Care Home Direct Enhanced Service in Tower Hamlets

Healthwatch Tower Hamlets undertook research on the Care Home Direct Enhanced Service (DES) provided to care home residents in the borough. They spoke to managers from five of the ten care homes in Tower Hamlets during May and June 2022 to understand how GP services and wider healthcare support were being delivered to residents. 

Care homes generally viewed the DES positively and described GPs as responsive and supportive, particularly when residents' health deteriorated. Home rounds were taking place regularly and families were often involved in discussions about residents' care. Medication support was largely viewed as effective, and care homes reported positive experiences of GP access and advice.

However, several areas of concern were identified. Care homes reported difficulties accessing dentistry, mental health support and physiotherapy services, and there was evidence that end-of-life and after-death support was inconsistent. Managers also described problems with communication, delays in digital systems, limited involvement of care home staff and specialists in multidisciplinary team meetings, and confusion around the use and implementation of GP care plans. 

Healthwatch Tower Hamlets concluded that while the DES was valued, it was not being delivered consistently across all areas. The report recommended bringing together care homes, GPs, commissioners, residents and families to review the findings, improve coordination, strengthen end-of-life support, increase access to specialist services and ensure a more effective and consistent service for care home residents.