Covid outbreaks in care homes may be linked to hospital exodus, Scottish public health chiefs admit

Covid outbreaks that ravaged Scotland's care homes may be linked to the SNP government's decision to transfer thousands of elderly hospital patients without testing many of them, public health chiefs have finally admitted.

In a revised analysis issued after a statistics watchdog criticised its original report, Public Health Scotland (PHS) said care homes were 21 per cent more likely to have an outbreak in the period within 30 days of a hospital discharge.

Although its new report said "no statistically significant association" was found between the two, it concluded: "We cannot rule out a small effect, particularly for those patients who were discharged untested or discharged positive."

The health body said the size of a care home was the largest factor in determining whether an outbreak occurred but its conclusion that hospital discharges may also have played a role placed further pressure on Nicola Sturgeon's government.

The First Minister seized on the original version of the PHS report, when it was published last October, quoting a passage that stated: "There is no statistical evidence that hospital discharges of any kind were associated with care home outbreaks."

But the Office for Statistics Regulation later criticised the presentation of the report, saying the discharges were "consistent with a causal relationship" between transfers and outbreaks.

Earlier this month, Jeane Freeman, the Health Secretary, admitted "we didn’t take the right precautions" when demanding that elderly Scots be transferred out of hospital wards and into homes.

Almost 5,000 patients were sent to care homes between March 1 and May 31 last year - most of whom were not tested. Even more shockingly, more than 100 were transferred despite having tested positive for the virus, without later testing negative.

Jackie Baillie, Scottish Labour's deputy leader and health spokeswoman, said the revised report provied "that the discharge of Covid positive patients into Scotland’s care homes fanned the flames of the pandemic and put lives at risk."

She said: “Despite the claims of the First Minister and the Health Secretary, it is clear that the discharge of Covid positive patients into care homes led to people’s lives being put in danger.

"The Scottish Government has catastrophically failed in its duty of care – this wasn’t ‘taking the eye off the ball’, this was a colossal and deadly failure of judgement. Those responsible must be held to account."

This revised PHS report said it was difficult to prove a link between hospitals and care homes, because patients were not routinely tested for Covid until April 21 last year.

By then 3,599 discharges had already taken place, of which only 650 were tested before they were transferred to a home. Seventy-eight of this group received a positive result while in hospital.

The revised report said a further 1,605 discharges took place between April 22 and May 31, 1,493 of whom were tested in line with the new procedure. Of these, 278 tested positive and 233 later had a negative test before discharge, meaning 45 did not.

It also reported that mortality was high among people discharged to care homes, with 675 people dying within 30 days from March to June 2020.

Covid was linked with 21.6 per cent of these deaths and in the 30 days following discharge, 154 people tested positive for the virus.

An SNP spokesman said: "While this report shows that a range of factors, not just hospital discharge, contributed to deaths in care homes from covid, and that the size and type of the care home, as well as the prevalence of covid in the community were strong factors, we express our sympathy for all those who have lost loved ones, and for the distress and grief experienced by individuals and their families."

A Scottish Government spokesman said: "As with the last PHS report, we will take forward all of the recommendations in this updated report and we will use the report's findings to better understand all the factors driving outbreaks in care homes."