Care home and nursing home residents have the same rights as the rest of the population to access the full range of general medical services, yet evidence suggest that many residents are unable to access GP services. Nearly half a million adults, mostly older people, live in care homes in England. There’s a danger that those people could lose their access to a GP service that they had come to expect at home.
Evidence of good practice is variable but from today, care home managers and staff now have extra support in helping people to access GPs. A new guide from SCIE, with a foreword from Health Secretary Jeremy Hunt, sets out the steps that care home managers and GPs should take, in areas such as record-keeping, medications management and monitoring resident feedback. It also focuses how and why care and nursing home managers can best sustain good access to GPs. This means that social care and health services are more integrated and can help, for instance, in addressing unnecessary hospital admissions.
Over 1.3 million front-line staff, who are not registered nurses, deliver the bulk of hands on care in hospitals, care homes and in people’s homes. SCIE say that staff need the confidence, communication skills and knowledge to initiate and handle the relationship with GPs. Managers and proprietors should ensure that care staff are trained, and supported to be aware of and understand, the medical and health needs of residents, and respond appropriately.
SCIE’s Chair, Lord Michael Bichard, says:
The health and wellbeing of older people in care homes depends on them accessing GP services in a timely way. The GP’s main relationship should be with the resident rather than the home; but, to achieve good results, care homes need to make sure that they are working effectively with GPs. For instance, managers should establish ways of listening to and regularly checking the views and experience of residents. One key area of this Guide looks at how care home staff can get the best out of GPs in the interests of their residents; by being supported to be confident and communicating well.
Health Secretary Jeremy Hunt says:
Care homes play a vital role in the health and care needs of our elderly population. Many operate in demanding circumstances and I know the best care homes do an extraordinary job and make a massive difference to people’s lives. I welcome this guide which will be an enormous help as we work towards creating a more integrated health and care service. By building better links between GPs and care homes, it will help staff address problems at an earlier stage, reduce pressure on A&E and provide enormous reassurance to residents and their families.
Chief Executive of the English Community Care Association, Professor Martin Green OBE, says:
People who live in care homes have the same rights to primary care as every other citizen and this new guide will be an important resource for every care home manager. The guide gives practical advice on how to ensure that the engagement between primary care and the care home works in a way that will deliver high quality and proactive healthcare for every resident. The SCIE guide is essential reading for every care home manager and for every GP.
Dr Maureen Baker, Chair of the Royal College of GPs, says:
With an ageing population, many of whom live with long-term, complex and multiple conditions, the delivery of care to older people in care and nursing homes will become an increasingly pressing issue for patients, their families, carers and family doctors. This guide is useful for drawing attention to issues facing those in residential care. GPs are keen to do more for older people living in care and nursing homes but are limited by a chronic lack of funding. Transforming patient care, including providing improved care co-ordination and planning for the frail and elderly and those with complex care needs requires a reverse in the decline of funding for general practice, which has dropped by a fifth to 8.4% of the total British NHS budget over the past eight years.
Among the recommendations, the Guide suggests:
- GPs and care homes should find ways to make the voice of the resident integral to care planning
- Care home managers should ensure that residents are registered with a GP of their choice
- Providers and managers of care homes should take steps to ensure residents have appropriate, high quality GP services readily available to them.
Many residents talk about how upsetting it is to have to change GPs but others feel it’s good that the GP ‘attached’ to the care home attends regularly. Practice is variable, but continuity of care, having a GP who has an interest in older people, sharing information about health care can empower residents.