Lancashire Teaching Hospitals NHS Foundation Trust

5. Mr A complains the Trust did not start compulsory COVID-19 testing for asymptomatic staff as soon as it should have. He explains Mr B caught COVID-19 while he was an inpatient. He tested positive for COVID-19 on 14 November 2020.

6. Mr A says he is left not knowing how Mr B caught COVID-19 while in hospital. He explains Mr B sadly died from COVID-19 pneumonia in early December and he feels this could have been avoided. This caused him and his family significant grief and upset.

7. He would like an apology and financial compensation.

8. Mr B had an abdominal aortic aneurysm. This is where there is a bulge in the aorta (the largest blood vessel running from the chest and abdomen to the heart). On 30 October he was admitted for emergency surgery to help repair this. He tested negative for COVID-19. After a successful procedure, he was transferred to the intensive care unit (ICU) for care and treatment.

9. On 6 November, staff transferred Mr B to a green bay on ward A. The Trust’s green bays were for patients who had tested negative for COVID-19 and had not been in contact with any COVID-19 positive patients. Mr B had another negative COVID-19 test result on 9 November, while in the green bay.

10. On 14 November, Mr B began to develop COVID-19 symptoms. Staff did another test and on 15 November the result was positive. Staff moved him into a red bay. The Trust’s red bays were for patients who had COVID-19.

11. Mr B’s condition began to get worse and he was readmitted to ICU on 23 November. On 25 November, he was moved to the respiratory high care unit. Sadly, Mr B’s condition did not improve.

14. The Trust explains that at the time of Mr B’s admission there were no national guidelines saying hospitals should test staff who did not have symptoms of COVID-19. It explains the national guidelines for this came into effect on 16 November 2020. In response to this the Trust started its new testing program for asymptomatic staff on 24 November. This required staff to test themselves, using lateral flow tests several times a week.

15. The Trust’s explanation is correct as we have seen NHS England issued its guidance on asymptomatic staff testing on 16 November.

16. Mr B sadly contracted COVID-19 before there was a requirement for asymptomatic staff to do regular lateral flow tests.

17. But we can see that NHS England’s letter to hospitals explains three possible situations when asymptomatic staff should be tested using any spare tests (after testing symptomatic staff and patients). These were:

- When there is an untoward incident in a shared location. This is when a single inpatient develops COVID-19 on or after day eight of admission.

- When there is an outbreak in a shared location. This is when two or more cases have become symptomatic or tested positive for COVID-19, on or after day eight of admission.

- When there is a high prevalence of COVID-19 at the organisation. This is when the organisation is identified as having a high number of COVID-19 patients who have developed COVID-19 on or after day eight of admission.

18. The IPC guidance shows us that when Mr B was at the Trust, it was a requirement for patients to be put in groups based on their COVID-19 status. Staff flow was also separated in those areas to minimise contact between different COVID-19 groups.

19. We can see Mr B tested negative for COVID-19 when he was in ICU and several days after being admitted to ward A. This shows us it is likely Mr B contracted COVID-19 while on ward A.

20. On ward A, Mr B was put in a green bay. We have looked carefully at whether there was a clinical situation in this bay that would have meant asymptomatic staff should have been tested for COVID-19.

21. To do this, we have considered Mr B’s medical records and the Trust’s records on the COVID-19 status of patients in ward A at the time, including the different groups they had been placed in (different rooms and bays).

22. Based on this information, we have seen no evidence to suggest there were any COVID-19 positive patients in the same bay as Mr B, until he tested positive for COVID-19 on 14 November.

23. This shows us that in Mr B’s group, there were no untoward incidents or outbreaks before he tested positive for COVID-19. The Trust was not found to have a high number of COVID-19 positive results during this time.

24. This means in line with NHS England’s letter to hospitals, the Trust was not expected to test asymptomatic staff at the time.

25. The Prime Minister’s statement on COVID-19 shows us that at the time of Mr B’s admission, there was an increasing number of COVID-19 cases in the UK overall.

26. Records from the Trust show that between 19 October and 9 November 2020 there were no untoward incidents or outbreaks in any groups on ward A. The only two untoward incidents after this were on 9 and 12 November, both in different groups to each other, and in different groups to Mr B.

27. During a time where COVID-19 was increasing in the UK, we would not have expected the Trust to use spare tests on asymptomatic staff working in groups where COVID-19 was not present.

28. We recognise Mr A wanted Mr B to have the best chance of survival during his admission. We recognised it would have been very difficult to see Mr B die from COVID-19, knowing he caught this in hospital. We do not underestimate the impact this would have had on Mr A.

29. The Trust’s testing programme was in line with the guidance in place at that time and we hope our explanation reassures Mr A that staff acted as they should have done.

30. We do not uphold this complaint.

1. The Parliamentary and Health Service Ombudsman has carefully investigated this complaint. Mr A is concerned his father, Mr B, contracted COVID-19 while in hospital, because Lancashire Teaching Hospitals NHS Foundation Trust (the Trust) had not started compulsory COVID-19 testing for asymptomatic staff (when you do not have symptoms). We recognise this must be very difficult for him and we are very sorry to hear about what happened. We thank Mr A for giving us an opportunity to investigate his concerns.

2. At the time of Mr B’s admission, national guidelines said staff should be tested if they had COVID-19 symptoms. The guidelines did not say it was compulsory for asymptomatic staff to be tested regularly.

3. There were some clinical situations where hospitals should have used spare tests to test staff who did not have symptoms, but none of these situations applied at this time.

4. Our explanation below gives more detail on our decision. We do not uphold this complaint. We hope the explanation gives Mr A some reassurance that staff did what they should have done.