Falkirk GP's concerns over hospital transfers into care homes without COVID tests

David Herron, the GP clinical lead for the Falkirk Health and Social Care Partnership, said he was concerned at a paragraph stating that testing may not be appropriate in some cases.

These included if a patient didn't have capacity to consent to a test; if it may cause distress; or in an end-of-life care situation.

Speaking at a meeting of Falkirk's Integrated Joint Board last week, Dr Herron said: "We need to consider how we interpret that locally, because I personally don't consider any of these three things as a reason not to test, given the possible implications for every other resident in the home.

"I don't know why that paragraph was put in Public Health Scotland's report and I am really quite concerned it might be interpreted in a manner that would be wrong."

Professor Angela Wallace, NHS Forth Valley's nurse director, told Dr Herron she "couldn't agree more".

She said: "From a Forth Valley perspective there is absolutely no suggestion that any of those reasons in that paragraph would happen here."

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She promised to take up his challenge regarding decision-making, saying "there is a real moral and ethical dilemma as well as human rights dilemma there".

"Decisions around all of these things can be very individual with clinicians and families and that's absolutely right - it certainly shouldn't be a blanket thing.

"I'd be happy to work with you to make it clear that wouldn't happen here, unless there was a reason for that and that was decided by families and clinicians and individuals alike."

Overall, the national report concluded that the size of a care home was the most important factor and the risk of an outbreak associated with hospital discharge "is not statistically significant".

Since April, patients have been required to have two negative Covid tests before they can leave hospital, and all new residents in care homes must be isolated for 14 days.

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