General Practitioners have to provide care according to their primary care contracts, in a manner which that is determined by the practice. Essential services are defined in the GMS, PMS and APMS contracts.

The essential services outlined in the GMS and PMS contracts do not have specific provisions for providing primary care services to patients who reside in specialised institutions.

As PMS and AMPS contracts are locally negotiated, these may have provisions for care of such patients but only if this has been agreed locally
Essential services are referred to in the regulations in the following paragraphs:

(3) The services described in this paragraph are services required for the management of its registered patients and temporary residents who are, or believe themselves to be –
(a) ill, with conditions from which recovery is generally expected;
(b) terminally ill; or
(c) suffering from chronic disease, delivered in the manner determined by the practice in discussion with the patient.

(4) For the purposes of paragraph (3)- “disease” means a disease included in the list of three-character categories contained in the tenth revision of the International Statistical Classification of Diseases and Related Health Problems; and “management” includes-

(a) offering consultation and, where appropriate, physical examination for the purpose of identifying the need, if any, for treatment or further investigation; and
(b) the making available of such treatment or further investigation as is necessary and appropriate, including the referral of the patient for other services under the Act and liaison with other health care professionals involved in the patient’s treatment and care.

(5) The services described in this paragraph are the provision of appropriate ongoing treatment and care to all registered patients and temporary residents taking account of their specific needs including –
(a) the provision of advice in connection with the patient’s health, including relevant health promotion advice; and
(b) the referral of the patient for other services under the Act.
Care for patients who reside in specialist institutions is by it’s very nature, specialised.  As such, it falls outside of the essential services of primary care contracts.  

Providing care in such instances puts patients and clinicians at risk by asking GPs to act outside of their competence.  This also goes against GMC Good Medical Practice.