Pressure grows on Matt Hancock over Covid policy for care homes

Guardian reports on Dr Cathy Gardner’s demand that the health secretary now releases crucial internal documents.

Robert Booth www.theguardian.com

Matt Hancock is facing further pressure over the measures put in place to protect care homes early in the coronavirus pandemic following allegations from Dominic Cummings that he misled the prime minister over the issue.

A woman whose father died of Covid in a care home that admitted an infected hospital patient is demanding that the health secretary release crucial internal documents about his risk assessment before thousands of people were discharged into care homes without tests.

The move is part of a potentially explosive high court case against Hancock, the NHS Commissioning Board and Public Health England scheduled for a three-day trial in October. It is likely to shed new light on this week’s claim and counter-claim between the prime minister’s former chief adviser and Hancock over care homes policy in the first weeks of the pandemic.

Cathy Gardner, who lost her father, Michael Gibson last April, said her lawyer was seeking the key documents before the autumn hearing to decide whether the discharge policy had broken the law. Government research this week concluded that hospital discharges had caused 286 Covid deaths, but the actual toll is likely to be significantly higher when fatalities who were not tested before death are counted.

Cummings told MPs about a discussion in government of the risks associated with the discharge policy, which he recalled as “Basically, ‘Hang on, this sounds really dangerous, are we sure?’”

He said the view was that there was no alternative because of the need to free up NHS beds to deal with the coming wave of patients. Crucially, he said, Hancock assured him and the prime minister that people who were being discharged into care homes from hospital would be tested.

Hancock responded on Thursday by saying he had told Downing Street they would be tested when sufficient capacity was available. He said it hadn’t been possible to test hospital discharges at the start of the pandemic, but he put that capacity in place.

Government guidance issued on 2 April 2020 said: “Negative tests are not required prior to transfers/admissions into the care home.”

The UK already had capacity for 10,000 daily tests at the start of April 2020, but Hancock said “we had to prioritise it by clinical need”. Between 17 March and 15 April, when tests were finally required before admission into care homes, around 25,000 people were discharged from hospitals into facilities, the National Audit Office has found.

The row has left people bereaved by Covid angry and frustrated at a lack of transparency. “People need the facts, instead of all this ‘He said, she said’,” said Gardner.

Gardner alleges that Hancock, the NHS Commissioning Board and Public Health England contravened the European convention on human rights, the Human Rights Act and the Equality Act when their policies allowed people to be discharged into care homes without being tested. The health bodies strongly dispute the claim.

Political allies backed Hancock on Friday. The business secretary, Kwasi Kwarteng, said care home residents “were protected as far as we could. We were absolutely focused at that time on saving as many lives as possible”.

But Sam Monaghan, the chief executive of MHA, the UK’s largest provider of not-for-profit care homes, which lost 121 residents to Covid in the three weeks to 7 April 2020, described the discharge strategy as “like putting kind of a live explosive into a box of tinder”.

Sarah Knowles, whose father Graham died of Covid in a Manchester care home on 27 April 2020, said the policy was “just wrong” and highlighted other vulnerabilities. She said her father’s carers were improvising face masks from plastic document folders in April.

“They should have had PPE,” she said. “It makes me angry. If people were discharged into the care homes, they should have been tested.”

Amos Waldman, 41, whose grandmother Sheila Lamb died of Covid on 2 April 2021 in a care home in north London, said: “It feels as though they are trying to cover their own backs with one eye on the future public inquiry.”

The Department for Health and Social Care has been approached for comment.

Mid Devon District Council gets £50K to develop “Beautiful” design codes

  • 14 councils across England given £50,000 each to develop new design codes [includes Mid Devon]
  • Codes will set out design principles for new development in local areas
  • Local design codes will be expected to enhance the character of the local area – for example by using honey-coloured stone in the Cotswolds or red brick in the Midlands
  • Selected areas will test how to give communities a real say in the layout, design and appearance of buildings in their area – helping the country Build Back Better

[Is six months long enough for a serious trial? – Owl]

www.gov.uk 

A new national design code meaning areas are beautiful, well-designed and locally-led is being tested across 14 areas in England, Housing Minister Rt Hon Christopher Pincher has announced today (21 May 2021).

