Thousands of hospital patients to be discharged early to hotels or their own homes to free up beds for Covid-19 victims in need of life or death care, the Guardian has learned .
Hospital leaders in England plan to begin early discharge of patients on an unprecedented scale, as an emergency measure to create “additional emergency contingency capacity” and stop parts of the NHS falling, senior sources said.
Documents seen by the Guardian also revealed that the NHS is urging care homes to start accepting Covid patients directly from hospitals and without a recent negative test, as long as they have been alone for 14 days and they have not shown new symptoms.
Under the “home and hotel” plan, patients discharged early to a hotel will receive assistance from voluntary organizations such as St John’s Ambulance and the British Red Cross, armed forces medical staff and personnel. any available NHS staff.
The London Hotel Group (LHG), which owns the best chain in the West, has begun taking Covid-positive patients who are homeless from King’s College hospital in south London and who are looking after them at their hotel in nearby Croydon. He is in talks with 20 other NHS trusts and says it could provide 5,000 beds.
Families will be expected to play a key role in monitoring and caring for loved ones who are sent home days or weeks before they leave hospital, with the support of health professionals where that can be done.
The plans come amid growing concerns that hospitals will soon recover and that the crisis may not go away for several weeks. There are more than 35,000 Covid patients in UK hospitals, with that number rising by 6,213 in the last week alone.
NHS leaders fear that the new Covid variant, which has raised disease rates in London and the south-east and east of England, is leaving many hospitals struggling to cope, and they will soon do the same in the south-west and north-west.
As a result of the high levels of sickness absence in the health service and its leading role in the government’s major immunization campaign, NHS sources have warned that many staff will not have time to deliver high quality care at home. private or hotels once patients are discharged.
But they said patients will not be asked to leave hospital early if they are still at medical risk, so they should need mostly mild care. “This is for patients who do not need to be in a hospital bed but still need to be in a protected environment,” said one official.
NHS England, as well as the leaders of the most stressed hospitals, are holding detailed talks about implementing the “home and hotel” option for what a major NHS source said would involve “thousands”. of patients. It is part of their effort to create “additional emergency care capacity” once other options, such as doubling or tripling emergency care capacity and the use of emergency Nightingale emergency hospitals, are said, sources said. .
LHG said their hotels could provide beds for at least 5,000 patients involved in early discharge, including 1,500 in London. LHG chief executive Meher Nawab said: “We will be looking to roll out this solution across our hotels to provide a lifeline to hospitals at this crucial time. “
An LHG spokesman said: “The group of patients that the NHS is trying to replace at this stage are recovering or recovering from Covid and are medically fit for discharge. , so they do not need special medical guidance or care, but cannot return yet. home. This frees up NHS bed space and makes it relatively easy for hotels to accommodate. ”
But the plan has sparked controversy, with patient groups raising concerns about its impact. Lucy Watson, chair of the Patients’ Association, said: “This is a difficult situation, where the NHS often does not have good options. Discharges early from hospital appear to be one of the few options open to the NHS to manage the scale of current need.
“However, early discharge can often cause complications that can cause harm to the patient and the need for re-introduction. Volunteer care in hotels is not an appropriate place for proper hospital care. But at a time when hospitals are overcoming critically ill patients and trying to prevent large-scale loss of life, it is clear that they are making urgent choices. ”
Dr Charlotte Augst, chief executive of umbrella group National Health Voices, said: “We have questions about where the health and care staff come from to look after these people and how to deal with a decline. any with the long waits. for 111 or 999 services.
“We believe this proposal is a reflection of the unsustainable decisions that NHS leaders are now making due to the significant pressures on the system with this latest lock-in. ‘coming back too late to enable the NHS to provide universal, high – quality services for all. . ”
Jeremy Hunt, the former health secretary who now chairs the Commons health select committee, warned on Tuesday that the NHS is facing a “triple whammy” of potentially dangerous pressures. in this winter and means that the maximum pressure may not reach until February.
Chris Hopson, chief executive of NHS Providers, said trusts would expand capacity but “will also work closely with community services and social care partners to make the most of medically fit patients”.
At the same time, the NHS is urging care homes to start accepting Covid patients directly from hospitals and in the absence of a recent Covid test, the Guardian has learned.
The policy was to send Covid patients to designated “hot” care homes where the spread of infection could be limited and to prevent last year’s spring infection in care homes, which was partially controlled. hospital discharge. But a target of 500 such homes was set at a loss, leaving only 2,533 beds available.
An NHS document sent to some care providers states: “We now advise that it will be appropriate for some in this group to move directly to a care home from hospital… because we now know that they are not an infectious hazard. other residents in a care home. ”
If clinicians assess that a patient has no new Covid symptoms or manifestations and has completed their loneliness, they may be discharged directly to a care home without further Covid testing in the 48 hours prior. released, he adds.
The plan has raised concerns among carers who want an assurance that no one who comes out of hospital 14 days after a positive test can pass the virus.
“We have said we need to see strong clinical evidence,” said Nadra Ahmed, executive chair of the National Care Association, which represents independent carers. “We need to have full confidence if someone is coming out of hospital having the confidence that they are no longer infectious. ”
Professor Martin Green, chief executive of Care England, which represents private care providers, said: “The key is, it’s up to the care homes to decide and hospitals should not stress or suitability of care homes. ”
The Department of Health and Social Care was invited to comment.