Patients discharged from hospitals without Covid test results

Almost half of hospital patients have been discharged without receiving the results of their coronavirus test – including some patients who were sent to care homes, new research has revealed.

Independent national patient body Healthwatch England said it had learned many patients were discharged from hospitals between March and August this year without proper assessments with many vulnerable people sent home without medication, equipment or the care they needed.

At the start of the pandemic thousands of patients were discharged to care homes as NHS England instructed hospitals to free up 15,000 beds ahead of the first wave of coronavirus.

Approximately 25,000 patients were sent to care homes with some not tested, sparking fears this helped seed care homes with the virus. There have been around 16,000 care home deaths linked to Covid-19.

According to a survey of almost 600 discharged patients and interviews with 60 NHS staff, Healthwatch England said it had found serious flaws with the way hospitals had followed NHS England’s instructions.

In joint research with the British Red Cross, shared with The Independent, it found 44 per cent of patients were discharged without knowing the result of their coronavirus test including some to care homes.

It said: “Despite the policy stating that all patients discharged to a care home should be tested for Covid-19, we found that 26 per cent of our survey respondents who were discharged to a care home were not tested.”

While the numbers involved were small, only 13 out of 50 patients, the report added this was “still a significant proportion of people who were required to be tested but did not receive one”.

Healthwatch added that while patients going to care homes must have the results available and shared with the home it was still not national policy to test everyone being discharged. It argued this should now be an ambition for the government.

Its report also raises concerns about the wider care of vulnerable patients sent home from hospital.

Key findings include:

88 per cent of patients reported having care needs after being discharged that have still not been met.  

82 per cent did not receive a visit or assessment from a health professional

Almost one in five of those who did not receive a visit reported unmet needs.

In total 45 per cent of people with a disability and 20 per cent of people with a long-term condition had support needs that were not being met following their discharge.  

Healthwatch England criticised the national discharge policy put in place by NHS bosses as “confusing” in places which it said may have contributed to some patients missing out on the care they needed.

Sir Robert Francis QC, chair of Healthwatch England, said: “In March, hospitals were asked to discharge patients with little or no notice and the speed with which this took place was important but led to mistakes.

“We do not want to detract from the heroic efforts of those on the frontline, who often put themselves at great risk to care for their patients, but services and system leaders have now had more time to prepare.

“It’s essential that we learn from what people have shared with us about the impact that a poorly handled discharge can have on them and their loved ones. Taking action now will not only reduce the risk to patients but will also help improve the way people leave hospital in the future.”

The British Red Cross and Healthwatch England said assessments for patients needed to be prioritised.

They also called for discharge checklists to make sure patients were asked if they needed help with transport and equipment.

Other recommendations included making sure carers and patients had a single contact for support which was already national policy but still not fully adopted.

The report also said community services needed to be boosted to cope with increased demands.

British Red Cross chief executive Mike Adamson said: “We’ve seen first-hand the huge efforts made to improve the discharge process for patients and their families. However, we also know despite good intentions and hard work, there are still barriers to making the ideals of discharge policy a reality.

“The Red Cross has been bearing witness to these issues for years, and we hope that the increased urgency of the situation will bring lasting change. Many of the people we support are older or more vulnerable, and fall into the higher-risk categories for Covid-19.

“Simple interventions, like getting equipment and medicine delivered, or follow-up visits, can make the difference between good recovery or someone regressing to the point of readmission - precisely at the time we want people to stay well, and stay at home.”

Professor Stephen Powis, NHS national medical director, said: “There has long been a wide consensus about the benefits for patients of being able to return home as soon as their specialist hospital care is complete, and it is good that delays have been reduced in recent times. While this is a very small snapshot survey, local hospitals will want to take account of the points it makes.”