The code will ensure future developments are beautiful and fit in with local character.

It gives local planning authorities a toolkit of design principles to consider for new developments, such as street character, building type and façade as well as environmental, heritage and wellbeing factors

The shortlisted councils [includes Mid Devon – Owl] will take part in a 6-month testing programme to apply the National Model Design Code (NMDC) in their area and help Britain Build Back Better, by making sure current and new residents alike will benefit from beautiful homes in well-designed neighbourhoods.

It is intended to provide councils with the guidance and parameters to shape new developments in a way which reflects what their communities truly want.

The measures mean the word “beauty” will be prioritised in planning rules for the first time since the system was created in 1947 – going back to a previous time when there was a greater emphasis on whether a building was considered attractive to local people. The government recently consulted on changes to the National Planning Policy Framework to take this forward, alongside the draft NMDC.

The Conservative Party received tens of thousands of pounds from non-existent companies

  • EXCLUSIVE: The Conservative Party accepted tens of thousands of pounds from companies that had been struck off, an investigation by Insider has found.
  • Tory politicians, including one currently serving government ministers, received the donations.
  • Political parties are obliged to carry out checks on any company offering them a donation.
  • Labour is calling for the Electoral Commission to launch an urgent investigation.
  • “This just doesn’t pass the smell test,” Labour Party chair Anneliese Dodds told Insider.

Henry Dyer www.businessinsider.com

The Conservative Party pocketed nearly £30,000 from companies that were no longer trading at the time the donations were made, an analysis of Electoral Commission records and Companies House data by Insider has found.

Under the Political Parties, Elections and Referendums Act 2000, UK political parties can only receive donations from actively trading companies and they are obliged to carry out permissibility checks on all donations from companies.

However, Insider’s investigation has found four donations from three companies that official records show were either dissolved or in the process of dissolution, with two of the donations received by currently serving government ministers.

Following Insider’s findings, the opposition Labour party called for an official investigation into the donations.

Anneliese Dodds MP, Chair of the Labour Party, told Insider: “This just doesn’t pass the smell test. The Conservatives need to explain why it seems they pocketed tens of thousands of pounds from companies that only existed on paper.

“The rules are clear: political parties must check that companies making donations are carrying on business in the UK. The Electoral Commission must launch an urgent investigation to find out what’s happened here – and any breaches of the law should be punished fully.”

Two donations received by a government minister

The first donation identified by Insider was to Wendy Morton, the Conservative Member of Parliament for Aldridge-Brownhills, and a junior minister in the Foreign Office, from a company called Unionist Buildings.

Companies House records show that Unionist Buildings was struck off the register on 17 January 2017, following an application, filed on 21 October 2016, by its directors.

However, Electoral Commission records show Morton’s local association received £6,000 from Unionist Buildings on 2 June 2017, less than a week before the 2017 general election. The donation was accepted on 5 June 2017.

Nearly three years after Unionist Buildings was struck off the register, Morton declared a further £4,000 received by her local Conservative association from Unionist Buildings and registered on 9 January 2020. Her entry also contains the £6,000 donation from 2017.

At the time Morton received the £4,000 donation in January 2020, she was a junior minister in the Ministry of Justice.

There is no suggestion of wrongdoing by Unionist Buildings, who did not respond to a request for comment by the time of publication. Morton did not respond to a request for comment by the time of publication either.

Donations were received from dissolved companies

Another donation was received from a company whose sole director was Conservative minister Charlotte Vere.

Vere is a Conservative life peer and a junior minister in the Department for Transport.

Companies House records for the firm Conservatives In, established to support the Remain vote in the 2016 Brexit Referendum, show it was struck off the register on 2 May 2017 following an application, filed on 3 February 2017, by Vere, the company’s sole director from June 2016 onwards.

On the application which Vere signed on 10 January 2017, she declared that “none of the circumstances described in section 1004 or 1005 of the Companies Act 2006 […] exists in relation to the company”.

