The head of the UK Heath Security Agency is facing a growing backlash after it emerged she suggested that discharging Covid-infected hospital patients to care homes would be “clinically appropriate” to protect the NHS from collapse.
Care home providers and the families of those who died after contracting Covid while in residential care said the revelations confirmed their suspicions at the time, adding that it disproved the claim of ministers to have thrown a “protective ring” around the homes.
It comes after the disclosure of an email from Dame Jenny Harries, then England’s deputy chief medical officer, sent in March 2020 as Covid was unfolding. In a message to health officials, she said that discharging care home residents from hospital would have to happen if there was exponential growth of Covid – and acknowledged the move would be criticised by the families involved.
“Whilst the prospect is perhaps what none of us would wish to plan for, I believe the reality will be that we will need to discharge Covid-19 positive patients into residential care settings for the reason you have noted,” she wrote. “This will be entirely clinically appropriate because the NHS will triage those to retain in acute settings who can benefit from that sector’s care. The numbers of people with disease will rise sharply within a fairly short timeframe and I suspect make this fairly normal practice, and more acceptable, but I do recognise that families and care homes will not welcome this in the initial phase.”
Appearing at the inquiry last week, Harries – who has since been promoted to run the UK Health Security Agency (UKHSA) and given a damehood – conceded that the email “sounded awful”. However, she had been taking “a very, very high-level view” of what would need to happen if the NHS was overwhelmed with an “enormous explosion of cases”.
It has now provoked an angry response from families of those who died in care homes and from care providers who complained at the time that they had not been prioritised on a par with the NHS. “In the face of a virus that would go on to kill 230,000 people in this country, Jenny Harries was employed specifically to find a way to protect people and make the best of the situation,” said Deborah Doyle, spokesperson for Covid-19 Bereaved Families for Justice UK.
“It’s clear that instead she took the ‘easiest’ and cruellest option of sacrificing care home residents, some of the most vulnerable people in the country. It was families like ours that paid the awful price for her failure and it’s absolutely disgraceful that she has since been promoted, made a dame and is head of the UKHSA.”
Prof Vic Rayner, chief executive of the National Care Forum, said the evidence heard so far “confirms the distressing experiences of our not-for-profit members, their staff, the people they supported and their relatives”. “On 19 March 2020, DHSC issued guidance to discharge people, regardless of testing status, into social care settings without ensuring that the necessary PPE, infection prevention control and clinical support was in place to keep everyone safe. Among the devastating revelations was confirmation that PPE paid for by social care providers was requisitioned by the NHS. The inquiry has laid bare that there was no ring of protection around care homes – instead decisions seemingly taken in abstraction of the reality of social care or available evidence were implemented with unforgettable consequences.”
Ministers are also facing political pressure over the revelations, with opposition parties stating that it now contradicts claims of prioritising care home safety. “The government said they were putting a protective ring around care homes, when in reality they were infecting care homes,” said Wes Streeting, the shadow health secretary. Daisy Cooper, the Lib Dem health spokesperson, said it was “simply staggering that the government knowingly spread Covid into care homes by allowing the discharge of patients with the virus”.
The UKHSA did not comment. However, an ally of Harries reiterated that she had been commenting on what would happen “if and only if” hospitals were overflowing with patients and the system had no other option.
• This article was amended on 2 December 2023 to clarify that Jenny Harries was deputy chief medical officer for England, not the whole of the UK.
