Question reference: S6W-00150
- Asked by: Mercedes Villalba, MSP for North East Scotland, Scottish Labour
- Date lodged: 21 May 2021
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Current status: Answered by Kevin Stewart on 27 May 2021
Question
To ask the Scottish Government, further to the answer to the Urgent question by Kevin Stewart on 20 May 2021 regarding the Mental Welfare Commission for Scotland report, Authority to discharge, whether it had sought advice regarding whether the discharge of patients who had not been tested for COVID-19 or had tested positive from hospital to care homes was unlawful and, if so, whether it will publish this advice.
Answer
The Scottish Government did not seek any advice on whether the discharge of patients who had not been tested for COVID-19 or had tested positive from hospital to care homes was unlawful. Any decision on whether a patient is ready for discharge is a clinical one, made by the clinician in charge. Where someone is most appropriately cared for after discharge is based on a multi-disciplinary assessment involving the individual and their family carers. In cases where a patient lacks capacity, an appointed guardian or carer with power of attorney, will be involved. If somebody is discharged to a care home it is because that has been assessed as the best place to meet their needs.
In March 2020 the Scottish Government issued guidance which stated that prior to people being admitted to a care home whether from hospital or the community, clinical screening should be undertaken of patients alongside a risk assessment to ensure sufficient resources including appropriate isolation facilities are available within the care home to support social distancing and isolation. The guidance recommended all admissions to be isolated for 7 days and if known to have contact with COVID patients for 14 days. Both clinical decisions around discharge and risk assessments are undertaken locally by health and social care professionals. There is no involvement of Scottish Ministers.
On 21 April 2020 the then Health Secretary announced that all admissions to care homes from hospital should have a negative test for COVID-19 prior to admission to the home, regardless of symptoms unless it is in the clinical interests of the patient to be moved, and then only after a full risk assessment. Where a patient has tested positive for Covid two negative tests are required. This policy is reflected in both Scottish Government and Health Protection Scotland guidance for care homes.
On 28 October 2020 Public Health Scotland published analysis of discharges to care homes between 1 March and 31 May 2020. This report was subsequently updated on 21 April 2021 This report is available on the Public Health Scotland website at https://beta.isdscotland.org/find-publications-and-data/population-health/covid-19/discharges-from-nhsscotland-hospitals-to-care-homes/ .