Section 1004 of the Companies Act 2006 states that a company may not apply to be struck off if it has, “at any time in the previous three months […] traded or otherwise carried on business”.

But Electoral Commission records show that less than three months prior to this, Conservatives In gave £9,754.98 to the Conservative Party’s central office. The donation was made on 22 December 2016, the day after Vere was appointed a government whip in the House of Lords. 

Vere’s entry on the register of ministers’ interests in November 2019 disclosed that her husband, Mike Chattey, is the head of fundraising at the Conservative Party. He has held the position since 2009.

Baroness Vere did not respond to a request for comment.

A company listed as a donor denies knowledge of donation

for the firm Stridewell Estates show it was also struck off the register in November 2016, following an application made in August 2016.

Over three years later, the Conservatives accepted a donation of £10,000 from Stridewell Estates. 

A spokesperson for Stridewell Estates told Insider that the entry on the Electoral Commission’s website “must be a mistake.” She said “no payments were made from this company after it was dissolved. It is very possible that the company that donated has been recorded incorrectly.” 

The spokesperson was unable to provide further details by the time of publication.

There is no suggestion of wrongdoing by Stridewell Estates.

“This just doesn’t pass the smell test”

Insider referred all of these donations to the Conservative Party. A spokesperson for the party said: “Donations to the Conservative Party are properly and transparently declared to the Electoral Commission and are published by them.”

The party did not seek to claim that any of the donations did not occur.

A spokesperson for the Electoral Commission said: “Political parties can only accept donations over £500 from permissible sources. This includes companies who are registered and incorporated in the UK, and who carry on business at the time they make donations. 

“We carry out our own permissibility checks on donors, though the legal responsibility lies with the parties to ensure that they only accept money from legal sources. Should there be evidence that the rules have been broken, we would consider it in line with our Enforcement Policy.”

Campaigners say there needs to be a stronger set of regulatory requirements for parties to ensure that they are receiving donations from permissible sources. 

Susan Hawley, executive director at Spotlight on Corruption, told Insider: “It is high time that political parties be placed under a proper legal obligation to do thorough background checks on the origins of donations and the Electoral Commission be given robust powers to penalise them when they fail to do so. 

“The public need to have confidence that electoral finance is squeaky clean and there aren’t any loopholes that would allow illegal or foreign donations which might skew our electoral process.”

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Covid: What happened to care homes early in the pandemic? Reality Check

Testimony from the prime minister’s former chief adviser, Dominic Cummings highlighted the issue of care homes during the first wave of coronavirus.

By Reality Check team www.bbc.co.uk

“We were told categorically in March [2020] that people would be tested before they went back to care homes. We only subsequently found out that that hadn’t happened,” Mr Cummings told MPs. He claimed it was Health Secretary Matt Hancock who said this.

Mr Hancock said: “My recollection of events is that I committed to delivering that testing for people going from hospital into care homes when we could do it…I then went away and built the testing capacity… and then delivered on the commitment”.

So, what actions did the government take and what guidance did it give the care sector in England, where there have been more than 40,000 deaths involving Covid-19.

Moving patients from hospitals to care homes

On 19 March 2020, NHS guidance said that “unless required to be in hospital, patients must not remain in an NHS bed”.

This policy was implemented to free up beds in advance of an expected surge in coronavirus patients.

On 2 April, the rules on discharging to care homes were clarified, saying “negative [coronavirus] tests are not required prior to transfers/admissions into the care home”.

Even elderly patients who tested positive could be admitted to care homes, according to the document, if measures – such as wearing personal protective equipment (PPE) and isolation – were used.

From 15 April, the government said that all patients discharged from hospitals would be tested for coronavirus.

By this time, an estimated 25,000 patients had been discharged to care homes. In July, Panorama gathered data from 39 hospital trusts, which showed three-quarters of people discharged were untested.

Up to this point more than 5,700 care home residents had died in England and Wales (either in homes or in hospital).

