Nicola Sturgeon: Older people may have died as result of care home policy

Nicola Sturgeon has admitted that older people may have died as a result of the government’s decision to discharge them from hospitals into care homes as it readied the NHS for coronavirus patients.
Care home deaths may have been the result of the Scottish Government's strategy, it has been admitted.Care home deaths may have been the result of the Scottish Government's strategy, it has been admitted.
Care home deaths may have been the result of the Scottish Government's strategy, it has been admitted.

The First Minister said that the decision to clear beds for an influx of Covid-19 patients had been right to protect older people who did not need to be in hospital for medical reasons, from catching the virus.

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However, while she said she could “not say for certain” that people died as a result of being discharged from hospital into care homes, she admitted “equally nor can I absolutely say that will not be the case”.

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Ms Sturgeon’s statement came as it was reported 14 people had died in Orchard Care Home in Tullibody, Clackmannanshire. It is operated by the same private firm HC One, that has seen 10 deaths in its Skye residential home.

Six in every 10 care homes in Scotland have now had at least one case of Covid-19, with 45 per cent of care homes currently infected. In total 1,623 residents have died due to the coronavirus outbreak.

Last week Health Secretary Jeane Freeman admitted that 921 “delayed discharge” patients were moved to care homes in March, yet mandatory testing of all those being moved into care homes only started on April 21, raising fears that the untested patients transferred from hospitals took the infection into homes with fatal results.

Today Ms Sturgeon said if hindsight was applied she would come to a different decision, but added: “We’re dealing with a situation that has a lot of uncertainties, that’s been true since day one and will continue to be and I try to be honest about the implications and consequences of that.”

She agreed that “serious questions” would be asked about the policy decision, but added: “It feels like we’re trying to be penalised for being open.

“If maybe we could wind the clock back we would take different decisions, but I cannot see the circumstances in which we would conclude it was right to keep older people who didn't need to be in hospital in hospital while hospitals were filling up with cases of this virus.

“When you deal with something like this there are no perfect options available to you, you have to do what you think is best based on the knowledge you have at the time. We didn’t do nothing to protect older people. Yes, there may be different things we would have looked at had we known then what we know now, but protection of people was foremost in our minds.

“I would rather deal with a situation where there are hard certainties, but that’s not the situation we have, and we are facing now, and as we go through next few weeks and months I am sure there will be knowledge that changes – that's what makes it so challenging.”

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Ms Sturgeon said that her “heart breaks” for all those who had “lost loved ones” and added: “The assurance I can give is that we will do the very best we can to protect people, including making sure we don’t act too quickly in easing lockdown restrictions.”

Asked if there would be a formal review into the government’s decision on discharging vulnerable patients to care homes, she said: “I have no doubt that there will be inquiries and reviews into every aspect of this crisis and how governments have handled it and that would be right and proper, and care homes will be part of it.

“It’s easy to apply hindsight and say what we did then was completely wrong, but if you think back to then we didn’t have many good choices. We had a situation where we had older people, who were not medically required to be in hospital, in the delayed discharge category, and at that time we were preparing for an increase in coronavirus cases into hospitals.

“Take ourselves back there and you realise it would have been putting people at significant risk not to get them out of hospital, and back then there was a different view on the efficacy of testing people who didn’t have symptoms. We have got to accept that what we did at the time was put in place a risk assessment process for patients who were discharged and issued strong guidance to care homes about isolation and infection prevention and control.

“I take real exception to anybody who suggests we didn’t act with thought and care about older people in hospitals being discharged to care homes, we can apply hindsight and say we could have done things differently, but at every stage we have sought to take the right decisions based on what we thought was the right thing to do to keep people safe.”

Pressed on whether she owed families who had lost loved ones in care homes an apology, she added: “I am trying to be as candid and open as possible, on a whole range of things which if we knew the information then as we do now, we may have taken different decisions.

“If we had left older people in hospital we would also have been putting them at significant risk and families would have been concerned about that. People who were discharged were risk assessed and guidance was given to care homes, including not having communal eating or activities.

“Taking knowledge we have now that we didn’t have then and applying that back is easy to do. As we learn about this virus we have adapted as the knowledge has suggested that we should and we will continue to do that.”

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Today Scottish Labour leader, Richard Leonard, said that the high number of deaths at the Orchard Care Home showed how “quickly the virus can spread and how susceptible older people are.”

He added: “Serious questions need to be answered by the Scottish Government about the delayed discharge policy at the beginning of this pandemic and also the impact that a lack of Personal Protective Equipment and testing has had on the spread of the virus in care homes.

“At a time when we should have been protecting the most vulnerable in our society, it appears that in a rush to protect the NHS from being overwhelmed, care homes were badly let down.

“From the beginning, it was known that elderly people are more vulnerable to the virus, therefore it was inexcusable to discharge patients into care homes without first testing them – a policy that was in place for six weeks.”

Health Secretary Jeane Freeman said that the government would publish all the data about care homes deaths when it was robust.

She added: “Public Health Scotland needs to bring two databases together – the discharge database and the testing database – and that is not straightforward. They have to find out if it’s possible to marry it up, that they haven’t missed anything, that they’re comparing apples with apples.

“We’ve said we will publish it, but it needs to be data people can rely on, so it needs to go through those processes with clinicians and statisticians to make sure it meets professional standards.”

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