Bríd Smith (Dublin South Central, People Before Profit Alliance)
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631. To ask the Minister for Health the number of patients released from acute hospitals to residential nursing homes since January 2020; if a protocol was in place in relation to Covid-19 in the transfer of these patients; and if he will make a statement on the matter. [8198/20]

Simon Harris (Wicklow, Fine Gael)
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The HSE through the Health Protective Surveillance Centre has developed an extensive body of guidance and support tools to assist in the management of COVID-19 cases, including in relation to decisions on transfer of patients/residents between care facilities where appropriate.

The current relevant guidelines are the: “Interim Public Health and Infection Prevention Control Guidelines on the Prevention and Management of COVID-19 Cases and Outbreaks in Residential Care Facilities and Similar Units”, version 4.1, 04/05/2020.

The decision to discharge patients from hospital to nursing home settings is subject to clinical assessment. Discharges to nursing homes and other settings are a regular, daily feature of a functioning health system. The period from early March to mid-April saw an increase in the number of such discharged patients as the health system prepared itself for the expected ‘surge’ in COVID-19 cases. From an older person’s perspective, being admitted for longer than necessary increases the risk of a patient contracting a healthcare associated infection and/or deconditioning. The vast majority of these discharges took place from the 10th March onwards, when clear public health guidance was in place.

On the 10^thMarch 2020, the HSE issued Interim Guidance on Transfer between Care Facilities, which included preliminary guidance on the transfer of hospitalised patients from an acute hospital to a residential care facility in the context of the global COVID-19 pandemic. The guidance based on the best available information at the time set out the various procedures to be followed, including:

- Patients with COVID-19 should not be transferred to a LTRC until they had two consecutive tests indicating virus not detected.

- Patients who were symptomatic and were contacts of a confirmed COVID-19 case should only transfer if the persons had a test indicating virus not detected and it was possible for that person to be isolated for the relevant incubation period;

- Patients who were asymptomatic and were contacts of a confirmed COVID-19 case should only transfer if it was possible for that person to be isolated for the relevant incubation period;

- Transfers from hospitals with no evidence of spread of COVID-19 should proceed as normal, except patients with respiratory tract infection meeting the then criteria for COVID-19 testing – in those cases testing should be carried out and the result should be virus not-detected before transfer.

With regard to the query raised in respect of numbers of patients, this data is not readily available to my Department but I will follow up with the HSE to seek further information.