Public Health England has published research into the impact of hospital transfers. It found that 1.6% of the lab-confirmed outbreaks in care homes that they knew about by mid-October 2020, had come from people discharged from hospitals.

But it is not clear what percentage of outbreaks up to 15 April (when the testing policy changed) were the result of patients being moved to homes.

And it is important to note that, at this time, there was a lack of testing so not every outbreak may have been recorded. Also, the figures do not count people who were not previously care home residents who were transferred into them from hospitals.

The government has repeatedly said that decisions to discharge patients from hospitals during this time were made by medical professionals on a case-by-case basis.

Testing

On 14 March 2020, the government began prioritising the most vulnerable individuals for testing, including those in hospitals and care homes.

If an outbreak was suspected, a handful of residents at a home could be tested.

Reality Check understands that some care providers found access to testing to be very limited at this time.

Chart showing coronavirus deaths

Figures for March to May 2020

On 15 April, the social care action plan was launched, as care home deaths in England were peaking at around 400 a day. This included a pledge to test all care staff who needed one, for example if they were in a household that was self-isolating.

At that point, just 1,000 care staff had been tested out of an estimated half a million who work in care homes.

All care home residents with coronavirus symptoms would also be tested.

On 28 April, this was extended to all care staff and residents, regardless of whether they had symptoms.

It’s important to remember that early in the pandemic it wasn’t widely understood that people who didn’t have symptoms could pass on coronavirus.

Personal Protective Equipment (PPE)

In March 2020, specific guidance related to coronavirus said that the PPE in care homes should be similar to that used in hospital settings.

The government launched the National Supply Disruption Response on 13 March, a centralised line for care and health providers to raise concerns.

This was followed on 19 March by a promise to deliver 300 masks to each care provider.

Concerns over PPE peaked at the end of March and early April, as bodies such as Unison, the Royal College of Nursing and care homes themselves highlighted shortages.

Because care homes are generally privately-run, they are responsible for purchasing their own PPE. Many found their local suppliers were running low and that they were competing with better-funded hospitals.

A letter from the government on 2 April recognised “the challenges providers may have experienced in obtaining PPE supplies over recent weeks,” and promised that the supply chain would be bolstered, with support from the armed forces.

On 10 April the government announced a PPE action plan, which included freeing up up 34 million pieces of equipment to “local resilience forums” who would then distribute it to care homes through local authorities.

By this point, 3,100 care home residents had died in England and Wales.

Visiting care homes

General guidance produced on 25 February 2020 included advice for carers on what to do if they came into contact with someone with Covid-19 – but there was nothing advising against visits to care homes.

In one section it said: “It remains very unlikely that people receiving care in a care home or the community will become infected.”

Another section said: “Currently there is no evidence of transmission of Covid-19 in the United Kingdom. There is no need to do anything differently in any care setting at present.”

However, the government’s own Scientific Advisory Group for Emergencies (SAGE) had advised on 10 February that “it is a realistic probability that there is already sustained transmission in the UK, or that it will become established in the coming weeks.”

Updated chart

Figures for 2020

On 3 March, the government released its coronavirus action plan – the document did not mention restricting visits to care homes.

By 5 March, England had had 273 cases of people with the virus.

That day the Chief Medical Officer for England Prof Chris Whitty told a committee of MPs that as there were cases that could not be traced back to people who had come from abroad, it was “highly likely therefore that there is some level of community transmission in this virus in the UK now”.

Italy suspended visits to care homes at this point, five weeks after recording its first case. A day later, Nursing Homes Ireland, which represents hundreds of care homes in Ireland, banned non-essential visits, just six days after the first confirmed case in the country.

On 10 March, Prof Martin Green, head of Care England which represents independent care providers, directed criticism in an Independent article at the government for its response.

At this point in England nearly 800 people had caught the virus, but the article noted that the generic guidance published by Public Health England appeared out of date, as it said there was no evidence of transmission within the UK. Prof Green said: “There is no evidence of a plan. I’m not even certain they have these plans and aren’t just making them up as they go along.”

Nevertheless, some homes were deciding to close their doors to visitors, with care groups Barchester and HC-One stopping non-essential visits on 10 March and 12 March.

