GPs caring for Care Homes

Top tips for GPs caring for Care Homes from the RCGP

As GPs you will continue to look after the most vulnerable in your communities during this pandemic in the same way as you did before: with ongoing continuity, individualised and holistic care. Many of you are liaising with homes more than you did before and have naturally increased the care that you offer in line with demand.

The RCGP have developed an e-learning module focusing on top tips for GPs caring for care homes. You can access this e-learning here.

It is also covered in a webinar which you can watch here.

Additional information

Presentation of covid-19 in care homes
High index of suspicion needed as vulnerable care home residents may not present with typical covid-19 symptoms, but with non-specific symptoms such as reduced appetite, falls, delirium, taking to their beds. Early isolation and barrier nursing encouraged until diagnosis is made.

Should face to face or remote consultations be performed
Where possible, routine reviews, ward rounds and consultations should be performed by remote consultation( telephone or video calls). Many examples of this are in place across the UK.

British Geriatric Society (BGS) recommends care home staff are trained to check the temperature of residents with tympanic thermometer and where possible check other vital signs including BP, heart rate, pulse oximetry and respiratory rate. This enables triage and minimises risk from health care professionals entering the home. Many care homes already doing this but some may need support and equipment.

BGS guidance states that care homes taking observations “Should be encouraged to use the RESTORE2 scoring system, to recognise deterioration in residents and to communicate concerns to health care professionals”. RESTORE2 is based on the NEWS2 score from the Royal College of Physicians.

Solutions for care home visits where needed
If an examination is required, always ask, can the patient be brought to the practice safely.

Some care homes will bring residents to see you with a carer. If this is possible, follow your local protocols for COVID-19/ non-COVID-19 patients, wearing appropriate PPE as per Public health guidelines 6.

If the patient cannot be bought to you and a home visit is required, follow local protocols for COVID-19/ non COVID-19 patients.

Examples in the document - Kent has a frailty home visiting service supporting care homes. In Wolverhampton and Derbyshire there is a red home visiting service for all confirmed and suspected COVID-19 residents, commissioned by the CCG, meaning individual GP practices do not need to visit these “At risk patients”