Care England may care about its care homes, but, as far as GPs are concerned, it seems it couldn’t care less. Because it has decided to withdraw retainers it’s currently paying to practices. And it’s calling for a revamp of the GP contract to clarify what basic general medical services care homes have a right to expect and which services might reasonably attract a fee.
Actually, that’s not a bad idea. Because it’s likely to prove the exact opposite of what Care England suspects: the truth is that most practices provide services to care homes which, in terms of quantity, quality and hassle, are way over and above bog-standard GMS.
We certainly do in our patch, given that care home staff always seem too stretched to bring patients to the surgery, call us sequentially through the day for visits to different inmates in the same home, send random urinalyses by fax for our attention with no clinical context whatsoever, have a vault-full of protocols all of which end with, ‘Call GP, now’ and so on ad nauseam.
And many practices, like ours, do this for no extra funding at all, aside from a risible extra few quid chucked in the global sum.
But actually, funding isn’t the point. So I hope this problem isn’t resolved in that predictable, linear medicopolitical way which goes, extra work →extra funds →issue solved. Because, even if I do earn more for care homes, they still remain my problem. Sure, I’d have extra money to pay for more staff. But then I’ve got, to find, say, a care home nurse practitioner, employ her, train her and then deal with the fallout when she goes off sick with stress after two days.
Ask any GP: it’s not more funds we need, it’s less work – and care homes are an excellent case in point. Yes, I want the residents to have quality care, but I simply don’t have the hours in the day to provide it.
So give the problem to pharmacists, to public health, to community geriatricians or even, for all I care, to a crack squad of government-funded, extended role, elderly-friendly Labradors. Just don’t give it to me.
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter@DocCopperfield