Nurse practitioners in care homes


Posted on September 1st, by geoff in CT blog. 3 comments

By Guest Blogger LEON SMITH

Executive vice president, Nightingale Hammerson

A recent Age UK report found that nearly two million NHS days had been lost since 2010 as people remained in hospital waiting for social care. For those of us working in the sector, this comes as little surprise.

Inordinate amounts of money are wasted every week, in some instances through unnecessary hospital admissions and certainly in many instances through delayed discharge. One wonders why this is the case. There are of course numerous reasons, some of these could involve funding issues and games of “pass the bill” between local authorities and the NHS.

Other reasons include the fact that there may not be a suitable bed in an appropriate home available. But another reason can be a lack of confidence on the part of hospitals that care homes are equipped to deal with providing quality medical and nursing care.

Research carried out some years ago on behalf of the Department of Health established that the presence of a nurse practitioner within a care home setting considerably reduced the number of hospital admissions from care homes and could hasten discharge.

In many cases it is simply not viable for providers, and particularly small providers, to bear the cost of a nurse practitioner but there is no reason why a small group of homes in a particular locality could not bear this cost between them, thereby enabling adequate nurse practitioner input, consequent speedy discharge and a subsequent saving to the National Health Service. Indeed, the concept of a senior nurse practitioner providing services to a care home is very much tied in generally with the provision of GP services and one wonders why it is not possible similarly for a GP practice to provide such a service to a group of homes.

To many of you this may sound like a pipe dream, given that a huge proportion of homes at the present time have to pay even to get a GP to come in. It is not, however, rocket science or indeed “go kart” science to deduce that such a scheme, if sufficiently resourced, could save the National Health Service many millions of pounds a year.

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.




3 responses to “Nurse practitioners in care homes”

  1. Irene Gray says:

    Music to my ears! I have been articulating exactly this case for the last four years. Indeed, I actually designed care pathways for care home groups to pull patients from hospitals with a nurse consultant lead providing the expert advice to both the home and the hospital. There has to be a concerted effort from the care home industry to invest in such models and convince the NHS and indeed social care colleagues that there is a highly professional service to be had in the care home sector. If nationally the challenge of caring for our growing elderly population is to be managed, we collectively have to be brave and try new approaches and learn to trust each other. Very happy to discuss this with anyone.

  2. leon smith says:

    thats very encouraging to hear . we would be delighted to be quoted/used as a n example of this system working well , there are no losers only winners

  3. Bob Ferguson says:

    Interesting that you highlight the potential savings for the NHS. Ten years ago, a PCT in the area in which I then worked piloted a nurse practitioner scheme in residential homes for older people. The plan was for an NP to triage all non-emergency requests for a GP home visit, hold regular surgeries in homes and prescribe medication, where appropriate. The PCT hoped this service would take some pressure off GPs and prevent hospital admissions. In addition, it was recognised that it would also complement any enhanced medical service for care homes that the PCT might commission from GPs.

    As I recall, the pilot was arranged in response to persistent lobbying from the local care homes’ association. Unhappily, the scheme withered on the vine – the money ran out!


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