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GPs to care for patients discharged from hospital to free up beds

Early hospital discharge plans could ‘destabilise’ GP practices, BMA suggests

GPs will have to manage elderly Covid patients discharged into care homes in a bid to help free up hospital beds, NHS England has said.

The requirement comes under the primary care network (PCN) contract’s enhanced service specification for care homes, it added.

Meanwhile other hospital patients are also set to be discharged into hotels to relieve pressure on secondary care services – with GPs providing care in the temporary accommodation.

Joint NHS England and Department of Health and Social Care guidance updated this month revealed elderly hospital patients who have tested positive for Covid may be discharged into care homes if they are ‘not considered to pose an infection risk’.

Patients within 90 days of a positive Covid test or symptom onset who have isolated for 14 days and have had no new symptoms or Covid exposure can be discharged without a new test or isolation on arrival, the guidance said.

However, it added that care home residents ‘may not present with typical symptoms’.

The guidance, which linked to NHS England’s enhanced health in care homes service specification, said: ‘Care homes should continue to receive clinical support for residents following hospital discharge as outlined in the framework on NHS clinical support to care homes.’

Care homes have ‘absolute discretion’ to accept or decline discharged patients and hospitals ‘must not put undue pressure’ on them, the guidance added.

At the same time other hospital patients will also be discharged into hotels, independent ‘hospital at home’ services and designated care homes in the bid to create more beds in secondary care.

In a letter to CCGs and adult social care leaders last week, NHS England said systems can ‘immediately’ begin implementing patient discharges to these locations, backed by a £588m hospital discharge fund until 31 March.

NHS England said the use of hotels would be a ‘short-term measure’ – meaning patients stay there for days rather than weeks – but said GPs would be providing care during this time.

The letter said: ‘Individuals are still entitled to normal health care support from primary care and community/mental health services during their time staying in the hotel including access to out of hours care services, as they would be if living in their own home.

‘Local providers of this care will need to be alerted by the
discharge teams with details of the hotels that people are being transferred

However, it remains unclear which practice will be responsible for their care if patients are discharged to a different area from where they are registered.

It comes as NHS England has said that an increase in cancer diagnostic tests provided by PCNs should be ‘considered’ to reduce the burden on hospitals.

Last week, Pulse revealed that two-thirds of GPs have experienced a ‘significant’ increase in ‘workload dump’ by hospitals due to the Covid-19 pandemic.

And earlier this month, NHS England issued new measures to tackle GP workload as Covid cases spiralled, including the suspension of local enhanced services and further QOF income protection.


John Graham Munro 26 January, 2021 9:41 am


Slobbering Spaniel 26 January, 2021 7:34 pm

So what’s changed?