Legal action threatens to send hospital patients back to care homes at start of Covid pandemic in Northern Ireland


The Department of Health is facing a High Court legal action over a controversial decision to send patients from hospitals to care homes at the start of the pandemic.

A pre-action letter is to be sent to the department stating the guidelines it issued in March 2020 – put in place as the NHS prepared for a surge in seriously ill patients – “did not take into account the risk of transmission from asymptomatic people”.

The action, which is brought by the daughter of a woman who died in August 2020 after contracting Covid in the care home where she lived, added: ‘The failure to consider this was irrational.

This follows a High Court ruling last week that government policies regarding sending patients back to care homes were unlawful.

While the judgment concerned guidance in England and Wales, Northern Ireland has largely followed the same protocols when it comes to running care homes during the pandemic.

The pre-action letter pointed out that the guidelines issued by the Department of Health “appear to be a duplication” of public health guidelines criticized by the High Court last week as unlawful.

The action asked Stormont’s Department of Health to accept that, in light of last week’s decision, the guidelines it issued were ‘unlawful as it was irrational not to advise that, in the where possible, a patient discharged from hospital – other than one who tested negative – should be kept away from other residents for 14 days.”

In May 2020, Professor Martin McKee said moving hospital patients to care homes led to residents becoming infected, which then allowed Covid to spread throughout the community.

Professor McKee, a member of the independent scientific advisory group Sage, appeared before the Stormont Health Committee, where he referred to research he carried out into the spread of disease in prisons in the former Soviet Union and in mining communities in sub-Saharan Africa. Africa.

Prof McKee explained that prisons, mining communities and care homes were ‘institutional amplifiers’ and that once a disease ‘enters one of these institutional amplifiers it spreads rapidly’.

He added: ‘I think being told at all times that people in care homes were not at risk was very strange in light of what we know about these facilities, and particularly because we We’ve seen exactly that happen on early cruise liners — another form, perhaps a high-end form, of institutional amplifier.

“So I think the issue of care homes, we can’t get away from it.

“One of the factors that will come into any further investigation looking at the UK is that we have a relatively low level of hospital capacity and there has been pressure to get people out of hospitals to save the NHS, itself a laudable goal.

“But that meant people were being taken out of hospitals into care homes and sowing the infection there and then more widely in the community at a time when the testing regime was not well established.”

However, the Department of Health has since dismissed concerns that residents leaving hospital and returning to care homes were a significant source of transmission.

A report commissioned by the Department of Health, published in November 2020, was unable to find a correlation between hospital discharges and infection rates in nursing homes.

The research also found that the decision to send people back to care homes during the first wave of the pandemic was not driven by ministerial or departmental communications and that all decisions were based on clinical data.

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