EXCLUSIVE: Government and NHS not to blame for COVID-19 discharges, says leader

Tony Stein at Healthcare Management Solutions at Drakes Cross near Wythall.

A care home leader has contested the view that the discharge of thousands of untested people into care homes resulted in the high number of COVID-19 related deaths.

Tony Stein, CEO of Healthcare Management Solutions (pictured), said this had “absolutely” not been the case at his care homes, adding he had struggled to find any evidence to back up the claim.

The care home leader told CHP: “I believe that it is not right to attempt to place blame on the government or the NHS for ‘forcing untested people into homes and therefore contributing to the high death toll’.

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“Operators had the choice and they, and only they, have to decide whether they can safely accept new residents into their services. If they block contracted beds in services that couldn’t safely isolate new admissions, then the fault surely lies in that decision.

“There were homes within our wider group that we knew had spare beds but in which we knew couldn’t, for a variety of reasons, safely isolate all new admissions for 14 days and we did not offer those beds.

“Those where we did offer beds, handled every new admission as though they might have COVID-19 and we isolated, and barrier nursed them until we knew they were not infected. We would have done this had they tested positive or not as the test would only have told them they were/weren’t infected at the time they were tested and that may have been days prior to discharge during which time they could have been infected.”

The care leader said operators who were arguing they had been forced to take in untested patients that they were unable to safely care for were in breach of their registration.

Tony said if LAs had threatened to withdraw their business from operators if they did not take in untested patients then that would have amounted to an “abuse of market position” and should be dealt with on a case by case basis. He added that none of the over 50 authorities he had dealt with had taken such an approach.

The care home chief’s comments follow major reports by ADASS and the NAO last week which revealed that 25,000 people were not tested on discharge to care homes from hospitals between 17 March and 15 April.

ADASS President, James Bullion, said the policy had been a “significant cause” of care home infection with “tragic consequences”.

Tags : CoronavirusHealthcare Management SolutionsleaderNHSTony Stein

The author Lee Peart


  1. I wonder if that article is missing the central point; which really is that small independent care homes weren’t within the “Operators had the choice…” scene at all. Those small independents didn’t have such choice, and that’s simply because they had to have ‘occupancy’; whereby, if an ambulance delivered a new admission to their door where the NHS had refused to prior-test for Covid-19 (Even after the Govt.’s announcement that such prior testing was policy – as I have seen evidence of having occurred) they were in an obvious Catch-22 position. What were they to sensibly do?

    1. Care homes were under pressure from the NHS but I suppose mostly to blame are greedy service providers who could not take in people from the community and couldn’t bear to have empty beds. You cannot isolate people effectively in a care home where people with dementia live

  2. Stephen, I sympathise and, to be fair, some of the larger operators were/are in a similar position regarding empty beds and financial commitments however I would always urge any home owner not to chase occupancy at any cost. We need to consider all of the variables if we’re to properly understand why there were so many deaths in some homes. If you did decide to accept a resident whose condition was unknown then following isolation protocols and barrier nursing for 2 weeks should have determined, one way or another, that particular resident’s condition. When this virus first appeared we didn’t understand about asymptomatic transmission. It may be that as our knowledge grows we’ll find that residents may well have been isolated for two weeks, shown no symptoms, but then still be found to have been carrying Covid? Who knows for sure? As an operator we can all list the possible reasons why some homes were hard hit and others weren’t. We had homes that didn’t take any of the hospital discharges but had deaths in double figures. A couple of these were in parts of the country very badly hit with the virus. Maybe it was simply to do with staff movement back and forth between home and community? I just don’t like overly simplistic narratives based upon anecdote and hyperbole as I don’t think that they help.To settle on “it’s all the NHS’s fault because not everyone discharged had been tested doesn’t seem right without hard evidence and ignores all of the other factors completely.

  3. Frequently patients are transferred to care homes with an incomplete discharge package and this was no exception during the Covid-19 outbreak.
    Discharges were sent via a ‘trusted assessor’ care plan which covered basic needs..
    At the outset of the pandemic, it was a pressing time for NHS staff to free up hospital beds; however systems of care must maintain safe standards whatever the cost.
    Facts about medical details can be omitted but they are essential to the Well being follow up care and should be made known to the new care provider.

  4. Mr Stein has not addressed the issue of residents who were in hospital for other reasons and then were returned to the care homes without being tested first. This happened to us just before lockdown and I was informed by the discharge nurse that hospitals were not testing before discharge and I was made to feel like some sort of criminal for suggesting that we would not take the resident back into the home before being tested.

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