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Can I invest in a nursing home where I look after the patients?

Dr Catherine Wills looks at the dilemma of whether or not a GP can invest in a nursing home and at the same time look after patients in the home

Dr Catherine Wills looks at the dilemma of whether or not a GP can invest in a nursing home and at the same time look after patients in the home

Q For several years I have been treating patients at a local nursing home. The company which owns the home has just invited me to invest in the home.

I'm tempted by the financial opportunity. But would I be able to continue to care for patients there if I went ahead?

A While you may be tempted by this business opportunity, you also need to consider your ethical obligations. In particular you need to consider whether investment by you or members of your family might lead to a conflict of interest.

You will almost certainly have to cease providing GP services to the home.

The GMC's relevant supplementary guidance, Conflicts of Interest (2006) states: "If you are general practitioner with financial interests in a residential or nursing home, you should not usually provide primary care services to patients in that home.

Exceptions may arise. For example a patient may ask you to continue acting as their general practitioner. Or there may be no alternative to your providing care.

If you accept a patient in these circumstances you must be prepared to justify your decision." (paragraph 6a).

The GMC expects you to ensure that such unavoidable conflicts do not adversely affect your clinical judgment. You may also wish to make a note in the patient's record if the situation arises.

If you cease providing care for patients, you will need to inform them of the reasons.

You will also need to take steps to ensure that arrangements are made promptly for their continuing care.

And you must pass on the patient's records without delay, in line with the GMC's guidance. (paragraphs 39-40, Good Medical Practice)

Some GPs may have a financial interest in an institution and be working under an NHS or employers' policy, for example in Practice Based Commissioning.

If this is the case, you should "satisfy yourself, or seek assurances from your employing or contracting body, that systems are in place to ensure transparency and to avoid or minimise the effects of conflicts of interest." (paragraph 5 Conflicts of Interest).

You must continue to act in the best interest of patients and be honest and open about any financial arrangements.

For example, if you were asked by a patient or their family to recommend a nursing home, you must ensure they are aware of your financial interest.

It is also a good idea to inform your colleagues about your investment.

Dr Catherine Wills is a medicolegal adviser with the MDU

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