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Care home LES payments under scrutiny after CQC report prompts claims GPs are being ‘paid twice’

NHS bosses have been urged to review GPs' enhanced service payments for treating patients at care homes after a CQC report prompted claims practices could be being ‘paid twice'.

The call came after a CQC report found 57% of care home residents did not have access to the care they need, and that many did not have adequate GP services.

The CQC report looked at seven activities to assess how PCTs used GPs to meet the healthcare needs of people in care homes. These included health assessments on admission, additional medication reviews, and support with end-of-life care planning.

It found only 12 PCTs (8%) took action across all the activities specified by CQC, and 35 (23%) PCTs took no action at all.

Half of PCTs used enhanced services to provide the seven activities, and half used contract enforcement, although these approaches were not mutually exclusive and 35 PCTs used both options. Seven PCTs provided enhanced services for all seven activities, but no PCT applied the contract enforcement option to all seven.

The British Geriatric Society (BGS), which reviewed the findings, said PCT managers should agree ‘clear and specific service specifications' with GPs, and in some cases consider enforcing GMS contract conditions to provide care rather than using LESs.

A statement from the BGS said: ‘As PCTs face the risk of paying twice where the "enhanced service" is actually a GMS service, they can choose to enforce their standard contract.'

CQC director of operations Amanda Sherlock said: ‘The small sample size limits our ability to draw national-level conclusions. However, we will be using this review to help us identify problem areas and we'll be looking at these issues in our upcoming inspection programme looking at dignity and nutrition in 500 care homes.'

‘All staff and relevant agencies, including the emerging commissioning cluster groups, have a role in improving the quality of and access to healthcare services for care home residents. This is a responsibility which needs to be taken seriously.'