• NHS England wants GPs and community providers to deliver a consistent care home service
  • The centre has denied this will amount to the early rollout of a controversial component of the primary care network contract
  • GPs remain concerned about staffing and paying for the new service

Commissioners, GPs and community health providers have a fortnight to start delivering a clinical support service to every care home in England, according to a letter from NHS England.

Some care homes are not receiving any clinical support from GPs and community health services and the national commissioner wants a consistent service across the country.

Every care home should get a weekly clinical review of priority patients, help with developing personalised care plans for residents, including end of life care plans and preferences, and pharmacy and medication support.

The centre will start collecting “regular ‘sitrep’ data from [clinical commissioning groups], starting next week, to understand the support being provided to care homes and the coverage achieved across the country”.

This will allow NHS England and NHS Improvement to see if there are “local issues which need to be addressed and whether regulatory provisions are required,” the letter added.

GPs are worried about their capacity and the additional costs of providing the new service, as well as how to staff the multi-disciplinary teams being created with community health providers.

There is also a wider concern in primary care that the new requirements equate to an early roll out of the controversial primary care network contract.

On funding, the letter said: “Additional costs for general practice and community health services – which cannot be met from their existing resources – may be eligible for reimbursement.”

There will be a “reimbursement mechanism” to help practices “meet the additional costs of covid-19 related activity which cannot be met from existing practice resources. Reimbursement will be managed through CCGs, on the basis of national guidance”.

NHS England has insisted the new service does not equate to the PCN contract starting five months early. It said: “We are looking for all practices to take part, not just [PCNs]. However, it will be less burdensome for general practice, easier for community partners and better for care homes for this to be delivered at a PCN level as the default.”

Community providers will contribute staff to the multi-disciplinary teams providing services to the care homes, and CCGs will need to coordinate these teams and networks of providers around care homes, the letter added.

“A network approach to delivery – backed by appropriate information-sharing arrangements – will ensure that individual care homes have a single point of access for the majority of their residents and should reduce the infection control risks associated with multiple teams visiting individual care homes,” it said. “As part of this process, networks should identify a named clinical lead for each care home.”

CCGs must also ensure “clear and consistent out of hours provision is in place for each care home”, using out of hours providers and community health services.