We have had a number of nursing homes open in Wisbech in the last couple of
years. No question at any time of extra retainers; just the expectation that
all needs would be met on GMS.
Feelings ran very high about a year ago; to the point of one of the other
three practices in the town threateneing to refuse any further nursing home
registrations (which would have led to a unanimous resistance from all of us
to ensure equity through allocation!).
Much of the problem was defused by a chat between GP's and management. An
open discussion of our respective problems and ways of dealing with them has
improved relations enormously.
The additional capitation that the health authority pays us for a few (very
few) extra services may also have helped ;-) There is this fund set up by
the last govt for the payment of extra funds to support additional community
& primary care services for the elderly and for mental health. The LMC and
HA decided together that nursing homes were a deserving cause. Maybe your
LMC might help?
There is a small (but growing) amount of evidence on health care needs of
nursing home residents. Rob Andrew in Durham has published a couple of
articles in the College journal. Ruth Chambers from Hull published a small
internal document on this which you could get from the University of Hull.
The evidence is that the overall number of visits is little more than the
number of contacts with over 75's as a group (but in the case of NH's are
all home visits, of course), that the out of hours call rate is
significantly higher, and that the state of preventive/proactive care is
*abysmal*. I have a research dissertation on the topic shortly to burst
into print.
Regards
Joe
Dr Joe Neary
Trinity Surgery
Wisbech, Cambs
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