We have a local arrangement for our low dependancy home we care for.
A job descri[tion was advertised and we have a contract for £4k for 
thirty -40 beds for a session a week to include advice and training to 
staff and regular GMS obviously. We have trained them to use the weekly 
sessions properly and have few inappropriate requests for coming in at 
other times.
Wev are about to enter our third year when it will be readvertised. 
Incidentally the patients also attract deprivation 2.
The HA pay the fee to social services who pay us annually.
Al though I am  a Brent Practice this is a cross border KCW arrangement.
Gillian BraunoldIn article <[log in to unmask]
com>, Patrick Pearson <[log in to unmask]> writes
>
>
>-----Original Message-----
>From:  Patrick Pearson [SMTP:[log in to unmask]]
>Sent:  10 February 1998 22:30
>To:    'gp-uk'
>Subject:       Nursing homes
>
>
>About 8 years ago a new nursing home opened in our practice area and the 
>owner?matron begged us to take on her patients because the poor sucker that was 
>already doing the job refused to come out at night from miles away and visit 
>anyone who was " a bit chesty and we would like him/her checked out". Against my 
>better judgement my senior partner agreed to take them on when she offered a 
>"retainer" fee  of £x per patient per quarter. Being the junior partner it was 
>democratically decided by everyone else that I should take on the work.
>
>They get a regular weekly visit, computerised repeat prescriptions with a one 
>day delivery service, visits on demand, regular reviews of patients and nursing 
>problems, advice on nutrition and hygiene, a 24 hour a day service, annual flu 
>and pneumovax service, visiting phlebotomy by our practice nurses as well as ear 
>syringing as the matron refuses to allow any of her staff to do this job,
>
>She had a row with the SP after he complained about yet another request for an 
>out of hours visit and she unilaterally refused to pay our retainer fee. 
>
>Since then she has steadfastly refused to pay up despite frequent requests 
>saying that we are not providing anything in excess of normal GMS services.
>
>We have one of the highest ratios of nursing home beds in the area and frankly I 
>am pissed off with going there.
>
>I realise that we cannot demand a "retainer fee" but I feel that the service 
>provided far exceeds  what is understood by GMS . The bulk of the patients are 
>very old, frail, demented and decamped from local long stay psychiatric 
>hospitals which are now closing down.
>
>What are other subscribers experiences of such situations??
>
>Patrick
>

-- 
Dr Gillian Braunold


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