Choosing a Care Home - GP continuity

Discussion in 'Welcome and how to use Dementia Talking Point' started by KTPM, Sep 22, 2015.

  1. KTPM

    KTPM Registered User

    Sep 16, 2015
    2
    My mother has Alzheimer's and following many years of being at home with family support, we finally had to make the decision for permanent placement in a care home following a fracture.

    As I am sure you will all appreciate it is a very difficult decision to make. Once the family had decided on which care home, we then lived in hope that mum would soon settle. It is still early days and too soon to tell.

    My real reason for this post is to share my experience on what I would do differently. Mum had not been in the care home very long when it came to our attention by chance, rather than being informed, that the care home had initiated deregistration from mum's GP, by the time we knew anything about this it had already occurred. My mother had a wonderful GP who has been very caring and supportive over many years and I knew that mum would never want to change GP. It is a systematic approach and one I found very upsetting and unacceptable.

    I did not realise that when we selected the care home we were selecting a new GP for mum and I feel I have let her down. In hind sight I feel I should have established which care homes mum's GP covered and if possible select one of those. When people enter a care home, they are generally in the final years of their life, is it too much to ask for them to have the continuity of their GP. They seem to be treated in the same way as someone who moves house and out of catchment.

    I am already thinking about my own old age and what I can put in place now for myself in case the day comes when I no longer have an input to my welfare.
     
  2. Beate

    Beate Registered User

    May 21, 2014
    11,499
    Female
    London
    I think it's entirely normal for residents of a care home to all be registered with a particular GP who is known to the care home and will make home visits. When I visited a care home to check it out for respite, they told me this would be the case for long-term residents. I am sorry this is causing you distress. Do you know whether your Mum's GP would have visited her in the care home?
     
  3. KTPM

    KTPM Registered User

    Sep 16, 2015
    2
    I have spoken to the GP who would willingly continue to see mum but all GP's in the practice would need to agree too. As yet I have not followed up on this and still considering whether to or not. I would have appreciated being informed before the deregistration was initiated.
     
  4. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    Care homes often do change the resident's doctor for the purely practical reasons of getting prescriptions quickly and easily and knowing the doctor well who would be attending. However it would have been better if they had discussed this with you first and assured you that the arrangement would be beneficial for your relative.

    xxTinaT
     
  5. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,491
    Female
    Near Southampton
    In our area a specific surgery is assigned a particular care/nursing home within their neighbourhood.
    Within our practice a GP usually then has responsibility for the patients in those homes, allowing of course for cover for holidays, sickness etc by another doctor.

    I dare say other area might differ but it makes sense, as Tina has said to have a local surgery as the usual GP for the home.
    I suppose it's a case of balancing the particular home one might like with it's location as regards keeping the services of the familiar GP.
     
  6. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,668
    Salford
    Doctors are a bit protective of their area, in theory you can register with a doctor out of your area, however, in reality this rarely happens. The BMA state that "if that address is outside the practice's declared area (including its outer boundary if one has been declared) to have no obligation to visit the patient at home if their medical condition dictates that a visit is appropriate" so you can register out of area but the doctor no longer has to do home visits even if the home visit is "appropriate".
    Some GP practices don't like having to give care homes cover as it's both time consuming and expensive, some charge the care home for supplying an "enhanced" service.
    I can see where the care home are coming from having a different doctor for every patient would be difficult to work with on a practical level, one GP/practice would be much easier.
    I'm glad you have a good GP, my wife never sees the same one more than once it seems, in theory she has a specific GP but you can only get an appointment with them if you're prepared to wait currently it's maternity leave so it's quite a long wait:)
    K

    http://bma.org.uk/practical-support...ice-provision/out-of-area-registered-patients
     

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