LIVES could have been saved in care homes in Scotland if it was not for the confusion caused by guidance issued in the early days of the Covid-19 pandemic, it has been claimed.
The Covid Inquiry has entered its third day in Edinburgh, where it is looking at how decisions were made during the pandemic by the Scottish Government. It is separate to the Scottish Covid Inquiry.
Speaking on Thursday, Dr Donald Macaskill (below), chief executive of Scottish Care, said he had “absolutely no doubt” deaths could have been avoided if it had not been for confusion over whether residents should or should not have been referred to hospital if they had Covid-19.
His statement came after Usman Tariq, counsel to the UK Covid Inquiry, read aloud an email that Scottish Care received on March 25, 2020, from one of its members raising concerns about guidance issued to the sector which seemed to suggest people in care homes who developed Covid-19 should not be referred to hospital.
Tariq told the inquiry the member said the suggestion appeared to conflict with the sector’s aim of protecting the elderly and most vulnerable and that he questioned whether there was “a better way” to deal with the unfolding situation other than keeping patients isolated.
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He said a statement provided to the inquiry by Scottish Care also made reference to what was presumed to be a “blanket ban” on referring people from care homes to hospital and asked Dr Macaskill how care home staff came to believe this was the meaning of the guidance issued on March 13, 2020.
“They arrived at that belief because it was their experience in numerous instances of attempting to gain access to a hospital, or indeed to a GP to enable an admission to hospital,” Dr Macaskill told the inquiry.
“There was a presumption that if an individual contracted Covid in a care home, they should be supported and enabled in the care home and should not be transferred out of the care home.
“I’m not denying that for many individuals that was the right clinical decision – to support an individual, often with palliation, to enable the end of their life in as supportive and dignified manner as possible.
“But the presumption that that should be the result and the end decision and clinical assessment for all is simply wrong.
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“At the same time, I was commenting publicly about the draft ethical framework which was developed by the chief medical officers at the time, which had used age as a proxy for decision making should we get to a situation where there were limits on resources available for clinical intervention.
“That existence of an age proxy – age discrimination – was evidenced, I believe, in the presumption that if somebody developed a condition such as dementia in a care home, they should not ordinarily be transferred to hospital.
“It wasn’t just Covid that was preventing somebody being transferred, it was other conditions where ordinarily they might not be transferred because of the desire to make sure the NHS was as clear as possible.
“I have absolutely no doubt that individuals whose lives could have been saved were not saved because of the nature of that uncertainty caused by this guidance.”
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