GPs are currently debating whether their responsibilities under the current GP contract should include home visits for patients who are living in care homes. They have identified that they have insufficient time to visit residents in care homes, where, by definition, some of their most frail patients will be living.
It is disappointing that the GPs’ position has been portrayed in the media as uncaring. We know that primary care services are under increasing demand and the budget they receive for their services has effectively decreased as a proportion of the whole NHS expenditure in recent years.
It is also disappointing that the potential contribution of nurses in this scenario is not being debated or recognised. In the QNI’s recent report on general practice nursing, it was demonstrated that over 38% of practice nurses undertake home visits to patients, including to those who are residents of care homes. In 2014, the QNI’s report on district nursing also demonstrated that the local district nursing service contributes significantly to the healthcare of residents in care homes, treating them in the same way as they would if the person was living in their own home.
The care home is, after all, a person’s home. This is where they live their lives and should be entitled to receive nursing and other healthcare, of a consistently high standard, as they need it.
The news about the GP debate on care homes came around the same time that Unison released its report on the care delivered in people’s homes, Suffering Alone at Home. The issue of 15 minute allocated time slots for carers providing personal care for older people has been raised again. It seems that despite NICE recommendations that no visit should be shorter than 30 minutes in the majority of circumstances, there are still many cases of care workers only being allocated 15 minutes to help wash, dress and prepare a meal for a frail, older person.
The time has come for real debate about the amount of money spent on health and personal care for the most vulnerable in the UK – and the disgracefully low percentage of our GDP we allocate to this, in contrast to several comparable European countries.
Crystal Oldman, chief executive, Queen’s Nursing Institute