This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

GPs to visit care home patients fortnightly under network requirements

GPs will have to carry out visits to care home patients 'at least' every fortnight from this September as part of the delivery of new network service specifications, new proposals have revealed.

According to a draft NHS England document outlining the primary care network service specifications, practices in PCNs will deliver five national services from April 2020 onwards, including enhanced care in residential homes and structured medication reviews.

Plans for services to provide anticipatory care and personalised care must be drawn up by 'no later than June 2020'. Services to support early cancer diagnosis must have a clinical lead in place from April, and during 2020/21 there must be a 'safety netting' approach put in place to monitor patients referred for suspected cancer.

In addition, the document reveals NHS England will look at whether out-of-hours care should become the responsibility of PCNs beyond 2020/21.

NHS England said it recognises PCNs are in the early stages of developing the five national services and so will ‘phase-in’ the requirements throughout the year, the first being structured medication reviews from April and enhanced health in care homes from June.

The document proposes practices in PCNs will work with community services to provide enhanced health in care homes, including a requirement for GPs to deliver a weekly ‘home round’ for patients in care homes, which can be led by a suitable clinician but must be a GP on ‘at least’ a fortnightly basis.

For the structured medication review (SMR) service, PCNs will have to develop a local approach that adheres to published guidance on SMRs. Networks must offer reviews to all ‘identified’ patients who would most likely benefit from the service, which NHS England says includes all patients in care homes.

NHS England said it expects an SMR to take 'considerably longer than an average GP appointment' and that PCNs should allow for flexibility in appointment length - though it suggests clinical pharmacists and advanced nurse practitioners carry them out, in addition to GPs.

NHS England said it expects the service will lead to a number of GP appointments being prevented.

In the document, NHS England added: ‘Though a combination of the additional workforce capacity within primary care, and the redesign of community services provision to link with and support PCNs, we expect the network contract DES both to reduce workload pressures on GPs and support improved primary care services to patients.’

The detail on the specifications was released by NHS England on 23 December, in addition to an online survey asking for feedback on the proposals, which will close on 15 January.

NHS England said the final version of the specifications will be published in early 2020 as part of the GP contract for 2020/21.

Under the network contract DES, PCNs are responsible for the delivery of seven national service specifications. The further two specifications - on cardiovascular disease prevention and diagnosis and tackling neighbourhood inequalities – will start from April 2021.

Earlier in October, NHS England unveiled new financial incentives for PCNs who meet targets ‘faster’ than others.

Readers' comments (56)

  • I dont pay the BMA any more they havn't been value for money for a long time and I'm sick of giving them a chance.They will let you down DT,wait and see.

    Unsuitable or offensive? Report this comment

  • Can we clearly identify the actual people behind this? How do we do that?

    Unsuitable or offensive? Report this comment

  • The greatest waste of time since the Grand Old Duke of York had his problem with hills.
    This is what happens when the BMA's General Practitioners Committee (GPC)sign up to a contract with no detail.

    Unsuitable or offensive? Report this comment

  • Where are the BMA now? Can pulse try and get them on - this is massively extra work for £1.50 per patient!!! His is crazy!!

    Let’s hear from our ‘Dear Leaders’ now

    Unsuitable or offensive? Report this comment

  • Took Early Retirement

    You have a stark choice: suck it up and carry on whingeing, or do something about it, like RLE. Your call.

    Unsuitable or offensive? Report this comment

  • WTF?

    Unsuitable or offensive? Report this comment

  • To be clear this will only take away from the front line, and allow the nursing home to employ even more junior cheaper carers so that the GPS are subsidising the nursing home owners. This is our experience when we tried weekly ward rounds that this just generated work because the staff at the home were downgraded when the owners realised we were in to carry the risk and do basic work such as referring to dietician etc. When we withdrew from weekly ward rounds the staff improved in quality.

    Unsuitable or offensive? Report this comment

  • So seeing 60 people in a nursing home every week reduces appointments how?? Call me old fashioned but that sounds like 60 appointments and not a couple of visits when needed.

    Who signed this off? Does anyone involved in negotiations actually work as a GP?

    Unsuitable or offensive? Report this comment

  • David Banner

    There are approx 410,000 UK care home residents.
    So for every PCN of 50,000 patients this is roughly 350 residents.
    If there are 25 FTE GPs in this Network, that’s 14 patients per GP.
    Since they want “substantially more” than a standard 10 minute appt, let’s assume 20 minutes per patient every fortnight, plus travel time.
    That’s the equivalent of 2 surgeries per GP every fortnight.
    So across the Network every GP drops the equivalent of a surgery every week.
    This is utter madness. Massively inefficient, with a huge impact on non-care home patients, and minimum benefit for care home residents, who still need another visit when they become ill the day after their fortnightly check up.
    In some Parallel Universe where GPs are plentiful this might seem a good idea, but in the present climate it’s catastrophic lunacy dreamt up by Blue Sky Utopians with zero grasp on the grim reality of the chaos that is Primary Care in 2020.

    Unsuitable or offensive? Report this comment

  • I am speechless and extremely glad to have walked away four years ago from being a f/t nine clinical session partner. The country is at least 7000 GPs short and daft ideas like this aren’t helping. Best of luck.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say