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GPs go forth

BMA not consulted on care homes enhanced service being brought forward

Exclusive The BMA's GP Committee has called on NHS England to reverse 'unacceptable' plans for GPs to do weekly 'virtual rounds' in care homes from May.

The GPC told Pulse it had not been consulted on the move, announced in a letter from NHS England chief executive Simon Stevens yesterday.

GPC chair Dr Richard Vautrey said GPs will be 'rightly dismayed' if they are expected to carry out this part of the PCN DES - which was not due to come into effect until October - before promised additional workforce and resources have materialised.

Dr Vautrey told Pulse: 'Practices are doing all they can to care for their patients in care homes through this crisis, and they should be able to do so with proper support, not more regulation and bureaucracy.

'We were incredibly disappointed to see in the letter from NHS England yesterday that it intends to bring forward the introduction of key elements of the care home specification without engaging with the profession, and in the full knowledge of the serious concerns many in the profession have previously expressed about this earlier this year.'

Last winter, as part of contract negotiations, NHS England was forced to water down its initial proposal for fortnightly care home ‘ward rounds’ amid an outcry from the profession, saying it would allow PCNs to decide themselves how often 'medical input' is required in care homes.

Dr Vautrey said: 'We have told NHSE/I that this approach is unacceptable. The profession will be rightly dismayed that this element of the contract scheduled for October, which depended on an expanded workforce and additional resources, could be imposed without either being provided.

'It is not too late for NHSE/I to change this damaging approach and instead work with us to support practices to provide the care they know their patients need.'

He added that GPs will appreciate the need to do all they can as part of the pandemic response, but said the focus should be on supporting care homes with the supply of PPE, coronavirus testing and IT infrastructure to enable virtual GP consultations.

Dr Vautrey said: 'Of course, with the shocking impact that Covid-19 is having, we appreciate that it is imperative to do all we can to help care home residents, as well as the staff, who need all the support they can get to mitigate the impact on this vulnerable group of patients and those caring for them.

'This includes a ready supply of PPE, timely access to testing, the guarantee that patients will be admitted to hospital when necessary, and the necessary IT infrastructure to support effective virtual consultations with GPs, community nursing teams and hospital specialists.'

Yesterday's letter from NHS England said the 'second phase' of the response to the coronavirus would include bringing 'forward from October to May 2020 the national roll out of key elements of the primary and community health service-led Enhanced Health in Care Homes service'.

NHS England said that 'further details' would be 'set out shortly', but said requirements will include a weekly care home round, carried out 'virtually'.

An NHS England spokesperson said: 'Although the coronavirus pressures on primary care have been different from those affecting intensive care doctors and nurses and hospitals, GPs are just as committed as every other part of the health service to go "above and beyond" in supporting vulnerable people in the biggest global health emergency in a century.

'Although practices report that GP consultations are sharply down, practices are stepping up in other ways including supporting older people living in care homes. These are vulnerable patients who are clearly are in need of the extra support which practices can - and are - helping with.'

Readers' comments (18)

  • The PCN DES was dead in the water before Covid19 came along, and I haven't seen the PCNs doing anything much to establish their position during the crisis. So stop worrying about this, keep calm, dump the DES and carry on.

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  • NHSE clearly want to micromanage us.
    They don’t want to negotiate or listen to our views, and they don’t respect, or constructively engage with, BMA or GPC.
    They seem to prefer dealing with the big IT companies, and appear to be actively working to construct a ‘primary care’ model that replaces autonomous general practice with digital triage, alternative video providers, and a small number of residual F2F.
    PCNs are their Trojan Horse for this, a necessary intermediate step to make sure there is some system continuity when practices start to fail, or to hand back their contracts.
    Covid is being used as an excuse to push these changes through.
    Richard is right to express his concerns, but we have to go further. We should boycott PCNs and insist on a new core contract, before it is too late. This was what the LMCs votes for just before Covid hit us.

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  • Well Done BMA for saying no! (so far)

    Please secure absolute certainty about what happens too QOF this year as that is vital income for us and at present we are not doing it on request and concentrating on Covid 19 response.
    This shows NHSE cannot be trusted to call a deal a deal.
    We can decline to sign up to the DEs (we have till 31/05) and even if you have signed up already , the rules say if the specifications are altered you can serve notice for up to a month later.
    If we all say no to this now we can still concentrate on patients and Covid and who will the patients trust more if there is a dispute ? us or NHSE?
    Agree with DT, say NO for now and let's ballot the profession now on the whole PCN part of the contract.

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  • To push ahead with their care home agenda with no discussion even after the outcry from GPs at the beginning of the year shows how little regard NHSE has for GPs in general and the BMA in particular.
    GPC its time to use all of that dry powder to go in all guns blazing. They've kicked sand in your faces and you need to stand up & give Stevens and NHSE a smack in the mouth.

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  • No change there then...
    All that recent hype in Westminster and Fleet Street about looking after GPs...
    Now same old bullshit.
    It'll never change...

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  • Hopefully this shows GPs precisely how little NHSE can be trusted.

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  • And reveals that the Independent Contractor status can be completely ignored when it suits them. We have the worst contractual situation in the history of contacts. - a conning pseudo-contract.
    “Incredibly disappointed“ is the sound of a totally beaten self defining profession that is in fact just a skilled workforce.

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  • Anyone who signs up to the DES has got no right to complain. It's VOLUNTARY.

    You guys (well most of you) are signing up to something and then complaining about how bad it is. Learn to say NO!

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  • Practices not signed up to the PCN nonsense can hand over patients and home to the PCN. Somebody else's problem, result!

    As for the BMA, they negotiated this pile of excrement in the first place.

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  • No consultation with us?? Funny that! So while my neighbours clap and I am supposed to be proud of my profession, I am yet again disappointed that the BMA Allow us to be steam rollered into something we all feel needs ‘working up’ ( which is different to rejecting)!
    Have reminded myself why am not a member of the BMA!

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