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Can I refuse to treat patient sent to distant nursing home?

Question - One of my patients is an inpatient and is not fit to be discharged home. The hospital intends to transfer her to a nursing home for intermediate care. This is a long way from my practice and visiting would be very difficult. I have therefore refused to provide medical care while she is unfit for discharge and remains in the nursing home. I gather that the GPs close to the nursing home are also refusing to provide care. Am I justified in my decision?

You are not obliged to provide care while your patient is staying in the home and to do so could well prejudice your availability to other patients. Technically, as the patient is not fit for discharge and still needs intermediate care, she remains an inpatient.

The local GPs are therefore not obliged to provide care under their terms of service, as the acute hospital trust maintains responsibility for clinical care.

When intermediate care schemes are set up, it is essential that proper provision and funding are made for any ongoing medical care. Failure to do so invariably creates unnecessary difficulties for the patient and for all of the clinicians involved.

Neither Pulse nor Wessex LMCs can accept any legal liability in respect of the answers given. Readers should seek independent advice before acting on the information concerned.

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