Care homes hit out over GPs charging fees to treat residents

Practice of charging care homes for NHS care 'unacceptable and ageist', claims care provider umbrella body

The practice of GPs charging care homes retainer fees to guarantee NHS care for their residents is “unacceptable” and must end, care provider leaders have warned.

Research by Care England, the biggest umbrella body for English providers, found that 30 of 34 care homes surveyed were charged ‘retainer’ fees, in one case £2,400 a month, to guarantee GP care for their residents. One fee-paying provider said a GP practice insisted that patients use the pharmacy run by their surgery as a condition of receiving care.

GP practices that charge retainer fees often point to the fact that they are providing an ‘enhanced service’ beyond the ‘core’ duties they are contracted to deliver under the national GP contract. But providers that ran multiple homes told Care England that the service was often “equally good” from GPs that didn’t charge retainers.

Martin Green, the umbrella body’s chief executive, said: “Charging care home residents for healthcare is ageist and totally unacceptable, and we call upon the government, clinical commissioning groups and the regulator [Care Quality Commission] to put a stop to it immediately.”

Green also called on the government to end “any future ambiguity” over what constitutes an “enhanced” service that GPs can charge for and services that should be free at the point of use by making this clear in the 2015/16 GP contract.

The issue of ‘retainer fees’ has attracted controversy in recent years. A 2011 report by the British Geriatrics Society highlighted concerns that retainer payments were potentially unlawful and could be seen as GPs being paid twice for providing services to care home residents.

Care England was formed by a merger of the National Care Association and English Community Care Association.

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4 Responses to Care homes hit out over GPs charging fees to treat residents

  1. Johann van Zyl January 15, 2014 at 10:35 am #

    This is a very positive move by Care England to investigate this practice of GP’s charging care homes monthly retainers. Our one care home in a specific city was refused by 11 GP practices as they were not only prepared to accept a very big retainer. The only way we could secure the services of a GP Practice was to agree to pay a monthly retainer plus £160 per hour plus £50 travelling costs for every visit to our home. Prof Martin Green has our full support in lobbying the inclusion of a clause in the 2015/16 GP contract that prohibits this from happening.

  2. Stephen James January 15, 2014 at 11:28 am #

    I could not agree more with what Martin Green of Care England has outlined here. It is absolutely disgraceful behaviour from those GP’s who are responsible for making these financial demands on care home providers. The point made relating to the legality of making these charges should also not be lost on the government and regulator, as I would expect action to be taken sooner rather than later on this, although because we are talking about doctors, it would not surprise me in the least to find that it is not addressed by either. It also raises the old chestnut regarding doctors regulating doctors within CQC and the potential conflicts of interest that are now evident between CCG’s and GP’s.

  3. Miss B January 15, 2014 at 3:50 pm #

    Just a point of clarity for one of the comments above:

    Martin Green, the umbrella body’s chief executive, said: “Charging care home residents for healthcare is ageist and totally unacceptable, and we call upon the government, clinical commissioning groups and the regulator [Care Quality Commission] to put a stop to it immediately.”

    Clinical Commissioning Groups DO NOT have any involvement in the GP contract and DO NOT commission Primary Care. That is the responsibility of NHS England and NHS England alone.

    However agree entirly with the artical and the view point, GPs are paid already for every patient registered on their list and it is totally unethical and discriminatory that people living in care homes are being paid for twice.

  4. Dr J January 20, 2014 at 1:34 pm #

    I am a GP and have worked in practices with large homes in the area. It can be extremely time consuming to look after a home or 5 (current area) and adds a lot of work which is funded the same as normal worried well patients.

    Many practices employ extra staff top ensure decent medical care and this costs a lot of money.

    The biggest issue in unfunded areas is patients who are well enough to go to hospital outpatients/day trips etc but who the homes request home visits on for routine medical care.

    Should they have to come to the practice instead?

    Be careful what you wish for?