Scottish Care – a representative body for social care in Scotland – advised care homes to close to visits on 11 March.

On 13 March, the government’s guidance from 25 February was updated to say that “care home providers are advised to review their visiting policy, by asking no-one to visit who has suspected Covid-19 or is generally unwell, and by emphasising good hand hygiene for visitors”.

On the same day Bupa and Four Seasons care homes stopped non-essential visits.

It wasn’t until 16 March that it was announced that social distancing should be carried out by everyone, in particular those aged over 70 and vulnerable people.

That day, the prime minister was asked about care homes and said: “We don’t want to see people unnecessarily visiting care homes.” By this point there had been 3,200 cases in England (although the figure given by the authorities at that point was less than half of that; positive cases are now dated to the day the sample was given).

In the period between 25 February and 16 March, 14 deaths of care home residents were reported along with 30 outbreaks in England’s 15,000 care homes.

On 21 March, guidance was introduced to encourage medically vulnerable people to remain indoors as much as possible until the end of June – a process known as shielding.

On 24 March, lockdown began with people ordered not to leave their homes at all except for “essential” reasons, which didn’t include visits to care homes.

Finally, on 2 April another document from the Department of Health and Social Care said that “family and friends should be advised not to visit care homes, except next of kin in exceptional situations such as end of life”.

Speaking on 15 May, Health Secretary Matt Hancock said that on the basis of the 13 March guidance “many of the care home providers, for instance Care UK, at that point stopped visitors”.

There have since been extensive changes to the guidance, with restrictions relaxed as lockdown eased.

This piece was originally published in July 2020 and has been updated to include the findings of the PHE report into the impact of patients discharged from hospitals to care homes in 2020.

Tory Rebel Warns Boris Johnson Of Election ‘Spanking’ Over Planning Reforms

The Tories’ voter coalition could “unravel” in an election “spanking” over Boris Johnson’s planning reforms, one of the party’s MPs has warned.

Arj Singh www.huffingtonpost.co.uk

Bob Seely told HuffPost UK’s Commons People podcast that “dozens” of Conservative MPs were now lining up against the prime minister’s plans because they fear house-building would be concentrated in the party’s southern heartlands.

He warned that the planning bill could give the Liberal Democrats a chance to “revive” in the south and start threatening Tory seats, stressing the party this month lost control of the council in his Isle of Wight seat “because people are fed up” of planning.

The new proposals risked becoming a “developers’ charter” to build on greenfield land, Seely warned.

He told Commons People: “If we end up with a developers’ charter, it won’t work and we will take an absolute spanking in the local elections and probably national elections from now on.

“And we will immediately start to unravel that amazing coalition that we’ve got.

“And actually that’s a really dumb thing to do.

“Tories lost control in the Isle of Wight because people are fed up, in part, of planning, people are fed up, in part, of development.”

Johnson is facing fresh rebellion over planning after MPs on his own side last year effectively killed off a so-called “mutant algorithm”, which would have dramatically increased house-building in southern Tory cities and shires.

But the PM is believed to think home ownership is key to cementing the party’s gains in the so-called “red wall” in the north and Midlands and returned with fresh proposals to overhaul planning in this month’s Queen’s Speech.

The government has said it wants to speed up the planning process to deliver new homes and infrastructure more quickly, at the same time as protecting the environment, as part of efforts to hit Johnson’s target of building 300,000 homes a year by the mid-2020s.

But Tory rebels and countryside campaigners have warned that the bill will divide places into areas earmarked for either growth or protection, and that growth areas would undermine local democracy and give developers a green light to build on rural land.

Former prime minister Theresa May has said it would mean “the wrong homes being built in the wrong places”.

Seely meanwhile warned the government against casting opponents of the bill as “nimbys”, adding: “If you start throwing meaningless insults, it proves you’ve lost the case and actually, nimbys tend to be Tory voters.

“They are people that love their area, that care about it, who care about their communities, who very often take a part in the local plans because they realise they need homes, very often for their kids and grandkids.

