GPs vote to withdraw healthcare services for elderly care home residents

Care home operators may be forced to pay additional fees for medical services after GPs voted to stop looking after residents.

At a British Medical Association conference on Saturday, representatives for dozens of GP practices said that visiting elderly residents in care homes was placing an unbearable burden on doctors and risking patient care.

Chaand Nagpaul, chair of the GP committee of the BMA, said government healthcare policies were asking GPs to provide services in the community that should be delivered in hospital.

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At the conference, he said it was not safe to see patients with complex multiple needs in 10-minute consultations or have 70 patient contacts each day.

The conference heard that GPs want the right to opt out of their responsibility to care for highly dependent patients living in care homes.

Care England, which represents care homes in the UK, suggested that the policy was discriminatory. “Residents of care homes should not be treated any differently from those living in their own homes; a care home is their home. GPs are a vital part of the fabric of the care package for any care home and it is impossible to imagine residents receiving the care and attention that they require without full access to primary care,” said Professor Martin Green, chief executive of the organisation.

A Department of Health spokesman said: “GPs are contracted to ensure their patients receive full and proper standards of care – and that includes carrying out home visits where necessary.”

Care England questioned whether the BMA decision was in response to Government moves to reform the way GPs are funded. “One wonders whether this decision by the BMA is a reaction to the end of GP retainers.  If so, let’s have an honest discussion without forgetting the dire financial state of affairs affecting the care sector,” Professor Green demanded.

Analysis by the Daily Mail found that GPs carry out routine check-ups with care home residents once or twice a week, in addition to visiting any who suddenly become very unwell.

There are 16,589 registered care homes in England. If they were each attended by a GP once a week, that amounts to more than 860,000 visits a year.

Around one third of GPs charge for such services, with fees ranging of between £12,000 and £100,000 a year to a care home operator.

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In a BBC Radio 4 interview on Monday, Mr Nagpaul denied accusations that family doctors were abandoning older patients. He said that the vote to withdraw services to care homes was driven by a need to guarantee quality of care.

“The problem we have got is that patients in care homes have additional complex needs who would have been in a hospital setting. You wouldn’t expect GPs for example to visit patients in hospital when they have been admitted to hospital.”

He added that elderly patients were being discharged from hospital too soon, which is adding to strains on community healthcare providers, including GPs and care homes.

Please let us know your thoughts on this issue by contributing a comment below.

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2 Comments

  1. Brianc said:

    Do the GP actually think that hospital bed blocking is a better alternative than their providing these services to care homes in the community? Perhaps the answer is that we need more competent GP’s on staff who can provide the services to the care homes, in order to allow the patients the dignity of having care in their home setting, and to support care staff to keep them well whilst in the home.

  2. M Taylor said:

    Frankly the GPs have a sound argument; patients are being discharged with ongoing medical care needs which require ongoing medical monitoring, advice and medication management. However keeping elderly people with complex needs in an acute hospital setting any longer than absolutely necessary on the assumption that they will be better cared for and better treated than when looked after by community GPs and the 24/7 high quality care delivered within a quality Nursing Home setting is fantasy.
    Therefore the heart of the argument is that if community services (of all varieties) are to effectively look after an increasing elderly population with complex needs then the services must be appropriately funded, staffed, supported and fit for purpose.
    This is not the responsibility of individual GPs and Care Providers it is the responsibility of the Government.

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