Discharging hospital patients who are infected with coronavirus into care homes has always been allowed in “exceptional circumstances”, Nicola Sturgeon has insisted.
The First Minister said the Scottish Government’s policy – thought to prevent infected patients being moved from hospitals to care homes – has always contained exemptions.
When asked in the Scottish Parliament last week if a woman who tested positive for coronavirus should be discharged into a care home, Ms Sturgeon told Scottish Labour MSP Neil Findlay there was “no policy of that nature”.
The few instances we are aware of are where a resident is being discharged because they are at end of life – they are going home to a place which is prepared and ready for them with all support needed – we all deserve to die at home amongst those we know.
— Scottish Care (@scottishcare) November 22, 2020
Independent social care sector group Scottish Care tweeted to say the “few instances” it was aware of relating to infected discharges involved end of life care but Mr Findlay said this did not apply in the case he raised.
Health Secretary Jeane Freeman has also previously said “no-one should be discharged from hospital who has a positive test for Covid-19” and had not mentioned any exemptions.
Guidance announced on April 21 stated anyone being admitted to a care home should have had two negative test results beforehand.
At Monday’s coronavirus briefing, Ms Sturgeon said the policy has always allowed some infected patients to be discharged without requiring them to test negative for the virus.
She insisted the policy has not changed and it always said moving anyone with a known infection from hospital would require “exceptional circumstances” and be based on the “clinical interest of a patient”.
The First Minister said: “The policy is that anyone who has had Covid-19 should have two negative tests before being discharged from a hospital to a care home.
“Anyone who has been in hospital for reasons other than Covid-19 should still have one negative test recorded before they are discharged to a care home.
“That is the policy and that is very clear, and it has not changed since we introduced that earlier in the pandemic.”
Arguing that politicians should not interfere with clinicians’ decisions, she added: “In any situation in a hospital, fundamentally and ultimately there will be exceptional circumstances where the clinical needs of a patient demand that something outside an overall policy happens.
“That is true in Covid, it is probably true on absolutely everything.”
Scotland’s interim chief medical officer Gregor Smith said there is an “ethical necessity” for some people to be exempt from taking a coronavirus test and risk assessment is more important than the outcome of tests.
“The guidance is very clear in the sense that people should have a negative test before there is any movement from a hospital to a care home but there may be exceptional circumstances where that doesn’t happen,” he said.
“We know that the case of infectiousness tends to be between particularly the first seven days, it can extend a little bit further than that up to 14 days, but beyond that it’s very unusual to get any transmission.
“So all of that is risk assessed for anyone who is discharged, even though you can get a persistent positive test for many weeks beyond that.”
The latest figures show Scotland has 141 homes (13%) with coronavirus infections.
A total of 5,486 care home patients have tested positive for coronavirus and there have been 2,071 deaths of residents attributed to Covid-19, according to Care Inspectorate figures.
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