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Practices to be relieved of almost all care home patients under CCG plans

Practices in one area will see three-quarters of care home patients removed from their lists under a CCG’s plans to create a ’virtual GP practice’ dedicated to care home residents.

NHS Southend CCG plans to tender a contract for a provider to take on a patient list made up entirely of care home residents, who will have full medical and medication reviews, which will be potentially ‘weekly for clinically complex patients’.

It said that approximately 75% of the 1,800 care home residents would be moved from their current practice’s list to the new service.

The CCG said that care home residents are a huge demand on practices, who are not even receiving the full enhanced service payments because they are not coding residents properly, while care homes say they are struggling to register patients.

It is using money reclaimed from PMS practice premiums to set up a pilot, which if successful will go to full competitive tender with private providers invited to bid alongside local organisations for the service.

As well as the medical reviews, the new service will provide a care plan for each newly registered patient, reviews after A&E attendances or admissions and training for care home staff in managing urgent conditions.

Performance will be measured on a variety of indicators including patient satisfaction, reduced A&E attendances and emergency phone calls responded to in less than an hour.

The scheme was proposed by local GPs, led by NHS Southend CCG chair, Dr José Garcia Lobera, who said: ‘The borough has more than 100 care homes with nearly 2,000 beds and many of the residents of care homes have complex needs. This has placed additional pressure on local GP practices many of which are already struggling to provide sufficient capacity to registered patients.

He added: ‘Local GP practices will be able to tender for this contract, but it would be as an additional service and not one that would replace their current patient list. The feedback on this pilot scheme was extremely supportive and positive, both in terms of improving primary care services for care home residents and relieving pressures on Southend’s GP practices.’

A CCG board paper for its meeting on 25 September said: ’We expect growth of the practice list size to be slow and steady and for around 25% of the population to remain registered with their local GP practice.

We have estimated that around 100 new patients will register with the service during each month of the pilot.’

Pulse reported in August that Care England – the largest representative of the care home industry – had said they would stop paying ‘unethical’ retainers to fund care home enhanced services, calling for clarity over what GPs could charge for.

However, the GPC said they were underestimating the workload demands involved.

North and South Essex LMCs chief executive Dr Brian Balmer told Pulse that the LMC had not evaluated the programme, but added: ’Care homes are a staggering workload for practices, and I’ve been saying for some times we need to do something about them.’

Readers' comments (13)

  • been done before ... it can work, will be popular BUT expensive. from past experience it will be wound up and list forced back to practices.

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  • Bob Hodges

    A patient choice comes into this at what point?

    Good luck with that one.

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  • I cannot see the comments already made on this story

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  • We need to do something about the burden of workload of care home patients. How about this for a radical solution- pay normal GMS practices fairly rather than all this convoluted tendering. They are effectively privatising these patients' care as I bet it is an APMS contract. Bonkers!

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  • I would be wary of a one-model solution to any geographical locality as the individual processes and protocols of adult social care providers can differ wildly and might not be in a position to accept such a service.

    Best wishes to all involved.

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  • Looks good at first sight, but more complicated once you think about the problems in detail.

    What about patients who have been with a GP practice their entire life?
    What about patients who move in to a nursing home then move out again?
    What about patients who move in to a nursing home for end of life care?

    It seems like the entire process is being done to reduce admissions rather than make lives better for the patients involved.
    Since when did reducing admissions become most important?

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  • Why is the money for this coming out of the PMS review/Primary Care?

    The operational models of adult social care providers need to be thouroughly scrutinised and their relationship with health service should be clearly regulated, rather than attempting to patch up local problems.

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  • The assault on GPs finances and livelihoods continues!

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  • no doubt care homes are heavy work load. it is gp's choice if he want to continue as it is and patient's choice who they register with. ccg have no power to remove patients on gp's list. i doubt if all gp's will agree to this plan. removal of these patient will reduce practice income.

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  • Well, shoot me down, but I think it's worth a try. We can't complain about workload and then decry a pilot scheme which might actually mean the lifting on a huge burden off some practices shoulders

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