Government guidance on the treatment of care home residents with coronavirus is to be revised after cases where older people have been denied acute care.

One care home manager in Moray told healthandcare.scot current guidance led her to believe residents who contracted covid-19 would not be taken to hospital “under any circumstances”.

They had to go through a "painful process" of trying to get treatment for three residents presenting with coughs who they thought had chest infections, not covid-19.

She was informed by out of hours GP services they would receive no further treatment in line with government guidance.

A local GP who was subsequently contacted agreed with care home staff and prescribed medication to the residents who are now on the road to recovery.

Campaigners have raised serious concerns over a blanket approach. They say it could mean people are denied acute treatment in hospital solely on the basis they are in a care home, and that staff are placed at significant risk without the right protective equipment and soaring workloads.

healthandcare.scot understands work is now underway to revise the guidance.

Scottish care chief executive Dr Donald Macaskill has been leading the charge against the “potentially discriminatory” guidance.

Had the manager not fought for their residents, he says, they “those people would have gone on to palliative care.”  

“It is clearly happening, that individuals are adopting a blanket ban at the acute sector level on allowing people form care homes to be admitted.

“What I want to do is to work with clinicians and government to make sure there is flexibility for instances where there is the prospect of a positive clinical outcome. It’s the one size fits all approach that risks discrimination and that is what we want changed.”

The Scottish Care chief believes current guidance “has not been sufficiently clear and…makes it presumptive that somebody should be maintained and treated where they are putting at a disadvantage people in care homes – it makes it automatic that is it only palliative care that will be provided.

“So, in light of that, Professor Graham Ellis who is the lead on that guidance has agreed to rewrite it to make its intentions clear.

“From my perspective I want it to be clear that if it is going to be of clinical benefit to somebody to be transferred to an acute environment then that option should be open to the clinicians involved.

“I have been getting emails – including some from consultants – that some of the barriers and blocks to acute care have been when people have been received at A&E and effectively turned away.

“I hope the new guidance that will come out this week hopefully should make it more explicit and less discriminatory.

“Possibly now there is more understanding that we could have capacity – it’s difficult to know why it wasn’t more permissive in the first instance – possibly a fear of the acute sector being completely overwhelmed – but all I am really concerned about now is it becomes more permissive now going forward, and that that messages gets out to front line clinicians in the acute sector.”

 

 

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