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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)

  • Im pretty sure Matt the app would advocate virtual care home rounds?

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  • Which will lead to a reduction in GP appointments and more people going to A&E. There is no extra time in the day, or staff to do this. I hope PCNs realise that

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  • having had a good read of this there is an enormous amount of demands upon individual Practices , not just on the mythical PCN. if this goes ahead I will withdraw my Practice from our PCN.
    check out 3.16 4. even if my patients are not in a PCN I might be required to provide the PCN DES in care homes!!

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  • Where is the Opt out button?!

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  • What a load of bullshit as ever.

    NHS E seem to have forgotten that Primary Care safety netting of 2WW referrals was actually already in their Achieving World Class Cancer Services plan 2015-2020.

    Having Cancer Care Lead in each PCN will really help too just more GP time taken away from front line service and fragment delivery when no one can agree!

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  • This is ridiculously onerous, time-consuming and would take GPs away from useful clinical care. Were any practising GPs involved in drafting the proposals? If so, can they please explain how they see it working in practice. if not, why not?

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  • When will these people realize there is a MANPOWER issue !

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  • load of Cummings, I agree with you
    I was thinking of when to retire; this has made my decision so much easier

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  • Hello Mrs Sprott hows the dementia? Great see you in a fortnight....

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  • This isn’t what GPC promised. They said the specs would require no more extra work.
    This is unmanageable: there isn’t anywhere near enough resource in the PCN DES, and there isn’t the workforce.
    GPC must take aN immediate and very public stand; individual LMCs must stand up and be counted - and if there isn’t an immediate retraction and redrafting of the specs into a radically improved form, they must advise all practices to step away from the PCN contract until it is made fit for purpose.
    Fight back, for heavens’ sake, before you take down general practice and the NHS with it.
    Chaand, Richard, Krish - this is what we pay you for.

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