“But at the same time, they reject the unsustainable, destructive, mass-produced, large-scale, low-density, car-dependent greenfield housing estates that just spoil the areas they are built on.”

Seely said the rebels are trying to unite around three issues: that development should be community-led, that it should be ambitious and focused on brownfield sites like London Docklands, and that it must be environment-led.

He said: “How on Earth are we going to meet carbon targets when we know the most inefficient form of housing environmentally, ecologically is low density greenfield housing?

“If government is going to be coherent, you can’t have an ‘anything goes, concrete the south-east and we’re going to be very, very green’ [strategy] – you do one or the other, you ain’t doing both”.

Seely also said there could be close to 100 Tory MPs opposed to the plans.

“There’s not 100 but there isn’t that far short of it – but those are people who have been concerned about the algorithm as well,” he said.

“If you are stripping away some local democracy and that’s combined with higher targets and no community say, and it gives a chance in the south for the Liberals to revive, then I think you are going to start to feel pressure.”

Is it time for the East Devon AONB Partnership to “Come Out”?

From a planning correspondent:

This self- congratulatory e-mail from the East Devon Area of Natural Beauty set me thinking

 “After a successful bid for funding, the East Devon AONB partnership are looking forward to delivering a brand-new programme to help people creatively connect, experience, and better understand our natural environment. 

Over the next year, on behalf of the AONB, artist Emma Molony will work with a range of creative facilitators, organisations, and the non-arts sector to co-deliver a series of high quality, accessible and inclusive art experiences for schools, families, wider communities, and marginalised groups.

Supported by the Arts Council England (ACE) lottery fund, the project will work to build links between community, cultural and landscape partners, bringing together different fields of expertise to engage rurally and culturally isolated communities in East Devon.”

AONBs and National Parks are of equal importance regarding landscape and scenic beauty and have EQUAL STATUS when it comes to planning decisions on landscape issues.

They both exist for the purpose of conserving and enhancing their natural beauty. National Parks, BUT NOT AONBs, in addition to this, have other very important purposes;

a) to promote understanding and enjoyment of the area’s special qualities by the public and because of this extra (and substantial) layer of responsibility they have their own independent National Park authorities with full planning powers running them.

b) the National Parks conservation and enhancement purpose specifically includes “wildlife and cultural heritage”.

East Devon planning watchers may be surprised that AONBs have a planning role at all, given the silence of the East Devon AONB Partnership on even the most sensitive planning applications in its area. East Devon District has 2/3rds of its district covered by the two AONBs of East Devon and the Blackdown Hills. So what part will East Devon AONB play in this difficult time when the government has a BUILD BACK BETTER agenda and EDDC has to find close to 1,000 new build houses a year? 

I think the answer may be found in their latest management plan.

On planning matters the partnership will: 

“Respond to planning consultations in accordance with the AONB protocol AS RESOURCES ALLOW” 

But on the other hand, resource seems to be directed to secondary, and arguably less contentious priorities: “Whilst recreation is NOT a primary purpose for designation, it is recognised that DEMAND SHOULD BE MET THROUGH ACTIVE MANAGEMENT

See: https://www.eastdevonaonb.org.uk/wp-content/uploads/2020/02/AONB-Partnershipplan_lowres_final.pdf

This active management can be seen in the variety of projects which have been undertaken and are now being actively pursued. The latest very commendable project (see above) required much active management to acquire the Arts Council England (ACE) lottery fund funding. The project will work to build links between community, cultural and landscape partners, bringing together different fields of expertise to engage rurally and culturally isolated communities in East Devon, not part of its statutory remit. One of the latest projects –“Saving the Grey Long Eared Bat – East Devon AONB “ is, again, not a statutory obligation. 

So, to the person in the street, it looks like the partnership has chosen to include projects not part of their primary purpose and relegate their statutory planning responsibilities only when resources allow.

 If the partnership wants to act like a National Park, it should “come out” and actively join and promote the “East Devon and Dorset National Park” initiative, so that these commendable ideas can be properly resourced. We might also get a bit of landscape sensitive planning as well.