Tests denied to care homes at pandemic peak

Matt Hancock gives the daily press briefing from Downing Street on 15th April 2020
Matt Hancock gives the daily press briefing from Downing Street on 15th April 2020

Government agency told Enfield care homes with symptomatic residents it could not provide testing, report James Cracknell and Bella Salteil

Care homes in Enfield were refused Covid-19 tests for symptomatic residents at the peak of the pandemic, the Dispatch can reveal.

Health secretary Matt Hancock told a Downing Street press conference on 15th April that any symptomatic care home resident would be tested. But days later, Public Health England (PHE) was still refusing to issue such tests to care homes in Enfield – reserving them only for homes “reporting recent suspected outbreaks”.

At Elizabeth Lodge, where care worker Sonya Kaygan and several residents died in the borough’s worst coronavirus outbreak, tests were refused on the basis that Covid-19 had already spread widely throughout the home. A spokesperson for Care UK, which runs the Highlands care home, said that on 16th April “we asked for tests for residents who were displaying symptoms and were told that we couldn’t have tests because we already had an outbreak at the home”.

In an email to another borough care home, seen by the Dispatch, a PHE official told the home’s manager on 18th April that they were “not managing this as an outbreak at this stage” and would not issue any tests. One resident at Eastbrook House in Edmonton had already died, while two others had Covid-19 symptoms.

By chance, Eastbrook House was later invited to take part in a pilot programme of mass testing. Manager Jonathan Beacham says the care home was one of just 15 across England to take part, a “stroke of luck” that he says saved lives. The tests subsequently administered proved that half of Eastbrook’s residents had Covid-19 – including the two residents denied tests a few days earlier.

Jonathan told the Dispatch: “Lives were saved by being in that pilot. It enabled us to focus on isolating residents who had coronavirus and stopped it from sweeping to the rest of the home.

“If it wasn’t for that we could have had a full house of Covid-19. We got away with it by the skin of our teeth.

“If other care homes were waiting three weeks to get any tests, the virus would have spread. They were just too slow. You can promise 100,000 tests [per day] but delivering it took too much time. Public Health England was only capable of [mass] testing residents at 15 care homes – that is not good enough.”

Out of 25 deaths at Elizabeth Lodge during the pandemic, 17 residents and one member of staff are confirmed as having died from Covid-19. Although Care UK says that supplies of PPE had been sufficient and that no patients had been discharged from hospital to Elizabeth Lodge, on the issue of testing the company’s spokesperson said: “Along with many other care home providers, we worked with Care England to flag to ministers concerns around the lack of availability of testing for the care home sector.”

According to the Office of National Statistics, Enfield had the most coronavirus-related care home deaths in London. Between 10th April and 19h June, there were 187 total care home deaths across the borough, of which 74 were “deaths notified as involving Covid-19”. Enfield has the third-highest number of care homes in London, with 82.

On 5th June Enfield Council leader Nesil Caliskan wrote to Matt Hancock calling on the government to fix “flaws” in its testing regime – saying only one in ten borough care homes had been offered mass testing. On 15th May the health secretary promised to “test every resident and every member of staff in our elderly care homes in England between now and early June”. At the end of June one third of care home residents were still awaiting tests.

National Care Association chair Nadra Ahmed has been scathing of the government’s response. She said: “Why on earth did it take so long to recognise the importance of testing? This is the unfolding tragedy of the decisions taken not to support vulnerable people in social care settings – it is unforgivable.”

A Department of Health and Social Care spokesperson said: “During this unprecedented global outbreak we have kept our social care guidance under constant review and have been working tirelessly with the sector to reduce transmission and save lives.

“As a result, according to the latest PHE statistics, 57% of care homes have had no outbreak at all. The government has built a robust and efficient testing programme at record pace, ensuring that anyone who needs a test can access one.”

Dr Edward Wynne-Evans, from PHE London, said: “All of Public Health England’s advice and guidance, including specific guidance for care homes, is based on the latest scientific evidence. As the pandemic develops, evidence and advice evolve and guidance is actively updated to reflect that. The care homes guidance we produced was related to what we knew at the time, and with further evidence, it was later updated.

“Care homes have always been a priority for Public Health England, and along with the wider health sector we are working closely with care homes and the care sector to provide advice and support to them in preventing and managing cases and outbreaks. Our routine infection control advice includes advising on isolating and cohorting residents, cleaning and appropriate use of PPE.”