SHOCKING statistics are emerging about the number of Covid-19 deaths in care homes. The response of the media has been focused on the need to provide care-home staff with testing and protective clothing. Both are important, but less attention has been given to the urgent need to provide palliative care to those frail elderly being scythed down by this horrible virus.
Those of us who have witnessed the death of an elderly parent in recent years know that since the Dr Harold Shipman scandal the use of so called ‘end-of-life medication’ has been very strictly controlled and that stocks of the drugs (notably morphine and its derivatives) may not be held by nursing or care homes or carried by GPs.
In every case a fresh prescription must be requested from a GP and, if granted, taken to a pharmacy to be dispensed. In the event that the drugs are not needed or used up, they must be returned to the pharmacy to be disposed of.
That’s fine in theory – powerful palliative drugs can hasten death and it’s right that they should not be sitting in the first-aid cupboard for anyone to use. But the trouble is that even pre-Covid, contacting a GP, especially out of hours or at weekends, is no easy matter. Vital hours can be lost while a patient lies in great distress, waiting for prescriptions to be obtained and for carers to drive around finding a 24-hour chemist. It is no surprise to learn that as Covid deaths mount, doctors have called for the Shipman rules to be relaxed. The Home Secretary is said to have been sympathetic to their request but legislation remains unchanged and, according to yesterday’s Times, care home representatives and NHS consultants remain gravely concerned.
Everyone who has a relative or friend in a care home should add their voice to the pleas of carers to ensure that the necessary medication is accessible at short notice to nurses in care homes whose residents are in extremis. Restrictions linked to staff seniority and next-of-kin approval could readily be substituted for the present tangle of red tape.
This pandemic has shone a light on the ‘just-in-time’ nature of every supply chain in the NHS. Lack of palliative care is perhaps the most distressing example of unwieldy bureaucracy getting in the way of humanity.