GPs charging care home residents

I know people don't like links, but this is worth reading to get a better picture:

www.pulsetoday.co.uk/your-practice/regulation/cqc/field-criticises-gps-for-charging-retainers-for-care-home-provision/1/20005921.article?PageNo=3&SortOrder=dateadded&PageSize=10#comments

It would appear that a few GPs are possibly abusing the system, which allows them to charge extra.

However, some of the problems are:

care homes are understaffed or, at least, don't have enough qualified nursing staff and call out GPs for problems they should be able to deal with themselves;

some residents are mobile, but care homes won't use their own staff to take them to a surgery;

care homes require a 'hospital' standard of paperwork from visiting GPs, which takes extra time;

some care homes are almost identical to the old geriatric wards and should have hospital staffing levels;

some CCGs don't put extra funding into care for people in residential homes.

I'm with Gaggi. If a GP has a number of care homes in his/her area (as some do), I'd be very miffed if the GP didn't have enough time to see all regular patients, because he/she was forever being called out to care homes. The extra funding to the GP should pay for extra surgery staff to cover for absences.

It is important to understand the impact of care homes and the demands they make on already overstretched GP practices. Of course everyone is entitled to care but there aren't enough doctors to go round. I have an interest as DD1 is a GP and know how difficult it is to recruit new GPs. DD certainly doesn't have a financial interest in any care homes, and I've never heard of this.

And how many of these Doctors own or have a stake in the care homes they are 'visiting'.

True. It should have been planned in advance and not left for the current working age population to pick up the bills.

If we look back through our lives there will almost certainly have been long periods when the only reason to see a doctor might have been for a repeat Pill prescription or for a poorly child. If you are lucky, from your 40's through to your 60's you may not need to go at all! This should balance out the demands of elderly patients' needs. All things being equal. Of course with an increasing elderly population, because we are surviving the illnesses which bumped off our grandparents, there is greater need, so why does a government with all the bean counters at its disposal not work that out in advance?
It's like building houses for young couples and then wondering why 5 years later, there are insufficient places available at local schools.
It's called forward planning, but piss-ups and breweries spring more readily to mind.

I had elderly neighbours who constantly called the GP . The practice left a notebook on the mantelpiece and wrote time of the visit and what advice had been given. I suppose it was before we recognised that dementia had set in.

Patients with dementia (or any other patients for that matter) should be able to see a GP for free, wherever they live. What I'm saying (and I know this happens) is that GPs are sometimes booked to make regular visits to care homes, whether or not they're needed, in which case they charge the home a fee. You wouldn't expect GPs to visit all their vulnerable patients at home, just on the off chance they're needed.

That care home residents should be able to see a GP for free in non-emergencies as well is, I think, what the article is saying. The fact that someone is old, has dementia and lives in a care home shouldn't make any difference.

It is not the fault of the old people needing doctors that there aren't enough GPs to go round.

Plus, I wonder how much 'shoddiness' there is in the approach of some GPs and
locums. Yesterday I heard from a ninety-five ear old woman (96 this month) who had a scratch on her leg go septic. Her home help arranged for a doctor to call in the evening. According to the 95yo, no doctor came. According to the doctor he came but no-one answered the door so he went away.
Scenario: doc has been called to deal with a septic wound on a very old person; no-one answers the door; he buggers off.
!!! No checking the door to see if he could get in or any other practical action taken.

It's a grey area. Private are homes often employ GPs to do 'rounds' - they're there on set days every week and the homes pay them a fee to provide the service, even when nobody is actually in need of a GP. Sometimes private providers are used. If a resident needs emergency care, they should then see a GP for free.

Perhaps they would do better to have local teams of care home doctors and nurses specially recruited to provide these services for elderly care within a particular area.
I can see how a lot of care homes in one area could impinge on the work of regular GP services.

"We and they were spared much suffering"

Angry, sad and despairing in equal measure. If it doesn't impact us directly now (e.g aged parents or perhaps partners) it surely will and I would rather not look ahead to that day.
My DM and MIL both died suddenly and however saddened and shocked we all were by their loss, in hindsight we and we were spared much suffering

I'm ignorant enough to be shocked by this.
I'm also sad and disgusted.

Someone needs to take hold of the NHS and make it fit today's world then this would not happen.

There has been no forward planning for an aging population and their needs. We have 'virtual' wards round here and they seem to work well as they operate in a holistic way but the cover is patchy.

I appalled at this but somehow not surprised. For many years now GP s have been asking for additional payments from the NHS when large care homes open on their patch. In the past some of the larger homes have paid them a retainer (which of course they passed on in the fees) but this seems to have ended now. These patients are fully entitled to all NHS service free and what needs to happen is that the homes should be advocating on their behalf when the GP tries to charge and report them to the local commissioning group. I hope this article stirs things up!

It's a damned disgrace and about time that such negligence was treated as criminal and these peope tried in court.

It's rather a sickening story, isn't it?

So, once again, it's the old and vulnerable who get the thin end of the wedge.