British Geriatrics Society comments on provision of GP services in Care Homes

BGS Logo CMYKFollowing today’s news that GP representatives of the British Medical Association have voted for a change in contractual arrangements, which may adversely affect their provision of services to care home residents, BGS President Professor David Oliver has made the following comments on behalf of the Society:

“We are very supportive of our GP colleagues in drawing attention to a major crisis in the recruitment, training and retention of GPs. We acknowledge that GP consultations have risen year on year, and that around 90% of the work of the NHS is done in primary care for less than 9% of the NHS budget.
However, we would oppose removing a duty of care for care home residents from the GMS contract without first putting in place robust alternative arrangements to ensure that no resident is denied access to proactive and responsive primary and community health care services.

There are over 400,000 people living in nursing and residential homes in the UK. They generally have very complex health and care needs, which require skilled support not just from doctors, but from a range of other health and care professionals.
Under the terms of the NHS Constitution, the Equality Act and the current GMS contract, these older people are entitled to the same level of access to a full range of health and care services as all other citizens. This is not simply about respecting older people’s rights: it is also the right thing to do for our highly pressurised health and care systems.
We must ensure that care home residents can continue to access the health care services they need. We call on the BMA and GPs to ensure that, in protecting the future sustainability of their services, they do not classify care home residents as anything less than full members of society, with the same healthcare entitlements as the rest of us.”

6 thoughts on “British Geriatrics Society comments on provision of GP services in Care Homes

  1. There has been a failure of policy and effective professional leadership for more than 20 years regarding medical care in care homes. Lets hope this “headlights in the eyes” instigates meaningful change. 400,000 beds…. must be a bit sweaty in DH !

  2. I wholeheartedly agree with this comment. People live in care homes in the same way that we all live in our homes. What next, not allowing admission to hospital for people.

  3. There is no doubt that frail older people in care homes have complex needs and require high levels of primary care; and I respect the arguement that it is necessary to invest and regulate this input to ensure their care is of the highest quality and best delivered to minimise the burden on the individual and their demands on other health and social care. So, in many areas CCGs have developed locally enhanced services (LES) to facilitate dedicated high quality GP input to care home residents. I am dismayed that this good work might be unravelled and that those in most need may be at risk of being denied equity of access to primary care. Is this the thin end of the wedge in privatising primary care. Which sections of society will GPs decline to provide care for next: those living in sheltered housing, children in boarding schools?

    • The comments from the LMCs meeting seem to indicate a genuine reognition that those in care homes need better provision than current overstretched GP services can currently manage. GPs aren’t sitting there twiddling their thumbs wondering which of their meaningless littlle jobs they can dicard next so that they can go and play golf. Nobody is going to suggest that groups of at-risk patients do not need to be seen – quite the contrary, they need dedicated, allocated time rather than being crammed into packed visit lists.

  4. The problem is not one for the UK alone. In Australia where health care is much better funded and GPs have greater choice in their hours an work, resident of Aged Care Facilities lack effective supervision and are too often shunted away to an acute hospital when some minor crisis occurs and the only medical support is a locus service.
    I feel that only way forward is to
    a) set GP services IN aged care facilities with responsibility for local outreach into homes as well as continuing care for residents.
    b) See these settings as Commnitiy Hubs, charged with encouragement of health ageing, using facilities (pool, gym, meeting areas, meals, showers) available to the local community as well as residents..
    c) Much of the careprpivded can be done by non-medical staff, but they need local supervision on the spot. More use of ours practitioners in aged care, palliative care, mental health, supporting care workers and volunteers,

  5. Thanks for the comments so far – all adding to the debate. I would not want mumhasdementia to misunderstand our position. We very clearly said that GPs were under massive pressure right not from both demand and workforce. We also very clearly said that IF care homes were to be removed from GMS it should ONLY be if alternative provision was in place. We clearly said that residents needs went well beyond simply GPs and we have campaigned for several years well before the LMC vote for alternative models of healthcare support for care homes – for instance in our Care Home Commissioning Guidance which was co-written, sense checked and endorsed by GPs with expertise in commissioning and in the care of older people. It is hard for us to be any clearer that this not about criticising GPs but we are unapologetic about advocating for the care of older care home residents – its a key part of our strategic priorities right now.

    David Oliver

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