BMA condemns 'unacceptable' plan to fast-track PCN care home support

Plans to fast-track GP support for care homes through the primary care network (PCN) DES have been rushed through without consultation and are 'unacceptable', GP leaders have warned.

In a scathing response to a key plank of NHS England's second-phase response to the COVID-19 pandemic, BMA GP committee chair Dr Richard Vautrey condemned plans to 'bring forward' part of the enhanced care in care homes specification under the PCN DES.

NHS England set out plans on 29 April to accelerate implementation of the DES specification to increase support for care homes during the pandemic, with practices expected to perform a 'virtual weekly care home round of residents needing clinical support'.

The decision to speed up practice support for care homes through the DES came as part of plans to begin restoring NHS services, with the COVID-19 pandemic thought to have passed its peak in the UK.

Care home support

But plans to accelerate part of the PCN DES run counter to warnings from general practice that GPs and practice teams will need time to recover and catch up on routine work suspended during the crisis.

LMCs warned earlier this month that it was 'astonishing' that the NHS planned to press ahead with rolling out the PCN DES this year despite the pandemic. Some LMCs have questioned whether practices should sign up to the DES given plans to roll out three specifications - covering structured medication reviews, early cancer diagnosis and enhanced care in care homes - from 1 October.

BMA GP committee chair Dr Richard Vautrey said: 'Practices are doing all they can to care for their patients in care homes through this crisis, and they should be able to do so with proper support, not more regulation and bureaucracy.

'We were incredibly disappointed to see in the letter from NHS England yesterday that it intends to bring forward the introduction of key elements of the care home specification without engaging with the profession, and in the full knowledge of the serious concerns many in the profession have previously expressed about this earlier this year.

GP contract

'We have told NHS England and Improvement that this approach is unacceptable. The profession will be rightly dismayed that this element of the contract scheduled for October, which depended on an expanded workforce and additional resources, could be imposed without either being provided. It is not too late for NHS England and Improvement to change this damaging approach and instead work with us to support practices to provide the care they know their patients need.

'Of course, with the shocking impact that COVID-19 is having, we appreciate that it is imperative to do all we can to help care home residents, as well as the staff, who need all the support they can get to mitigate the impact on this vulnerable group of patients and those caring for them. This includes a ready supply of personal protective equipment (PPE), timely access to testing, the guarantee that patients will be admitted to hospital when necessary, and the necessary IT infrastructure to support effective virtual consultations with GPs, community nursing teams and hospital specialists.'

An NHS spokesperson said: 'Although the coronavirus pressures on primary care have been different from those affecting intensive care doctors and nurses and hospitals, GPs are just as committed as every other part of the health service to go "above and beyond" in supporting vulnerable people in the biggest global health emergency in a century.

'Although practices report that GP consultations are sharply down, practices are stepping up in other ways including supporting older people living in care homes. These are vulnerable patients who are clearly are in need of the extra support which practices can - and are - helping with.'

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