Ministers have asked local directors of public health to take charge of Covid-19 testing in English care homes in what will be seen as a tacit admission that centralised attempts to run the programme have fallen short.
In a letter to sector leaders, seen by the Guardian, the care minister, Helen Whately, acknowledged that testing of care home residents and staff needs to be “more joined up”. She describes the new arrangements as “a significant change”.
Under the new approach, public health directors employed by local councils will take lead responsibility for arranging the testing of some 400,000 care home residents and 500,000 staff, in discussion with directors of adult social services, local NHS bodies and regional directors of Public Health England (PHE).
Critically, the local public health directors will decide which homes should have priority in the testing programme, which is still working up to a capacity of 30,000 tests a day for the sector.
The switch is a conspicuous, if belated, vote of confidence in local government’s ability to help get a grip on the Covid crisis. There has been frustration and incomprehension that public health teams have until now been left as bit-players in the testing programme and in tracking and tracing carriers of the virus.
One senior director of public health said: “We’ve been pushing and pushing government to realise that we exist and that we are best placed to organise things like testing, alongside directors of adult social services, because we know our patch.”
The plight of care homes has shot up the political agenda in recent weeks as Covid has swept through many of them, leading to the deaths of 6,686 people up to 1 May in England and Wales. The health and social care secretary, Matt Hancock, offered on 28 April to test all residents and staff, but there has been widespread criticism of the availability and speed of checks.
In her letter, sent on Thursday, Whately says there will “soon” be capacity for 30,000 daily tests of care home residents and staff, adding: “This ambitious plan requires a close partnership with local leaders to help direct these efforts to where it is needed most.”
Outlining plans to order visits by mobile test units via a new online portal, the minister says lead responsibility is being given to public health directors “to ensure that testing of staff and residents in care settings is more joined up, and that available national capacity we are delivering is targeted to areas and care homes with the greatest need”.
Care home sector leaders said that while any move to reform the testing system was welcome, homes would still have no say in determining local priorities or timetables. Lack of capacity remained a grave concern.
Vic Rayner, executive director of the National Care Forum, representing not-for-profit care homes, said: “With almost a million people needing to be tested, and only 30,000 tests a day envisaged at best, what our members really want to know is when all this is going to be a reality.”
