic, to reject as evidence the findings of the PHE report.

'Upsetting' PHE report

In a letter to the Health and Social Care Committee and the Science and Technology Committee sent on 9 June, the care leader asks MPs to “call for an independent review” into the data.

Vic Rayner wrote: “The [PHE] report contains a number of inaccuracies”.

“Its main statement, that 1.6% of outbreaks were identified as potentially seeded from hospital, has provided a completely unrecognisable position from that experienced by hundreds, if not thousands, of care providers across the country between March and April.

“It is not correct to conclude that hospital associated seeding accounted for a small proportion of all care home outbreaks.”

The report also said a total of 806 (1.2%) care home residents had confirmed infection associated with these outbreaks.

The care leader has called the report an “upsetting and seemingly politicised response to support a narrative that implies that hospital discharge was not a primary cause of outbreaks.”

Covid negative patient discharge policy arrived 5 months later than claimed

Vic Rayner said the report gave “no meaningful context” about how many of the 25,000 people discharged to care homes during this period were tested.

Her letter, which was also sent to the Public Accounts Committee, highlights that for the period March 2020 to April 2020, “it is not possible to determine” how many outbreaks came from hospital.

When Mr Hancock referenced the 1.6 per cent figure as part of his evidence to MPs, Greg Clark, chair of the Science and Technology Committee told the health secretary this figure was “a stretch of the imagination”, as the data was not there to back it up because "people weren't tested."

Vic Rayner’s letter said the PHE report also failed to mention government guidance published on 2 April 2020 - which stated that residents did not need to be tested at the point of hospital discharge.

During March to mid-April last year, the care leader said any Covid tests that were used were reserved for those who demonstrated the government-defined symptoms of Covid, “which were often not those experienced by older people”.

The PHE report has been criticised for stating that on the 15 April 2020, a policy was introduced to ensure hospitals could only discharge a patient to a care home once they had received a negative Covid-19 test.

Vic Rayner wrote: “This was not the case”.

She says government policy to only discharge patients who tested Covid negative, was not introduced until the Autumn of 2020 as part of the winter plan – a whole five months later than claimed.

PHE report ‘silenced’ the ‘real experiences’ of families and care providers

Vic Rayner has criticised the “dismissive approach within the report" to what it refers to as to ‘anecdotal accounts’ from care homes of infections originating from hospitals.

She wrote: “These accounts were based on the real experiences of people, families, care providers and the workforce. These accounts are effectively silenced by the way in which data is utilised within the report.

‘Very real’ care home commentary has ‘as much validity' as data

Vic Rayner said a lack of testing in March and April 2020, and the sole focus on symptomatic testing meant in reality that “it is impossible to determine completely the cause of outbreaks”.

Therefore, she says “the very real commentary from homes about their perceived link between discharge and the seeding of infection should be viewed as having at least as much validity as the data presented in the report, if not more.”