At least 41 people with Covid-19 have died in care homes and hospices in Northern Ireland.

The figure represents around a quarter of the overall tally and involves 23 separate establishments, official statistics up to earlier this month showed.

Pauline Shepherd represents care homes and said hospitals should routinely carry out tests before discharging patients to them.

She said: “We have 490 care homes in Northern Ireland, there are lots of people who may have no symptoms and they want to protect their residents.”

We have seen this around the whole world, we have seen that nursing homes are probably among the most prone to coronavirus

The chief executive of the Independent Health and Care Providers organisation said the latest figures should not be a shock to anyone since many residents had underlying conditions and were frail.

Ms Shepherd said: “We have seen this around the whole world, we have seen that nursing homes are probably among the most prone to coronavirus.”

She said more analysis of the data was needed to establish whether the virus was the primary cause of death or a contributory factor.

Ms Shepherd added: “The symptoms of end of life often are pneumonia and lung problems and Covid-19 could be suspected, but unless you test you do not actually know.

“I would be pressing strongly that there needs to be increased testing in homes and pre-admission.

“Some care homes are saying we won’t take anyone from hospital unless they have been tested and are negative.”

First Minister Arlene Foster said patients being transferred from hospitals were now being tested but there was an issue around people coming from their own homes having to undergo self-isolation.

Dr Tom Black, chairman of the British Medical Association (BMA) in Northern Ireland, said residents often have other underlying illnesses which leave them at greater risk.

“It is distressing for anyone to lose a family member due to Covid-19, whether that is in a hospital, care home, hospice or family home, but we need to get a clear picture of how our population is being affected as this will help us plan our services in the most effective way,” he said.

“Unfortunately, most people in care homes will be at greater risk of coronavirus as they will generally have co-morbidities, which means they have more than one illness, and this increases their risk from the virus as their overall health is poorer.

“Care home residents will also frequently have in place an advance care plan where they and their family have had the chance to discuss with their GP and others involved in their care what sort of treatment they would like at the end of their life.”

Concerns have been expressed by staff and relatives of residents about the situation in care homes.

Dr Black strongly encouraged families with a loved one in a home to agree with them what to do during end-of-life care.

“It is much easier to do this in advance than when under pressure to take a decision about what interventions you want undertaken.

“In general, it wouldn’t be appropriate to transfer someone who is at the end of their life to hospital to allow them to die in hospital if that isn’t medically necessary.”

He said measures are being put in place for geriatricians to go out to care homes to advise on and supervise care.

Residential home staff are linking in with hospital teams to ensure residents are receiving the best palliative care.

Stormont Health Minister Robin Swann has said he wants to reassure people that relatives are receiving the support and care they need.

Deputy First Minister Michelle O’Neill said: “We know that older people are particularly susceptible to the devastating effects of Covid-19, and our care homes are very vulnerable at this time.”