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The waiting game

Care home 'clinical leads' will not be held 'medically responsible' for residents

NHS England has moved to reassure GPs that the new clinical leads mandated for all care homes will not be held ‘medically responsible and accountable’ for residents.

Last week, it was announced that all care homes should have a named clinician by today, as part of the support practices have been asked to provide to care homes during the coronavirus pandemic.

It follows confusion over whether the service was being brought forward as part of the network DES and concern over the role. 

However, NHS England confirmed today that medical responsibility for care home residents remains with their registered GP and that residents should not be re-registered.

An email bulletin said: ‘The clinical lead is not medically responsible and accountable for the care of individual care home residents. 

‘Medical responsibility and accountability for the care of individual care home residents remains with their registered GP – and there may be residents with different registered GPs within a care home. We do not expect residents to be re-registered.’

‘The majority’ of areas now have clinical leads in place for their care homes, it added.

Meanwhile, NHS England said in a GP webinar last night that practices will need to ‘sort out the relationships’ between them if care homes are served by multiple practices or PCNs.

It followed concerns from GPs over the practicalities of the arrangements.

National clinical director for older people and integrated person-centred care Adrian Hayter said: ‘We’re used to working together as practices and the role of the co-ordinator is to be able to work with both of those practices and the registered GPs to be able to make things really work for the home.

‘We want the best care and infection control and we want the practices to work together on that.’

If care homes span multiple PCNs, there will need to be ‘practice-to-practice discussions’ supported by the CCG, he added.

NHS England also said that clinical leads need not be GPs but could be paramedics or advanced nurse practitioners.

Mr Hayter said the role could be filled by anyone who is ‘used to working in a multidisciplinary way and leading the care of older people’.

He added: ‘It’s about the person being responsible and skilled enough to be able to do the work, which is around managing some of those complex situations which occur in care homes.’ 

NHS England, which asked all CCGs to report in by Wednesday this week, said in today’s bulletin that ’the majority of areas now have a clinical lead for their care homes’. 

Other measures to support residents include training on infection prevention and control for staff, as well as testing for patients prior to discharge to care homes and the national procurement of pulse oximeters to support remote monitoring.

Practices should not be asked to deliver this training, which should be led by CCG directors of nursing, but should focus on activities where they can ‘add most value’, NHS England medical director for primary care Dr Kanani said.

Last week, GPs were told they might face regulation unless care home ‘coverage’ - including appointing a clinical lead and setting up weekly virtual ward rounds - is achieved across the country.

Meanwhile, NHS England confirmed that practices would receive funding for ‘additional’ capacity needed to carry out work in care homes as part of the Covid support fund and separate to DES funding.

Readers' comments (24)

  • “I am not Medically Accountable” said the Scapegoat!

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  • what are they responsible for ?

    if nothing , are they needed ??

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  • Got to be seen to be doing something after the horse has bolted. Been trying desperately to highlight shortcomings in my locality since March, but nobody was listening. Pathetic political attempt to demonstrate that Care home deaths are being taken ‘seriously’. No Protection for careers at outset; discharge of Covid + patients and untested potentially + patients to care homes; CCG infection control leads ‘training’ care home staff how to mitigate risks from afar; testing by June; named GP’s (for what purpose exactly?). Too chuffing late you ivory tower REMF. Shame on you all.

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  • Oh dear...what a gibberish. It's almost like NHSE are showing, by own example, not to expect much from so called leaders. Sounds desperate- to demonstrate some sort of "progress".

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  • What a remarkable concept! Someone somewhere do something so that it sounds like we are doing something. And if that someone somewhere is from a different network if anyone is still doing something with networks, then sort something out amongst yourselves. Good British common sense. Glad that’s all clear & sorted out then. Stay Awake! Or is it alert? Or away? Well it’s something like that, just make it up as you go.

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  • So ludicrously stupid I’m lost for words, even after pinching myself really hard more than once.

    NHSE you have surpassed yourself!

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  • Just had stiff coffee and realised its a reincarnation of Reggie Perrin GROT shop, I’m so honoured to be led by staff of this quality and acumen.

    Off to do some medicine and rejoin the human race.

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  • David Banner

    -Dr A is clinical lead GP
    -Dr B is registered “named” GP
    -Dr A alters Dr B’s management plan on virtual ward round
    -Patient dies
    -Family sues Dr B
    - Dr B says “not my fault, pal”
    - Family sues Dr A
    - Dr A says NHSE stated he was not “medically accountable “
    - Both Dr A and B are found liable, Dr A for making the initial error, and Dr B for not picking up on the error.

    GPs making clinical decisions carry medicolegal responsibility, period. For NHSE to pretend GPs are not “medically accountable” is either a devious fib or demonstrates an astonishing lack of medicolegal knowledge.
    The GMC will laugh in your face if you try to use this fallacious NHSE advice as your defence.

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  • Flip flop flip flop.... if they are not accountable, then can someone please ask me whats the point of all this? Its a bit like NHSe generally....what IS the point?

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  • Actually, can anyone name something positive that NHSe has done for us as a profession since this all started?

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