East Lothian ‘not as badly affected’ by transfer of patients to care homes

by Marie Sharp Local Democracy Reporter

No incidents of patients being moved from hospital to care home during lockdown are under investigation in East Lothian.

Alison Macdonald, East Lothian’s director of health and social care, said that low levels of delayed discharge patients from the county meant it was not as badly affected by the transfer of patients as other areas.

A Public Health Scotland report into the decision to move elderly patients out of hospitals and into care homes in the early stages of the pandemic was published this week.

It revealed that nearly 5,000 patients were moved from hospital to care homes between March 1 and May 31 in Scotland.

Between March 1 and April 22, 3,599 patients were released, with more than 80 percent of them not tested for coronavirus before being transferred to care homes – one in three were delayed discharge patients.

In the NHS Lothian healthboard area alone, 771 patients were moved into care homes, with nearly half of those transfers taking place in March, before it became standard practice to test them for the virus.

The number of patients transferred into East Lothian’s 19 care homes has not been released; however, the national report acknowledged that East Lothian Health and Social Care Partnership had moved 12 patients from hospital into temporary care home accommodation during the first wave of lockdown.

Speaking about the impact of transfers at a meeting of East Lothian Integration Joint Board, Ms Macdonald said that a low level of delayed discharges – people in hospital because they were waiting for a care package to allow them to be released – helped the county.

She said: “East Lothian had a low level of delayed discharges, we did not have a huge requirement to move people through the system, there were some, but we have not been made aware of any that are subject to investigation.”

She added, however, that did not mean that it would not happen in the future.

Councillor Fiona O’Donnell, IJB chairperson, paid tribute to care workers in the county for all their work during the pandemic.

She said: “I want to put on record my thanks to care home teams and all our staff; this report must weigh heavily on them and we thank them for their continuing efforts to keep people in our care homes safe.”

The independent report into the impact of transferring patients into care homes concluded that the biggest impact was in homes with more than 90 residents, with more than 90 per cent of Covid outbreaks occurring in the larger homes, compared to just 3.7 per cent in homes with 20 residents or fewer.

The report said: “Care home size has the strongest association with outbreaks of Covid-19, and this association persists after taking account of other care home characteristics, including discharge from hospital.

“Risk of a care home outbreak increases progressively as the size of the care home increases.

“Hospital discharge is associated with an increased risk of an outbreak when
considered on its own.

“However, after accounting for care home size and other care home characteristics, the estimated risk of an outbreak reduces and is not statistically significant.”