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Field criticises GPs for charging ‘retainers’ for care home provision



The chief inspector of primary care has attacked GPs following claims that some practitioners are charging ‘retainer’ fees for treating patients in care homes.

Professor Steve Field told the CQC board meeting on Wednesday that he had talks with ministers about GPs ‘refusing to talk to patients from care homes unless they get a fee’ following newspaper reports.

However, doctors’ leaders pointed out that GPs were only charging extra to care homes for providing services ‘over and above’ what was expected of them as part of the GMS contract.

Professor Field told the CQC board that he was in discussions with ministers about the issue.

He said: ‘I am disturbed by some of the newspaper reports about GPs refusing to talk on patients from care home unless they get a fee, that is completely wrong and we will look into that when we start to do our inspections.’

The reports followed research by Care England, the biggest umbrella body for English care home providers, published last month that found that 30 of 34 care homes it surveyed were charged ‘retainer’ fees to guarantee GP care for their residents.

However, Dr Richard Vautrey GPC deputy chair hit out the claims, saying that GPs were only charging extra to care homes for extra services provided.

He said: ‘Some GPs for example provide a weekly ward round to care homes for which they charge a retainer to the care home which is used to backfill for the time that a particular doctors spends away from the practice.’

He accused care home providers of having a ‘vested interest’ in not paying such retainers and therefore driving up their profits further.

‘Many GPs have got concerns about the numbers and the experience of care home staff who are employing less experienced staff which means an extra workload on practices,’ he said.

‘Many care homes are looking more and more like elderly care wards but they are greatly understaffed.’

Dr Vautrey warned that the CQC’s own expectations on care home provision was creating a ‘ripple effect’.

‘The more they ask of care homes, the more impact this is having on GPs, so CQC needs to be careful of the ripple effect they are having,’ he warned.

Meanwhile, Professor Field said he was ‘shocked’ at some local area team’s apparent lack of knowledge about which bodies provide out-of-hours GP services in their area.

He said that the CQC had written to CCG and local area teams requesting information about which out-of-hours providers they were commissioning, but said he had only so far received responses from nine of the 25 LATs.

‘It is disappointing that when we ask for information it does not come back quickly and that is a learning point for all of us,’ he said.