Paying for healthcare remains a reality for care homes
Care England report says many providers are still being charged for GP services
Caring Times, March 2014
In 2008 Care England’s predecessor body, ECCA, investigated the practice of GPs charging retainers to work with care homes. The research showed this was a widespread practice and that the pronouncements that health care was free at the point of need, were not necessarily true for care home residents.
In 2013 ECCA re-ran this research, and discovered that six years after its initial report, the practice is still going on at much the same levels. Care England chief executive Professor Martin Green said that while Primary Care Trusts and Clinical Commissioning Groups may be aware that GPs are charging care homes in this way, it appeared that they had no powers to deal with the problem.
“Charging care home residents for healthcare is an ongoing malpractice despite the changes to the primary healthcare system,” Prof. Green told Caring Times.
“Some care homes are paying thousands of pounds for a basic health service, which citizens have always been told would be free, and we have discovered one GP who has insisted the care home use his surgery pharmacy, as a condition of attending to care home residents. These retainers are ageist and totally unacceptable, and we call upon the Government, CCGs and the regulator, to put a stop to them immediately.”
Professor Green said figures obtained from the survey, showed that retainer fees charged to care homes for basic services were as high as £24,000 per year. In addition, there was a huge disparity across the care homes that paid retainers in terms of the fees they paid, with little variation regarding the service they received. Consequently, the level of retainer fees appeared to be calculated on a largely arbitrary basis.
“Some GP practices provide excellent services to care homes at very little extra cost, but the payment of retainers remains ubiquitous across the sector and in most instances, the care homes that pay retainer fees only received basic services.”
Professor Green said that, at a time when local authorities’ budgets are being cut to the extent that they can no longer afford to pay providers the true cost of care, it was unfair to ask these providers who were already seeing their funding cut, to pay a retainer fee for services that their residents should receive free of charge, and the Care England report makes the following recommendations:
Recommendation 1: Specifically state in the 2015/16 GP Contract, which services GPs have a right to charge for and which should be free at the point of use. This information could also be added as an amendment to the NHS Constitution to prevent any future ambiguity between enhanced and basic services.
Recommendation 2: Ensure that the chief inspectors of both adult social care and general practice at the CQC prioritise the insertion of a set of metrics into the regulatory framework that can effectively monitor the practice of GPs in this regard.
Recommendation 3: To reflect changing health need, NHS England should review what constitutes an ‘enhanced service’ offered by a GP to a care home, on an annual basis and give guidance on how a fair fee for those services should be calculated.