GPs vote to axe care home visits: Fears elderly patients will be left with inferior care and higher fees after decision at crisis meeting
- GPs have voted to stop looking after thousands of care home residents
- Fears remain elderly patients will be left with impersonal or inferior care
- Residents could also face higher fees as homes pass on the cost of paying to bring in private doctors
- GPs want the right to opt out of being responsible for frail patients
GPs have voted to stop looking after hundreds of thousands of care home residents, raising fears that elderly patients will be left with impersonal or inferior care.
Residents could also face higher fees as homes pass on the cost of paying to bring in private doctors.
GPs want the right to opt out of being responsible for frail, highly dependent patients in care homes. This could lead to private firms staffed by unfamiliar locums carrying out visits instead.
The prospect has infuriated campaigners for the elderly – but family doctors say they no longer have the time to provide the right level of attention to such increasingly infirm residents.
The cost of bringing in private providers is likely to lead to higher fees for residents. Around one third of care homes already pay GPs for the service
Many require dedicated care and, in the past, would have been looked after in hospital. There are around 300,000 elderly people in care homes in England and managers are obliged to ensure they are all registered with a GP nearby.
Currently, family doctors carry out routine check-ups once or twice a week, in addition to visiting any who suddenly become very unwell. There are 16,589 registered care homes in England. If they were each attended by a GP once a week, that amounts to more than 860,000 visits a year. Controversially, around a third of GPs charge for such services, with fees ranging of between £12,000 and £100,000 a year
The cost of bringing in private providers is likely to lead to higher fees for residents. Around one third of care homes already pay GPs for the service.
Up to 300 GPs’ representatives from powerful regional bodies voted to end being responsible for care homes at a crisis summit this weekend.
The British Medical Association union may now lobby the Government to remove the responsibility of looking after residents from the GP contract.
The Government is due to announce a new contract later this month, which will then be thrashed out with the BMA.
Officials at the Department of Health admit the union could demand that the clause of care home responsibility is removed from their duties.
Up to 300 GPs’ representatives from powerful regional bodies voted to end being responsible for care homes at a crisis summit this weekend
The British Medical Association union may now lobby the Government to remove the responsibility of looking after residents from the GP contract
But Caroline Abrahams of Age UK said: ‘Older people in care homes are just as entitled as anyone else to good NHS treatment and because many are frail and unwell, continuity of care from a GP whom they get to know is especially important.
‘We would be very concerned at any move which hived off healthcare in care homes into a separate category and which led to more fragmented GP care for residents from an ever-changing cast of characters.’
The vote to be allowed to opt out of care home responsibility took place at emergency summit on Saturday, attended by GP representatives of Local Medical Committees – regional bodies. GPs spent seven and a half hours in Central London discussing the urgent measures needed to avert the looming crisis in surgeries.
Rising numbers of family doctors are retiring or moving overseas just as demand from patients is soaring due to immigration and the ageing population.
They specifically voted to have ‘separate contractual arrangements’ for residents in care home or nursing homes. They could choose to subcontract services to private firms – as happens with out-of-hours care – or do it themselves for far more money.
Residents could also face higher fees as homes pass on the cost of paying to bring in private doctors
Dr Stefan Kuetter, a GP in Marlow, Buckinghamshire, who proposed the motion to end care home visits, said: ‘You can’t say no for fear of being labelled uncaring or missing something. Time spent in care homes is disproportionately higher than time with other patients.’
Dr Sam Hilton, who practises near Exeter, said care home residents could only be properly looked after by GPs doing ‘ward-rounds’ – like those done in hospitals. But he said there was ‘not enough time’ as this can take a half-day for a dozen patients.
Dr Chaand Nagpaul, chairman of the BMA’s GP Committee, pointed out that many ‘seriously ill’ patients were being moved out of hospital into care homes.
But Simon Bottery of the charity Independent Age said it would be ‘totally unacceptable’ for GPs to halt care home visits.
‘There is a real risk that this could result in a second-class service for residents,’ he said. Joyce Robins, of Patient Concern, added: ‘The whole point of having a family doctor is that its someone who has known you for years and who you trust.’
GPs also voted to demand the Government increase their funding by 43 per cent, in line with the demand from patients.
A Department of Health spokesman said: ‘GPs are contracted to ensure their patients receive full and proper standards of care – and that includes carrying out home visits where necessary.’