General Practitioners are required to deliver care in accordance with their primary care contracts, which include the General Medical Services (GMS), Personal Medical Services (PMS), and Alternative Provider Medical Services (APMS) contracts. However, the way in which services are provided is determined by each individual practice.
The essential services defined within the GMS and PMS contracts outline the core responsibilities of general practice. These contracts do not contain specific provisions requiring GPs to provide primary care services to patients who reside in specialised institutions, such as nursing homes, residential care homes, or secure units.
Since PMS and APMS contracts are negotiated locally, there may be specific provisions for the care of such patients, but only where this has been explicitly agreed upon through local contract negotiations.
The essential services component of GP contracts is referenced in regulations and outlines the care that GPs are obligated to provide for their registered patients and temporary residents. This includes:
Management of patients who are:
Definition of disease and management responsibilities:
Ongoing treatment and patient care responsibilities:
Patients residing in specialist institutions often require highly individualised, multidisciplinary care that extends beyond the scope of essential GP services. This is because:
While GPs play a crucial role in delivering comprehensive, patient-centred care, the limitations of primary care contracts must be acknowledged. Specialist institutions require bespoke healthcare solutions, often involving multidisciplinary teams with specialist knowledge and skills beyond the remit of general practice. Ensuring that these patients receive the right care in the right setting is vital for both patient safety and clinician accountability.
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