Guidance on Hospital Admission and Care for those who are Disabled and are diagnosed with Co-vid 19

07/04/2020

Over the past few weeks there has been increasing concern that those with underlying health conditions or disabilities will not receive the same level of treatment if taken poorly with Co-vid19.  This followed an initial statement by NICE, that suggested the Clinical Frailty Scale should be used when assessing an individual’s suitability for hospital admission and more recently contact from some GP’s suggesting that those in care homes should be considered for Do Not Resuscitate notices.

This of course has been very distressing for our community to hear and rightly this has been challenged by national organisations representing those with disabilities.  Positively this position has now been reviewed and there are a number of documents and statements that parent carers should be aware of.

Firstly the NICE guidance on accessing suitability for hospital admission have been rewritten and clear guidance has been given stating that the Clinical Frailty Scale should not be used “in younger people, people with stable long-term disabilities (for example, cerebral palsy), learning disabilities or autism. An individualised assessment is recommended in all cases where the CFS is not appropriate.” It goes on to say that if placing any individual in critical care is being considered then clinical staff should “Discuss the risks, benefits and possible likely outcomes of the different treatment options with patients, families and carers using decision support tools (where available) so that they can make informed decisions about their treatment wherever possible.”

https://www.nice.org.uk/guidance/ng159/chapter/1-Admission-to-hospital

This position has been further strengthened through a letter from NHS England and NHS Improvement to all Primary Care providers, Acute Trusts and Community Trusts making it clear that “It is imperative that decisions regarding appropriateness of admission to hospital and for assessment and treatment for people with learning disabilities and / or autism are made on an individual basis and in consultation with their family and /or paid carers, taking into account the person’s usual physical health, the severity of any co-existing conditions and their frailty at the time of examination. Treatment decisions should not be made on the basis of the presence of learning disability and / or autism alone.”

The letter can be read in full here.

Finally the British Medical Association (BMA), Care Provider Alliance (CPA), Care Quality Commission (CQC) and the Royal College of General Practice (RCGP) have issued a joint statement about advanced care planning https://www.rcgp.org.uk/about-us/news/2020/april/joint-statement-on-advance-care-planning.aspx

We hope that the information above provides some reassurances for you and your family.  Please do let PACC know if you have any further questions about this situation or if your experience of support does not reflect the guidance above.