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BMA not consulted on care homes enhanced service being brought forward



Exclusive The BMA’s GP Committee has called on NHS England to reverse ‘unacceptable’ plans for GPs to do weekly ‘virtual rounds’ in care homes from May.

The GPC told Pulse it had not been consulted on the move, announced in a letter from NHS England chief executive Simon Stevens yesterday.

GPC chair Dr Richard Vautrey said GPs will be ‘rightly dismayed’ if they are expected to carry out this part of the PCN DES – which was not due to come into effect until October – before promised additional workforce and resources have materialised.

Dr Vautrey told Pulse: ‘Practices are doing all they can to care for their patients in care homes through this crisis, and they should be able to do so with proper support, not more regulation and bureaucracy.

‘We were incredibly disappointed to see in the letter from NHS England yesterday that it intends to bring forward the introduction of key elements of the care home specification without engaging with the profession, and in the full knowledge of the serious concerns many in the profession have previously expressed about this earlier this year.’

Last winter, as part of contract negotiations, NHS England was forced to water down its initial proposal for fortnightly care home ‘ward rounds’ amid an outcry from the profession, saying it would allow PCNs to decide themselves how often ‘medical input’ is required in care homes.

Dr Vautrey said: ‘We have told NHSE/I that this approach is unacceptable. The profession will be rightly dismayed that this element of the contract scheduled for October, which depended on an expanded workforce and additional resources, could be imposed without either being provided.

‘It is not too late for NHSE/I to change this damaging approach and instead work with us to support practices to provide the care they know their patients need.’

He added that GPs will appreciate the need to do all they can as part of the pandemic response, but said the focus should be on supporting care homes with the supply of PPE, coronavirus testing and IT infrastructure to enable virtual GP consultations.

Dr Vautrey said: ‘Of course, with the shocking impact that Covid-19 is having, we appreciate that it is imperative to do all we can to help care home residents, as well as the staff, who need all the support they can get to mitigate the impact on this vulnerable group of patients and those caring for them.

‘This includes a ready supply of PPE, timely access to testing, the guarantee that patients will be admitted to hospital when necessary, and the necessary IT infrastructure to support effective virtual consultations with GPs, community nursing teams and hospital specialists.’

Yesterday’s letter from NHS England said the ‘second phase’ of the response to the coronavirus would include bringing ‘forward from October to May 2020 the national roll out of key elements of the primary and community health service-led Enhanced Health in Care Homes service’.

NHS England said that ‘further details’ would be ‘set out shortly’, but said requirements will include a weekly care home round, carried out ‘virtually’.

An NHS England spokesperson said: ‘Although the coronavirus pressures on primary care have been different from those affecting intensive care doctors and nurses and hospitals, GPs are just as committed as every other part of the health service to go “above and beyond” in supporting vulnerable people in the biggest global health emergency in a century.

‘Although practices report that GP consultations are sharply down, practices are stepping up in other ways including supporting older people living in care homes. These are vulnerable patients who are clearly are in need of the extra support which practices can – and are – helping with.’