GPs will have to carry out visits to care home patients ‘at least’ every fortnight from this September as part of the delivery of new network service specifications, new proposals have revealed.
According to a draft NHS England document outlining the primary care network service specifications, practices in PCNs will deliver five national services from April 2020 onwards, including enhanced care in residential homes and structured medication reviews.
Plans for services to provide anticipatory care and personalised care must be drawn up by ‘no later than June 2020’. Services to support early cancer diagnosis must have a clinical lead in place from April, and during 2020/21 there must be a ‘safety netting’ approach put in place to monitor patients referred for suspected cancer.
In addition, the document reveals NHS England will look at whether out-of-hours care should become the responsibility of PCNs beyond 2020/21.
NHS England said it recognises PCNs are in the early stages of developing the five national services and so will ‘phase-in’ the requirements throughout the year, the first being structured medication reviews from April and enhanced health in care homes from June.
The document proposes practices in PCNs will work with community services to provide enhanced health in care homes, including a requirement for GPs to deliver a weekly ‘home round’ for patients in care homes, which can be led by a suitable clinician but must be a GP on ‘at least’ a fortnightly basis.
For the structured medication review (SMR) service, PCNs will have to develop a local approach that adheres to published guidance on SMRs. Networks must offer reviews to all ‘identified’ patients who would most likely benefit from the service, which NHS England says includes all patients in care homes.
NHS England said it expects an SMR to take ‘considerably longer than an average GP appointment’ and that PCNs should allow for flexibility in appointment length – though it suggests clinical pharmacists and advanced nurse practitioners carry them out, in addition to GPs.
NHS England said it expects the service will lead to a number of GP appointments being prevented.
In the document, NHS England added: ‘Though a combination of the additional workforce capacity within primary care, and the redesign of community services provision to link with and support PCNs, we expect the network contract DES both to reduce workload pressures on GPs and support improved primary care services to patients.’
The detail on the specifications was released by NHS England on 23 December, in addition to an online survey asking for feedback on the proposals, which will close on 15 January.
NHS England said the final version of the specifications will be published in early 2020 as part of the GP contract for 2020/21.
Under the network contract DES, PCNs are responsible for the delivery of seven national service specifications. The further two specifications – on cardiovascular disease prevention and diagnosis and tackling neighbourhood inequalities – will start from April 2021.