Simon Heng on GP-commissioning of social care

My local health centre looks after my physical well-being so well with such a sympathetic, person-centred approach that it would be hard to find any faults.

The district nurses visit me every week, ensuring regular health checks. The specialist nurses – I have Type II diabetes, and I have survived bowel cancer, as well as being tetraplegic – keep an eye on my other conditions on a regular basis.

When I feel ill, one of the team of GPs is usually with me within a couple of hours they are, without fail, aware of my medical history. They treat me as an adult, discuss treatment options with me as an equal, and have kept me alive and relatively healthy for the past 12 years.

The one thing they don’t do is to co-ordinate their efforts with other agencies: housing, adult social care and Supporting People, for example. I have never heard of GPs attending case conferences, or reviews, or even contribute reports to inform other professionals’ decisions.

This may be because they are so constantly busy looking after their patients’ immediate needs that they have no time to go to these meetings maybe it’s because it has never been in their contracts to allocate time to meet with other agencies. Many expect payment for attending meetings. Maybe they think that their patients should take responsibility for sharing medical information with social care professionals.

Whatever the reason, GPs are not formally tied into the social care network. So when I heard that the Commissioning Framework for Health and Well-being suggested that GPs were well-placed to “prescribe” aids, adaptations and social care as preventative measures, I wondered who was going to take responsibility for co-ordinated packages of care.

And then I realised that care provided by the NHS is not means-tested. So does this mean that anyone who has been assessed as needing care, but has been asked to contribute towards the cost, could go to their GP so that they could get the same care for the price of a prescription?

I’m just asking for clarification…

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