GPs are routinely charging care homes thousands of pounds for services that should be free on the NHS, according to an investigation by the English Community Care Association.
ECCA has found widespread evidence that care homes are paying hefty retainers to GP practices. These should only be payable for extra services only, such as weekly onsite check-ups, but ECCA says the fees were often predominantly paying for basic services, which should be provided under GPs’ general medical services contract.
Receipt of payment for providing essential level primary care to registered patients is illegal.
ECCA says there is a lack of clarity
“There is a real lack of clarity and consistency as to exactly what services GP practices can charge care homes for and how much these services should cost,” said rpeort author Maria Patterson, ECCA’s external relations manager.
In 2004, the health select committee, in its inquiry into elder abuse, called for the abolition of retainer fees for basic GP services.
In its response, the government distinguished between the right to free NHS care and the business arrangements that can be made between GPs and care homes, where charges were legitimate.
Most pay retainers
This distinction is being regularly flouted, according to ECCA’s report, which was based on a member survey. It found the majority of its members were paying retainers to GP practices.
One large care group said about 12% of its homes pay retainers, ranging from £897 to £24,000 per year, with £7,000 being the average. The payments were made simply to secure NHS care within the homes.
Many homes said they paid the fees to ensure that all residents could be signed up to the same practice. They also said that rates appeared to be arbitrarily set and did not reflect the service homes were supposed to be receiving.
Several ECCA members also said they had no choice but to pay GP retainers, as practices have threatened to remove patients from lists if they did not pay a retainer.