Covid hospital patients can be discharged to care homes without a test,  say guidelines sent to providers

Coronavirus hospital patients can be discharged into care homes without being tested under draft Government guidelines leaked to the The Telegraph.

Care providers have said they are "deeply worried" about the latest proposed rules, which advise clinicians to release patients without requiring them to have a test 48 hours before discharge if they have no new virus symptoms and have isolated in hospital.

For the first time, the Government appears to acknowledge that people could test positive for Covid but not be infectious, suggesting "it will be appropriate for them to move directly to a care home from hospital… because we now know they do not pose an infection risk to other residents in a care home".

It describes this sub-group as "immunocompetent and with no new symptoms" even if they are within 90 days of their initial symptoms or positive test result.

Care home owners fear a repeat of the rapid spread of infections caused by a Government diktat of March 19 stating that infected patients could be discharged into care homes without a test.

The widely-criticised policy was blamed for care homes accounting for roughly half of all excess deaths – 25,374 – between March 7 and September 18, according to the Office for National Statistics (ONS).

The proposed guidance, sent out this week, states: "Clinicians should review people who have previously tested positive for Covid-19 and are within 90 days from their illness onset and test date, against the following considerations.

"Does the patient have no new Covid-19 symptoms or Covid-19 exposure? Have they completed the appropriate isolation period? If the answer is ‘yes’ to both, the person may be discharged straight to a care home without having to enter and isolate in a designated care setting. The person does not require a further Covid-19 test in the 48 hours prior to discharge."

Patients who do not meet the criteria must isolate for 14 days upon arrival into a care home.

The move comes amid growing concern about the reliability of lateral flow (LF) tests that the Government last month stipulated should be used by home staff twice a week on top of their weekly polymerase chain reaction (PCR) tests. 

Professor Jon Deeks, of the University of Birmingham, said it was "a scandal and a tragedy" that LF tests were being used in care homes and schools after research found they failed to pick up 60 per cent of Covid-19 infections in Liverpool, including 30 per cent of people with high viral loads.

"There has been no proper scientific evaluation of these rapid tests," he said. "No one seems to be telling anyone that negative results are completely unreliable, so they are spreading more infection. They’ve got to be stopped.”

Nadra Ahmed, who chairs the National Care Association, said members were "deeply worried" about the latest proposed advice on hospital discharges, warning that care homes would refuse to accept patients if they weren’t "100 per cent confident" that they were no longer infectious, exacerbating bed shortages.

A Department for Health spokesman said:  “Our priority is to ensure everyone receives the right care, in the right place at the right time. 

“We have been doing everything we can to protect care homes since the start of the pandemic providing billions of pounds of additional funding, free PPE, infection control guidance, increasing staff testing and providing priority vaccines.”

After the Telegraph went to press, the Government updated its official guidance. Like the leaked draft, it states that individuals who are within 90 days of their initial symptoms and positive test who have already completed 14 days isolation, have no new Covid-19 symptoms or exposure "are not considered to pose an infection risk."

It adds: "They therefore do not have to be re-tested and can move directly to a care home from hospital."

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