This site is intended for health professionals only

GP commissioners could be liable in next Southern Cross, warn lawyers

GP commissioners could be held liable if care homes such as those operated by struggling provider Southern Cross go out of business, lawyers have warned.

Oliver Pritchard, a partner at Browne Jacobson told Practical Commissioning that the new clinical commissioning groups would have to be able to show that they had taken steps to check the financial viabililty of care home providers. Mr Pritchard was commenting on the recent case where Britain´s biggest care home provider Southern Cross faced possible closure of its 750 homes housing 31,000 residents as it struggled to pay an annual rent bill of ?230m. A last ditch deal between the company and its landlords last month staved off collapse. Mr Pritchard said recent cases like Southern Cross and the serious abuse by carers revealed by BBC TV´s Panorama at Castlebeck´s Winterbourne View residential hospital sounding a warning bell for commissioners. 'When they´re commissioning care for vulnerable patients like adults with learning disabilities , GPs will have to show they´ve taken steps to check the financial viability of the provider, he said.

He said ‘serious questions' were already being asked about PCTs´ roles in commissioning care in the Castlebeck case and warned GPs could face similar pressure.

He suggested that commissioners should negotiate such contracts with great care: ‘The point is that GPs currently have a re-active role in safeguarding - GPs who have a patient sitting in front of them that they suspect may be being abused or neglected, will know that they should report that patient to the relevant social services.

‘But under commissioning, GPs will have to be more pro-active and be seen to take steps as commissioners to mitigate the risks.

It´s a question of making sure you have the right levers in the contract, and then ensuring that they are used. You may have to specify things like the right to audit the providers' whistleblowing procedures and compliance with the rules on CRB checks for staff. When you´re commissioning care for vulnerable patients like the elderly you´ll have to show you´ve taken steps to check the financial viability of the provider', he said. Last week, the Royal College of GPs announced plans to deliver training for GPs wishing to become GPSIs in care home patients.

The proposal for GPSIs in care homes is being led by Professor Keri Thomas, a former GP and RCGP clinical champion for end of life care, who said the College is working to develop specific expertise, training and clinical supervision for GPs working in care homes.

‘What we are proposing is that we put something forward with care homes and associated training, as there's been an increase in interest in this area of work which is encouraging.

‘The GPSI role would be in recognition of the important role of GPs working with care homes. We are working with the British Geriatric Society who are launching guidance for GPs in the management of residents of care homes and nursing homes at the end of June and who wanted GPs to have that recognition.

‘It would formalise would happens informally in some practices. You could increase the quality of care given to people and save money by inappropriate hospital admissions.'