David Behan told the Commissioning in Healthcare conference in London that some care homes feel they have to ‘buy’ access to primary care, and warned there is ‘huge variation’ in how GPs see their responsibility to care home residents.
GP leaders said all care home patients should have access to primary care services, but warned that practice funding does not reflect the rising complexity of cases and growing numbers of patients in care homes.
Health secretary Jeremy Hunt has warned that there could be contractual changes for GPs to make more visits to care homes, as part of his plans to make GPs responsible for the 24-hour care of frail elderly patients.
Mr Behan said: ‘One of the other contributing factors to why there are inappropriate admissions is that I don’t think there is enough primary care support for people in care homes.
‘I understand from many care homes, they feel they have to buy that service on top of what is already there.
‘I think it is a real issue that needs to be tidied up about whether people that live in care homes have a right to access primary care services.’
One GP in the audience said that the CQC care home inspection regime was creating a fear culture in care homes, which was leading to inappropriate hospital admissions.
Mr Behan told him: ‘I think there is a huge variation with your colleagues as to how they view their responsibilities for people in care homes. My personal opinion about this is that residents in care homes are citizens of the area they live in and have an entitlement to access primary care services.’
GPC chairman Dr Chaand Nagpaul said that all care home residents should have access to GMS services.
‘We need to recognise that an increasing number of patients in care homes have complex medical problems and require enhanced levels of care,' he said.
‘We are looking at patients with high needs, increased complexity and that has not been factored in the current funding arrangement for GPs.
‘These problems will increase as care is moved out of hospitals. We need to make sure that GP practices are resourced for this level of care.’
