Claims That Older COVID-19 Patients Were Denied Treatment 'Offensive'

Peter Russell

October 26, 2020

A newspaper report that said older people were excluded from hospitals and intensive care during the height of the COVID-19 pandemic's first wave to help prevent the health service being over-run was described by the NHS as "deeply offensive" to health professionals.

It followed an investigation by the Insight team at The Sunday Times that claimed a 'triage tool' drawn up at the request of Prof Chris Whitty, the Government's chief medical adviser, was later used to prevent a number of patients from receiving ventilation in intensive care.

The report quoted intensive care doctors who said the triage criteria were used in hospitals in Manchester, Liverpool, London, the Midlands, and the south east of England.

It said one guideline advised medics to exclude anyone over 80 years from ventilation.

'Untrue' Claims: NHS

The NHS said no intensive care triage tool was issued by the NHS. The guidance was never completed or issued because it became clear that the NHS was not in danger of being overwhelmed.

It said healthcare staff were repeatedly told that no patient who could benefit from treatment should be denied it.

Stephen Powis, NHS national medical director, said: "These untrue claims will be deeply offensive to NHS doctors, nurses, therapists, and paramedics, who have together cared for more than 110,000 severely ill hospitalised COVID-19 patients during the first wave of the pandemic, as they continue to do so today.

"The Sunday Times' assertions are simply not borne out by the facts: it was older patients who disproportionately received NHS care – over two thirds of our COVID-19 inpatients were aged over 65."

The newspaper report said it carried out a 3-month investigation into the Government's handling of the pandemic during lockdown weeks and spoke to 50 witnesses, including doctors, paramedics, care home workers, and politicians.

The report claimed that GPs in some regions were asked to identify frail, elderly patients who could be kept at home even if they were seriously ill with COVID-19, while ambulance and admission teams were encouraged to be more selective about who should be treated in hospital.

While patients over the age of 80 made up 60% of the total deaths from SARS-CoV-2, only 2.5% of people in this age group who were admitted to hospital were given access to intensive care, the report said, citing NHS data.

It also claimed that the proportion of people over 60 years receiving intensive care treatment halved when pressure on health service resources intensified at the height of the pandemic.

Guidelines Were 'Never Endorsed'

In its detailed statement, the NHS said clinicians were left to make their own decisions about individual treatment, older people were not denied admission to intensive care, and that the optimal therapy for most people hospitalised with COVID-19 turned out to be oxygen therapy, which could be administered on a general ward.

The Intensive Care Society said guidance was commissioned from an expert group for consideration by the Government, but that work stopped in late March without being implemented by the Department of Health and Social Care or the NHS.

A spokesperson for the Society said: "It therefore remained in draft and unpublished at this point.

"Subsequently the draft document was further adapted and refined for release as an independent professional and academic publication."

Publication of the draft document was released by the Society on 28 May 2020. "No interim versions were released, published, endorsed, or authorised" before that date, the spokesperson added.

Dr Alison Pittard, dean of the Faculty of Intensive Care Medicine, said: "Throughout the first wave of COVID-19 the NHS did not run out of critical care capacity, which remained available to everybody who would benefit from it.

"As we learned more about COVID-19 treatment changed as it became clear that oxygen therapy, that can be delivered on general wards, is often more beneficial than being on a ventilator.

"The Faculty of Intensive Care Medicine has been clear throughout that doctors should make decisions about patients' treatment just as they normally would."

NHS figures showed that around the peak of the pandemic, on 14 April, NHS providers had 6818 operational ventilator beds of which 42% were occupied by COVID-19 patients, 15% occupied by other patients, and 43% unoccupied.

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