GP practice has resigned as nominated practice for care home

[Mum5net]

Red flags waving in the breeze for me. Doctors who have attended DM’s care home three times a week throughout the pandemic have advised families that they have given notice and will no longer be working with care home from a future date. Has this happened to anyone else? What could be the reason? Any theories welcome. Hope to speak practice manager and care home next week.

Possible contract issues between the practice and the home company? Care homes are a demanding caseload. The GPS may feel they're being asked to work for the care home owner rather than the patients.

It could simply be that they can't cope with the home anymore. Surgeries are so overwhelmed, and homes tend to be very time consuming. Are you happy with your DM's care ?

Are they a “retained gp practice”. So some care homes pay a gp practice to provide a service above nhs level. A lot of care homes are doing this because (a) residents are entitled to nhs gp provision and (b) a lot find gps are not doing any more then this.

What gps can’t do is not provide care to people registered with them. And everyone is entitled to register with a gp. If gps don’t have capacity you can to nhs England who will find you a gp.

Perhaps its a financial decision, or the ANP who led the ward round has left, or the relationship has broken down; none of us will know.
Are there many safeguarding cases at the home? How's the feel of the place?

Care home residents use a huge amount of GP resources and I'm surprised any surgeries take this on. I understand the benefit from the home's perspective but it's so difficult for surgeries to manage the workload. The practices I deal with continue care if the patient moves to a local care home, and wont refuse registrations from patients who move in from out of the area but none would commit to a home in the way you describe - though I have heard of it happening elsewhere.

Dependent on the size of the care home,the GP surgery could be spending a significant proportion of their time there and then getting lots of complaints about other patients not getting appointments. There's another thread happening today with poster saying how long they are having to wait.

It doesn't mean anything.

If anything it's more likely to be about how the GP practice is coping rather than the care home.

Lots of GP surgeries who do still have this arrangement are also moving to having specialist nurses who are doing 'ward rounds' in care homes rather than the GPs.

Any safeguarding work that was happening around the home if there was any would take a dim view of a GP practice that scarpered away from a home that was already struggling.

There are safeguarding issues and the home is under scrutiny. My DM appears very happy and I have no complaints but others have had problems . I have huge admiration for the GPs and nothing but positive experience with them. I’m just concerned that things are unraveling and I really think a move would be detrimental to DM. I’ m just trying to find reasons why the GPs are disengaging.

They could have lost a GP and are not able to recruit a new one. We cannot get extra cover in a major Scottish city. It's a nightmare and the cover nursing homes need is quite substantial and they need GPs back at the surgery. We gave up our nursing homes years ago as the workload was horrendous.

There's issues in huge numbers of care homes at the moment. The care system is in free fall.

No one can recruit staff, the staff they do have are burnt out and leaving. They can't get support from other community services as they are also overwhelmed and slamming their doors shut. Staff are making mistakes due to being burnt out which is leading to an increase in safeguarding concerns being raised generally.

A decent GP surgery wouldn't abandon their patients in a care home they feel is unsafe. They would continue to go in to keep an eye on things.

If you otherwise have no concerns and your mum seems happy... try not to worry too much.

Thank you all, your comments and suggestions have all been very useful. It is the 'enhanced' element that is being dropped so I better understand that it could be because of resource shortage rather than a 'falling out'.
DM has previously resided in a care home that was closed by the Care Commission for safeguarding concerns. It was a scramble to get her into somewhere else. I just recall the stress to DM, and to me. I will, however, take the advice, and not over worry.