Publications approval reference: 001559

15 April 2020

To:

Accountable Officers of all hospitals (public and private sector) working for the NHS and discharge teams

All NHS Commissioned Community health providers – including relevant NHS trusts, Community Interest Companies and Private Sector

Accountable Officers of Clinical Commissioning Groups

Cc:

NHS England and NHS Improvement Regional Directors and Regional Incident Response Teams

New requirement to test patients being discharged from hospital to a care home

Today, the Government has made a commitment to test all residents prior to their admission to a care home. As set out in the Coronavirus: adult social care action plan published today, the roll out of this policy will begin with testing all patients discharged from a hospital to a care home. This applies to all patients being discharged into a care home, regardless of whether they were residents of the care home previously or not.

Therefore, with immediate effect, the NHS now has responsibility for testing patients being discharged from hospital to a care home, in advance of a timely discharge. Where a test result is still awaited, the patient will be discharged and pending the result, isolated in the same way as a COVID-positive patient will be. Hospitals funded by the NHS will need to make the necessary arrangements to implement this.

This new testing requirement must not hold up a timely discharge. The COVID-19 hospital discharge service requirements, published 17 March 2020, remain unchanged and continue to apply. To ensure testing does not delay a timely discharge, testing for patients due to be discharged to a care home will need to be planned up to 48 hours before the scheduled discharge time. The information from the test results, with any supporting care information, must be communicated and transferred to the relevant care home.

Some care providers will be able to accommodate individuals with a confirmed COVID-19 positive status, through effective isolation strategies or cohorting policies. If appropriate isolation or cohorted care is not available with a local care provider, the Local Authority will provide alternative appropriate accommodation and care for the remainder of the required isolation period, utilising NHS community and primary care assistance as needed. This alternative accommodation should also be used in the exceptional cases of test results not being available at the point of discharge.

This additional testing requirement will be a small addition to the testing requirements already underway. We anticipate that this will be about a 6% increase on current testing rates in NHS labs.

Thank you for your support to implement this important new requirement. If you have any questions related to this letter, please direct them to england.covid-discharge@nhs.net.

Yours sincerely

Professor Keith Willett | Strategic Incident Director for COVID-19 | NHS England and NHS Improvement

Matthew Winn | Director of Community Health | NHS England & NHS Improvement