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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.’