Dilemma: Care home too demanding...
11 April 2014, Pulse
An increasingly complex and aged population together with the increasingly inexperienced staff employed in care homes mixed with a risk averse culture leads to higher healthcare usage. Our contract states that services required by registered patients should be ‘delivered in the manner determined by the practice in discussion with the patient’.
Collaboration and constructive working relations are key. The practice should meet with the key medical lead for the care home to engender mutual understanding of working conditions and constraints on both sides. Working together could allow mutually workable solutions.
The practice could ask for visit requests to be coordinated by one senior member of care home staff, agree a fixed day or time that visits will happen to control workload and agree that a staff member is available to attend the doctor to action any agreed outcomes. The practice should seek to develop with the home an understanding of the benefits for both sides of the patients travelling in. There are both benefits to time efficiency and patients’ interests, with better assessment facilities and access to patient records allowing safer care in the surgery environment.
On the other hand recognising the home’s difficulties in getting certain patients to the surgery may lead to other solutions such as using family members to help with transport or agreeing that the doctor may see a group of patients at the care home.
The practice could also engage with the CCG to seek a LES with admission reduction as an aim. With ultimate stalemate the practice can insist that mobile patients attend if appropriate.
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