ITV News has uncovered plans to discharge at least 1,800 patients from hospital into care homes during the coronavirus pandemic.
The government has denied there was pressure to move people from hospital into care, after Care England recently blamed discharges for spreading the virus into nursing and residential homes.
But data obtained by ITV News shows how, at the outset of the pandemic, the NHS and councils block booked beds in care homes to ensure they were ready to deal with a surge in patients coming from hospital.
NHS clinical commissioning groups and councils in 17 regions of England replied to ITV News telling us that they had reserved a total of 1,800 beds in care homes, including 182 beds in Suffolk, 122 in the Wirral and 86 in Oxfordshire.
Until mid-April, patients were not routinely tested for coronavirus before being discharged into a home, with care managers having previously told ITV News that they believe that’s how the virus spread among their residents.
The government advice to hospitals prior to April 15 was "negative tests are not required prior to transfers/admissions into the care home."
ITV News has also discovered some homes are continuing to take Covid-19 positive patients, despite their concerns.
Reporting on the coronavirus crisis in care homes from Paul Brand:
At Saint Cecilia’s nursing home in Scarborough, fifteen beds were block booked at the beginning of the pandemic to take in hospital patients.
They are currently looking after nine, six of whom are confirmed to have Covid-19 after leaving hospital.
The residents are isolated on the second floor of the home, with painstaking precautions taken to prevent the virus spreading to other occupants.
Those with Covid-19 are barrier nursed, meaning full PPE is worn by all staff with deep cleaning of the ward several times a day.
The managing director of the home, Mike Padgham, says he has been left with little choice but to continue accepting Covid-19 patients, given the financial pressures he faces and the need to help the NHS.
But he admitted that the arrangement does worry him.
He said without taking in Covid-19 patients the "business is not viable and that people might have to move or staff might lose their job, so it's not an easy decision to make".
"I've had a few sleepless nights over it to be honest, but I'm doing my bit and taking advice from everybody and taking a decision, whether it's the right decision, time will tell."
Other homes are now refusing to accept any new patients at all.
Wren Hall nursing home in Nottingham complains it is being used as a “Covid cleansing zone”, after agreeing to take 20 patients from hospital, many of whom were Covid positive.
The owner believed they were being discharged into the home to stay long term, but several have been moved on after their initial 14 day isolation.
The residents are isolated in a “red zone”, which is sealed off from other residents.
But the owner, Anita Astle says she has been taken advantage of by her local CCG.
"It’s been really frustrating as we’ve had people admitted for short term care...It’s turned out that they’re with us for the 14 days until they’re clear of Covid.
"It’s made us feel like a Covid cleansing house and put unnecessary strain on our staff and we’ve decided we’re not doing that anymore."
Today when we questioned the health secretary, he didn’t deny that there had always been a plan to discharge patients into homes.
After being asked several times whether block bookings were made as part of a plan to discharge Covid-19 patients into hospital, Matt Hancock did not provide a direct answer.
Instead, he insisted the number of people being discharged had fallen during the pandemic.
"We actually managed to reduce the number of people who were going from hospital into care homes, that number came down by around 40%," he said.
"It is important that infection control is in place, in the care home, so in some care homes, splitting the care home into an area where people have Covid and areas that are protected - and have that strong infection control - that may be the way forward," he added.
NHS England has so far declined to provide data on the total number of discharges into care homes during the pandemic, despite several requests from ITV News.
Responding to our report, Labour’s Shadow Care Minister Liz Kendall said,
“While the Prime Minister has claimed that there wasn’t a concerted effort to move people out of hospitals into care homes, this shows the opposite, and that Government measures to quickly discharge people from hospitals may have contributed to the tragedy that has unfolded in social care.
“Ministers must learn lessons from what has happened so far. They must get a grip of this crisis, implement a full strategy for supporting care homes, and give care services the priority and resources they deserve.”
The Scottish government has already disclosed that more than 900 patients were discharged into hospital there before mandatory testing took place.
Giving evidence to the Liaison Committee on Wednesday, the prime minister denied there was "concerted effort" to discharge patients from hospitals into care homes.
In response to a question from former health secretary Jeremy Hunt, Boris Johnson said he did not get any advice that discharging hospital patients into care homes could spread coronavirus.
Watch Boris Johnson's Liaison Committee appearance in full:
"It's just not true that there was some concerted effort to move people out of NHS beds into care homes, that's just not right," he said.
In relation to Wren Hall, Nottingham and Nottinghamshire CCG and Nottinghamshire County Council provided a joint statement saying health and care professionals have "offered support around all the issues" raised by Mrs Astle.
The statement went on: "But we recognise that there are some unique issues which have made Wren Hall more financially vulnerable than others, particularly the costs associated with operating a specialist dementia care facility.
"We will continue to provide close support to Wren Hall with a focus on discharge planning as well as staff testing and training.”