Care homes direct enhanced service

Healthwatch across North East London came together to deliver this additionally commissioned project seeking insight into GP services provided to Care Home residents, in each of the eight boroughs in the region. The project was commissioned by North East London Clinical Commissioning Group (NEL CCG), now known as NEL NHS. Direct Enhanced Service Enhanced services are defined as primary medical services other than essential services, additional services or out-of-hours services. GPs are additionally funded to provide these services.  They surveyed 130 managers of care homes.

Over four in five people surveyed had a positive view of the Designated Enhanced Service.  However, just over half felt all elements of the service were provided.

Over four in five care home staff were involved in multidisciplinary team meetings.  These were led by the GP half of the time. Other specialists such as physiotherapists, end of life teams and nutritionists were included in MDT meetings for 72% of the survey respondents.

Over half of care homes surveyed had a GP care plan in place. Home Rounds happened weekly in 57% of surveyed Care Homes, and 82% of Care Homes were happy with this frequency.

The findings are strongly correlated to the responsiveness of the GP. Some Care Homes experienced a lack of responsiveness from their GP and Managers very clearly linked this with worse outcomes for residents. Some contact limitations placed on Care Homes, such as two designated days for calls per week, did not seem to meet the needs of the residents and the speed at which an older person can become unwell.