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Local GP leaders protest against care homes being built without GP consultation

An LMC has taken a stand against local authorities approving new care homes without consulting GPs in the area, after the building of two last year left practices facing a ‘continuous daily battle’.

North Staffordshire LMC said local authorities have approved the building of new care homes with ‘no consideration’ for the increase in primary care and general practice cover needed to staff the homes.

Chair of North Staffordshire LMC Dr Paul Scott wrote to Stoke-on-Trent Council to demand better engagement with GPs before approving new care homes. 

He told Pulse: ‘We have a local and national problem in that nursing and other homes are being built with no consideration for increased primary care and general practice cover.

‘The local authorities approve them with no consultation and no health planning gain. The nursing home element is not core general practice and requires additional CCG investment for safe GP team cover.’

Dr Scott said the workload for each patient in a nursing home is often up to 20 times that of an average patient.

‘It’s the intense medical cover and input that most of these homes require, because the complexity of the patients at each level has gradually gone up over the years and with hospital pressures on hospital beds and discharge policies, often some of the patients going into the nursing homes are quite often spot purchased beds and palliative care beds, and you’re really running step down mini hospitals,’ he said.

‘Our problem is, certainly from an LMC perspective, when one of these things is built, there should be a health planning gain. So you build a 50, 70, or 100 bed one of these, that’s a lot of sessions of GP time to just be assumed can be picked up – and the capacity is not out there,’ Dr Scott added.

Dr Scott’s practice covers two care homes, one with 30 to 40 patients, and another with 50. He said these combined take up two GP sessions a week, but that is ‘just the tip of the iceberg’.

‘We do it with a hodge-podge of funding streams and just about manage to do it. But the homes that are long established value their relationships with general practice and really want to go the extra mile, often there’s even a semi contractual arrangement and you’ve got a good relationship with senior staff and it can really work - some of these new homes don’t have that understanding [and] expect it all on a plate,’ he said.

It follows a task and finish review of GP provision by Stoke-on-Trent City Council in October, which called for better engagement between the Council’s planning department and NHS England.

The review said this was to ‘ensure that the health needs of the local population are carefully considered and planned for’.

In response to this recommendation, the council said: ‘City council planning officers met with officers from the CCG in June 2018 to ensure growth in population and current and known future planning developments within the city were taken into account as part of the pre-consultation business case on the "Future of Health Services in Northern Staffordshire Consultation" that launched in December 2018.

‘Links now exist to continue to ensure the NHS are informed of future housing developments and proposals.’

Readers' comments (10)

  • Planners are not interested. A key factor in my early departure was the plan to build 450 new homes near my former practice. The three overloaded GP surgeries all turned up in person at the planning meeting to object, saying there was no capacity for these people. Ignored, waived through on the nod. Resigned the next day. Amazing how 2-3 locum sessions a week seems enough now.

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  • "Dr Scott said the workload for each patient in a nursing home is often up to 20 times that of an average patient".

    Yet the funding is very far from that....

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  • Time for payment by activity that will focus the mind of planners as much as whole areas without primary care cover.Would you buy a house with no effective healthcare nearby.Will be interesting when the 11000+ GPs are departing the coal face.

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  • Dear All,
    This would not be a problem if the "money followed the patient" (remember that?).
    The problem is that whilst the workload factor for nursing home patients is roughly 5 fold the Carr Hill formula weighting for nursing home patients was revalued at on;y 1.4 times the average, because they realised they couldn't fund it via the global sum. What is needed is a distinct nursing home resident premium GS top up and whilst i'm on this soapbox a separate payment for each and every nursing home admitted palliative care patient.
    Regards
    Paul C

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  • The NHS is killing General Practice. Time to leave.

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  • Payment by activity is the only solution. Till that happens there is no impetus for anyone to care about of consult General Practice.

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  • The bigger issue here is not planning. It's how do we provide medical cover to nursing and resident homes. Currently its dumped on general practice but this causes problems. And will only get worse as the population is set to age. We need a long term solution to something which affects every GP in the country

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  • We had a 50 bed dementia home built on our patch without consultation. It would not have been possible to manage so we applied to change our boundary. Fortunately another surgery was keen to take on the home but I can't see the same convenient solution being found again. It's a pressure that has the potential to sink practices and caused us untold worry.

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  • National Hopeless Service

    Its not just nursing homes its homes in general. We are about to have 300 new homes built near our surgery. The CCG are refusing to allow us access to any of the Section 106 money to extend our surgery because they want the money to build a hub in three years time (WTF) and recruitment in our county is dire.

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  • The planners are useless, just after money to make up the shortfall. Houses rising everywhere without the roads, schools or surgeries.

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